Organ donation consent rates in the UK have been stagnant over the last 10 years or more, despite the implementation of the taskforce recommendations, a modernised infrastructure and an increased work force of specialist nurses in organ donation. In order to address this deficiency NHSBT have begun the roll out of a Specialist Requester role across the UK. Based on the principles that concentrated training, practice, exposure and fewer people undertaking the role will increase the expertise of those performing that role and thus increase the consent rate. In addition to this, there has been a significantly high attrition rate with Specialist nurses, and feedback has demonstrated that a 24 hour on-call commitment was a trigger for individuals leaving the organisation. The implementation of a specialist requester role provides an opportunity to improve work-life balance of staff and reduce 24 hour working.

Following a 9 month pilot in two regional teams in England which demonstrated a 5-7% increase in consent rates, the Specialist Requester role will be implemented in selected teams across the UK, the aim of which will be to impact positively upon both consent rates and the working hours of the Specialist Nurse team. The evolution of the Specialist Requester role will see a change from the current working model and so engagement with clinical teams to address concerns and allay fears has been necessary to ensure the success of the roll out. There has been concerns from nurses and clinicians about the role, mainly regarding changes to pay, the focus on individual performance, role erosion and the potential impact on hospital development.

Despite the documented concerns, the Specialist Requester role is now live in 4 regions across the UK. The early indications are showing an increase in consent rate and a reduction in working hours. Initial concerns expressed by nursing and clinical teams have largely subsided and the role is becoming embraced and embedded in practice.

CITATION INFORMATION: Duncalf S, Ryan M. Implementing a New Specialist Requester Role to the United Kingdom to Address Consent Rates. Am J Transplant. 2017;17 (suppl 3).

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