Welsh "deemed consent" organ donation system shows promising results

The number of families agreeing that their loved ones’ organs can be donated for transplantation may be rising more quickly in Wales than other parts of the UK following the introduction of a groundbreaking new consent system, new figures suggest.

Health officials and ministers in Wales are encouraged by how the so-called “deemed consent” system is working and NHS Blood and Transplant (NHSBT) has said the picture in Wales is promising.

Under the new Welsh system, which came into force last December, residents are deemed to have consented to organ donation unless they positively opt out.

In June the Welsh government said the scheme had already saved dozens of lives after revealing that in the first six months, of the 60 organs that were transplanted, 32 came from people whose consent had been “deemed”.

New figures from NHSBT show that in the financial year 2015/16 the family consent/authorisation rate increased in Wales from 49% to 59%. Across the UK the rise was smaller: 58% to 62%.

Although the overall UK rate is higher, the more significant percentage increase in Wales last year may signal a change in attitude.

The number of living donors in Wales also increased by 20% to 49. Across the UK the number of such donors dropped by 2%.

Organ Donation week takes place across the UK from Monday. One priority in Wales is to get its messages across to young people and the Welsh government is mailing every new student arriving in the country this autumn to explain the system.

Under the Welsh system people who want to be an organ donor either register a decision to opt in or do nothing. For those who choose to do nothing, if they are 18 or over, have lived in Wales for more than 12 months and die in Wales, they will be regarded as having consented to organ donation.

Family consent, however, is still important because if a person has not opted in or out, relatives are still involved in the process and if they say their loved one would not have wanted their organs removed, a donation would not go ahead.

Dr Frank Atherton, chief medical officer for Wales, said he was pleased with how the scheme was working. “Things seem to be moving in the right direction,” he said. “It is encouraging. We’ve put a lot of effort into campaigns to help people understand their options. All that is starting to make an impact.”

He made it clear that the scheme was still in its very early days. The 2015/16 figures relating to family consent have to be treated with caution as the Welsh scheme was launched with only four months of the financial year to go and experts warn there could be fluctuations from year to year.

But Atherton said the move towards the system has certainly led to many more families discussing the topic. “Next year there will be a full evaluation of what the impact of deemed consent has been.”

Overall, the figures show there is still a long way to go if the UK target of increasing consent rates to 80% by 2020 is to be met. In Wales and in the UK as a whole, around four out of 10 families who were approached did not agree to organ donation taking place.

Last year in the UK, 466 patients died in need of an organ and a further 881 were removed from the transplant waiting list. Many of them would have died shortly afterwards.

Sally Johnson, director of organ donation at NHSBT, expressed optimism about what was happening in Wales. “We welcome the opportunities that the legislation and communications programme in Wales is providing in getting everyone in Wales to think about and talk about organ donation.

“We have been working closely with the Welsh government on the introduction of deemed consent and are working with them to make it a success. It’s early days, but things look promising.”

Case study

Kimberly Chard, 31, from Cardiff, who was born with cystic fibrosis, underwent a double lung transplant at the end of last year.

She said: “Every day I think of the selfless gift my donor and their family gave me, how they chose to save lives despite their loss. They are my heroes and I feel very blessed to have had the chance to live again. Having a transplant shows just how precious life is and what’s truly important. I will always treasure the future my donor and their family gave me.

“The new system has created an opportunity for everyone to get involved and discuss their choices and what their decision would be if they were ever in the situation to be able to donate their organs.

“By talking to their loved ones, people are making it so much easier for their family as they would know what their decision was and be able to honour their loved ones decision.”

Welsh "deemed consent" organ donation system shows promising results

Welsh government bans smoking in cars with little one passengers

The Welsh government says Wales is the very first nation in the United kingdom to tackle the problem of smoking in cars when children are existing. Photograph: Alamy

A ban on smoking in automobiles when young children are current is to be introduced by the Welsh government, 1st minister, Carwyn Jones, announced on Tuesday. The government in Cardiff stated a consultation on what it called a “landmark proposal” will be introduced shortly.

Two years in the past the Labour-run government launched its Fresh Start off Wales campaign to try to persuade men and women from smoking in private automobiles when young children were current.

It is claiming some accomplishment with new study concluding that the quantity of people who do not let smoking in their principal car has enhanced, from 71% in September 2011 to 76% in November 2013.

