The editorials on organ donation in the February issue do not mention the Welsh experience.1,2 As of 1 December 2015, the Human Transplantation (Wales) Act came into full effect, introducing a presumed consent system, in which every person ordinarily living in Wales voluntarily for longer than 12 months, aged 18 or over, and who has the required mental capacity is deemed to have given their consent to organ donation, unless they have specifically registered a decision either on the Organ Donation Register or verbally told family or friends. A formal evaluation, commissioned by the Welsh Government in 2014,3 has now reported, with the following main findings:
awareness of and support for the soft opt-out system of organ donation in Wales is high among the general public and NHS staff, although there has been a recent drop in awareness levels among the general public, suggesting that publicity of the law needs to be maintained;
more clarity around the role of the family in the organ donation process is required;
NHS staff working within organ donation may also benefit from further training, particularly around the organ donation conversation with the family;
analysis of routine data does not show any consistent change in deceased organ donations in Wales, or more widely from Welsh residents; and
analysis of consent data shows an increase in the percentage of families giving approval for donation. However, this is not reflected in a rise in donors overall, perhaps because the rules about which families could be approached were tightened at the same time as the law was introduced.
Notes
Competing interests
Roy A Carr-Hill was one of the researchers working on the evaluation of the Welsh opt-out system.
- © British Journal of General Practice 2018