Regional Collaborative South Central Regional Collaborative Data 13 th November 2014 Wokefield park.

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Presentation transcript:

Regional Collaborative South Central Regional Collaborative Data 13 th November 2014 Wokefield park

Regional Collaborative

Actual deceased donors- South Central team 1 April 2005 to 30 September 2014, data as at 14 October 2014 Hospitals are allocated to teams using the current team allocations, not the allocation at the time of donation

Regional Collaborative Actual deceased donors 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative Plan DCD DBD Our possible DBD not tested DBD case presentations (Roger)

Regional Collaborative DONATION AFTER CIRCULATORY DEATH

Regional Collaborative Why less DCD? Chance Not being referred? Referral % still increasing Fewer people dying in ICU Less withdrawal of treatment (LCP effect) Surgeons becoming more risk averse Informal triage filtering out patients who previously might have become donors

Regional Collaborative

South Central DCD referral rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DCD referral rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DCD SN-OD involved 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DCD consent rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DCD conversion rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative Trends in national DCD rates 1 April 2010 to 30 September 2014, data as at 14 October 2014

Regional Collaborative Trends in South Central DCD rates 1 April 2010 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DCD consent/authorisation rate by ethnic group 1 April 2014 to 30 September 2014, data as at 14 October 2014 ODS teamWhite patientsBAME patients Family approached Consent/ authorisation rate* Family approached Consent/ authorisation rate* Eastern London Midlands North West Northern Northern Ireland Scotland South Central South East South Wales South West Yorkshire Total * Consent/authorisation rates are not shown where the number of families approached is less than 10

Regional Collaborative DCD Summary Fewer people dying on ICU Fewer families approached More age 70 to 79 declined by transplant surgeons Consent rate dropped to 40% South Central SNOD involvement slipping?

Regional Collaborative DONATION AFTER BRAIN DEATH

Regional Collaborative Trends in national DBD rates 1 April 2010 to 30 September 2014, data as at 14 October 2014

Regional Collaborative Trends in South Central DBD rates 1 April 2010 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD- Neurological death testing rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD- South Central Neurological death testing rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD- South Central Neurological death testing rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD referral rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD approach rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD SN-OD involved 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD consent rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD conversion rate 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD consent/authorisation rate by ethnic group 1 April 2014 to 30 September 2014, data as at 14 October 2014 ODS teamWhite patientsBAME patients Family approached Consent/ authorisation rate* Family approached Consent/ authorisation rate* Eastern London Midlands North West Northern Northern Ireland Scotland South Central South East South Wales South West Yorkshire Total * Consent/authorisation rates are not shown where the number of families approached is less than 10

Regional Collaborative Coroner permission requested 1 April 2014 to 30 September 2014, data as at 14 October 2014

Regional Collaborative DBD summary 5% increase in DBD nationally but not in South Central Brain stem death testing rates remain red on dashboard at 66%. Blip or trend? Other areas of pathway remain ok

Regional Collaborative South Central Brain Stem Death Testing Jan to Oct cases BSD? Not tested 4/21 not referred 3/21 never planned to test We think 7 could/should have been tested

Regional Collaborative Reasons Delay in testing due to sedation Patient not for donation (malignancy, advanced directive, refusal after 1 st set) Miscellaneous (individual consultant behaviour)

Regional Collaborative BRAIN STEM DEATH? PRESENTATIONS Dr Roger Lightfoot

Regional Collaborative Questions, discussion 1.Compared to other regions our BSD testing is lower. Problem or statistical blip? 2.Is brain stem death testing whenever possible still our aim? If not why not?