The analysis identified that the quantity of children who said that smoking was permitted in the family auto when they have been in it had halved to all around ten%.

But Jones explained: “We created clear during that campaign we would think about the probability of legislation when proof of prevalence of smoking in cars carrying kids in Wales is offered.

“Although I welcome the fact the variety of kids being exposed to smoking in vehicles has declined, a sizeable minority of young people are still being exposed and grownups carry on to smoke in their cars when children are existing.”

He additional: “We will press ahead with ideas to ban individuals smoking in autos carrying children.”

The government says Wales was the first nation in the United kingdom to tackle the situation of smoking in vehicles when young children are present.

Legislation on banning smoking is a devolved matter and new laws would apply only to Wales. But the Cardiff administration mentioned it was liaising with the division of overall health in England to coordinate the two government’s approaches. In England, MPs voted earlier this 12 months to ban the practice.

Welsh government bans smoking in cars with little one passengers

Welsh hospitals report reveals "appalling" patient care failings

The Trusted to Care report named into question the ‘short-phrase economic planning’ in place across the NHS in Wales. Photograph: Cate Gillon/Getty Images

Frail elderly sufferers had been forced to endure chaotic, degrading and occasionally harmful situations, a extremely essential independent assessment into two Welsh hospitals has revealed.

Medicines had been administered in an inappropriate way, households complained their vulnerable loved ones had been left without having sufficient foods or drink and sufferers have been informed to go to the toilet in bed. Nurses and physicians felt a sense of helplessness and there was a shortage of certified staff, particularly at night.

1 female patient confided to a member of the evaluation group sent in to investigate the Princess of Wales hospital in Bridgend and the Neath Port Talbot hospital: “I am in hell.”

The review crew concluded that above a variety of years the Abertawe Bro Morgannwg University Health Board (ABMU), which runs the hospitals, appeared to be driven by the “quick-term fiscal organizing” that it said was in area across the NHS in Wales.

Their report, entitled Trusted to Care, explained: “The question should be asked about no matter whether this kind of a relentless concentrate on monetary delivery yr-on-12 months prompted by the nationwide program is distracting NHS boards from a proper concentrate on good quality and patient safety.”

It additional: “No 1 should be in any doubt that there are factors of the care of frail older folks which are basically unacceptable and need to be addressed as a matter of urgency via action by the board of ABMU and by the Welsh government.”

The Welsh overall health minister Mark Drakeford ordered an quick overview of the care of elderly patients across the nation. He mentioned there would be a series of unannounced spot checks by a ministerial group of experts to examine specifications of care for elderly individuals at district common hospitals in Wales. The spot checks will emphasis on the delivery of medication, hydration, evening time sedation and continence care.

Drakeford stated: “This review does not make straightforward reading through it will be specifically tough for all concerned with the care of older folks in these hospitals. I give my unreserved apology to those individuals and their households whose care has fallen brief of what they may well anticipate from the Welsh NHS. I have been shocked by some of what I have read through in this report.”

The findings have been instantly seized on by opponents of the Labour-managed Welsh government, whose well being record is continually attacked both at the national assembly in Cardiff and at Westminster by the prime minister, David Cameron.

The Welsh Conservatives’ health spokesman, Darren Millar, mentioned: “The startling severity of this review’s findings is almost unimaginable. It is clear that individuals have suffered appalling and unforgivable lapses in care that apologies will do little to put right. Not simply shocking – this evidence is horrific in the severe.”

The investigation, which was led by authorities from the Dementia Companies Development Centre and The People Organisation at the request of the Welsh overall health minister.

It was launched right after the case of Lilian Williams, 82, whose loved ones explained she endured appalling neglect at the hospitals and suffered a horrible death. Her son Gareth has named for a total public inquiry.

Amid the most striking components of the report had been direct testimonies of investigators, individuals and family members. 1 member of the assessment crew mentioned: “My 1st impression was of a chaotic environment. Workers appeared stressed and not in control. They informed me that they had been 6 senior workers down, with a single suspended and one particular on sick depart. There were individuals calling out and 1 lady mentioned to me: “I am in hell.”

They added: “Personnel have been not assured about caring for baffled men and women. Newly certified personnel weren’t getting supervised and junior physicians came and went with really minor interaction with the nurses. The noise and clutter was overstimulating, with TVs on but not being watched, and an ambiance in which there had been also a lot of people – doctors, cleaners, nurses, all in the patient area at when.”

An additional assessment member stated: “The chaotic atmosphere increases the chance of drug mistakes. Individuals that almost certainly have dementia have been being prescribed antipsychotics without a appropriate risk assessment. The inappropriate use of sedation for ‘aggression’ was observed.”

Sufferers have been given prescribed medication but not observed taking it. The assessment stated the way drugs had been administered in some circumstances was “unacceptable and hazardous”.

There was also worrying testimony from patients’ households. 1 relative stated: “They left him with the cloth and a bowl to wash himself. I located dried excrement on his legs.” An additional advised the investigators: “We couldn’t seem to the nurses to care for mum. They had no power. They could not get a doctor when we required 1. They couldn’t get medicines in excess of the weekend. My mum had no medicine or food or water for days.”

The report said employees appeared not to know about ameliorating the frequent difficulties in care of frail older individuals, such as management of continence, delirium, mobility, nutrition, dementia, hygiene, and worry.” It highlights failings in medical professionals, nurses, pharmacists and managers.

Looking at problems affecting the NHS in Wales in common, the assessment said: “It is not also great a stretch to see current muddled management structures, lack of clinical cohesion and failures to have sufficiently experienced and oriented workers functioning in frontline settings, as being straight traceable to an overemphasis on brief-phrase operational and economic delivery.”

The ABMU board apologised to individuals and their households or carers.

It accepted some care had been very poor and vowed to place it correct. The chair, Andrew Davies, mentioned: “This report was very uncomfortable to read but we are determined to emerge as a health board where all our hospitals give excellent, patient-centred care.”

Ten nurses have been suspended from Princess of Wales Hospital as element of a police investigation into alleged record-retaining anomalies.

Welsh hospitals report reveals "appalling" patient care failings

Welsh NHS has worst waiting instances in Uk for lifestyle-conserving diagnostic tests

The Welsh Labour government has come below attack for its NHS record like ambulance waiting times and hospital death rates. Photograph: Photofusion/Rex Functions

Wales has the worst Uk waiting times record for life-saving exams, according to the latest figures. Government statistics display that close to 42% of folks in Wales waiting for diagnostic exams had to wait much more than 6 weeks ahead of they were lastly noticed. This compares with one.eight% in England and three.8% in Scotland.

The statistics also show that 16.six% of sufferers on the Welsh diagnostic waiting record wait longer than twelve weeks. In Northern Ireland, 15.5% on the record had to wait much more than nine weeks. Physicians have described the statistics as extremely worrying and further evidence that the crisis in the NHS in Wales is worsening.

A Carmarthen-primarily based physician, Dewi Evans, who has been working in the wellness support given that 1971, mentioned early diagnostic tests had been critical simply because they could be a matter of existence and death. The checks – such as MRI scans and cystoscopies – can be used by medics to check no matter whether a individual has cancer.

Evans mentioned: “These investigations are the mainstay of early and exact diagnoses of daily life-threatening circumstances. In terms of significance, these are the most disturbing NHS statistics I have witnessed in a lot of many years.”

The Labour administration in Cardiff Bay has come under repeated attack for its NHS record considering that it returned to electrical power in the Welsh assembly in 2011.

As effectively as ambulance waiting times repeatedly failing to meet key targets, calls have been made for a public enquiry into death rates at Welsh hospitals.

But the nationalist party Plaid Cymru said the scenario was getting worse, soon after it collated official figures on diagnostic waiting times.

The Welsh government said claims created by Plaid were a “full distortion”. A spokeswoman mentioned: “In spite of the pressures on the NHS, accessibility to diagnostic exams is strengthening.

“However, the wellness minister, Mark Drakeford, acknowledges waits are nonetheless too lengthy in some instances, and last month announced £5m of new funding to help the NHS lessen waiting times for individuals scans and tests where there are distinct issues.

“Speeding up access to these tests will indicate that sufferers get the outcomes more quickly and can start their complete therapy sooner. We anticipate waiting times for diagnostic tests to come down.”

Welsh NHS has worst waiting instances in Uk for lifestyle-conserving diagnostic tests