National Retrieval Group


Terms of Reference for the National Retrieval Group

The need to ensure good clinical governance of organ retrieval and the effective delivery of the National Organ Retrieval Service is recognised by the formation of this group which will replace the Clinical Sub-Group, the Donated Organs Monitoring Group and the Retrieval Sub-Group of the Clinical Governance Monitoring Group.

The major roles of the Group are:

  • to assist NHSBT in the commissioning of efficient and effective organ retrieval services which enable organs of the highest possible quality to be retrieved from all solid organ donors in the UK in a timely fashion and to allow best possible outcomes for all recipient patients
  • to ensure good clinical governance of the retrieval pathway on behalf of the Clinical Governance Monitoring Group of the Directorate of Organ Donation and Transplantation
  • to ensure that most effective use is made of all donated organs
  • to monitor and investigate damage to retrieved organs
  • to supervise the Organ Retrieval Workshop

Membership

Chair:

The National Clinical Lead for Organ Retrieval at NHSBT will chair the Group. The co-chair will be the Assistant Director of Commissioning, ODT.

Support: The Chair and the Group will have defined administrative and statistical support from NHSBT through ODT Corporate Services to help deliver the aims of the group.

Members:

Membership of the Group will include:

National Clinical Lead for Organ Retrieval NHSBT (Chair)

Assistant Director of Commissioning, ODT (Co-chair)

Associate Medical Director ODT

Head of Nursing Development ODT

Clinical Lead for Donor Optimisation, NHSBT

One surgical representative from each solid organ advisory group (KAG, CTAG, LAG, BAG and PAG)

Head of Service Delivery, ODT

Representative from Directorate of Statistics and Clinical Audit

ODT Quality Manager

Other members co-opted by the group (may include representatives from relevant professional bodies, societies and Colleges)

The representative from each solid organ Advisory Group will be nominated by the Advisory group; the Advisory Group will agree the tenure for each representative’s membership.

The Group will report to and is accountable to the ODT Clinical Governance Monitoring Group.

There will be a sub-group that will meet monthly to review incidents reported to NHSBT.
Membership Responsibilities

Members will be responsible for presenting the views of the groups/organisations that they represent.

Members will be responsible for bringing to the Group any relevant concerns or suggestions from the groups that they represent. Where possible this should be in writing so that the paper can be circulated prior to the meeting.

Members will be responsible for responding to relevant items on the Agenda brought forward by the Chair or Associate Medical Director.

Members will be responsible for providing feed back to the Groups/ organisations that they represent
Frequency of meetings

The Group will meet at least three times a year.

The Group will host an annual open meeting (the Retrieval Consultation Group) to consult with representatives from all the designated retrieval units and a wider representation of the organ donation and transplantation community.
Minutes

The minutes of each meeting will be taken by the NHSBT (ODT) Secretariat.

The minutes and all papers of the Group meetings that could be requested under the Freedom of Information Act will be published (when approved) on the NHSBT web-site, unless they contain patient - identifiable material.

Minutes will be circulated electronically.
Support

Budget

The group will be allocated an agreed budget, administered by NHSBT, which will include travel expenses, hosting of meetings, working parties, consensus meetings and other relevant activities. Accountability for the budget will be with the Chair of the Group but the budget will be held within ODT.

Statistical and analytical support

The group will be allocated an agreed level of support from the Directorate of Statistics and Clinical Audit to support the activities of the group: this support will be used for analysis of outcomes, audit, governance issues, service evaluation, modelling of alternative methods of service delivery and other projects, agreed with the Chair of the Group, the Associate Director of Statistics and Clinical Audit and the Associate Medical Director ODT.

The Chair of the Group, Associate Director of Statistics and Clinical Audit and Associate Medical Director will meet at least every 6 months to agree the agenda, new projects and assign priorities and circulate this as an agreed work-plan.

Administrative support

The Corporate Services section of ODT will provide an agreed level of administrative support, to help with the planning and organisation of meetings, minute taking and other relevant matters.
Role of the Group

The Group will:
  1. Agree and review a work-plan
  2. Consider formally at each annual Retrieval Consultation Group meeting and advise NHSBT on operational aspects of organ retrieval including data analysis on:
    • Activity and outcome
    • Response times and delays
  3. Recommend national protocols and standards for organ retrieval
  4. Advise NHSBT on professional issues relating to training of retrieval surgeons
  5. Monitor the implementation of the standards and protocols and suggest changes and audit where appropriate
  6. Advise NHSBT and other bodies on appropriate methods of monitoring outcomes and interpretation of findings
  7. Monitor and investigate reported damage to organs
  8. Establish and review the donor and organ characteristics that will predict the non-acceptance of a solid organ where consent has been obtained for transplantation
  9. Determine the reasons for non-use of organs
  10. Explore the variation in practice between surgeons/centres with respect to organ refusal/non-use
  11. Review organ offering processes to improve efficiency and optimise rates of organ donation and transplantation
  12. Work with relevant clinicians
    • to review and revise guidelines for identification of those potential donors where organ donation will not take place
    • to review and revise guidelines for identification of those organs which are not transplantable
    • to develop guidelines to help clinicians identify those organs that could be safely used
  13. Monitor and report on clinical governance with especial reference to
    • outcomes and deviations from expected outcomes
    • clinical incidents reported to NHSBT
    • causes of non-retrieval
    • causes of damage to retrieved organs.
Sub-Group

The Sub-Group will meet monthly, immediately following the Commissioning Team Meeting, and review, investigate and make recommendations arising from incidents reported to NHSBT.

The group will be chaired by the Assistant Director, UK Commissioning and include the National Clinical Lead for Retrieval, Senior Commissioning Manager and one Regional Manager. Others may be co-opted as required.

The sub-group will report to the full Group.
Organ Retrieval Masterclass

NHSBT supports the annual organ retrieval workshop which is run in conjunction with the British Transplantation Society (BTS). NHSBT provides both financial and administrative resources and the BTS is responsible for the academic content. The Masterclass is part of the competency accreditation as a retrieval surgeon that is required to participate in a NORS Team. The Group will:
  • take responsibility, with the BTS, to ensure that the Workshop is consistent with NHSBT Retrieval Standards and any guidelines
  • appoint the clinicians who will run the workshop on behalf of NHSBT and BTS
  • ensure the good governance of the workshop
  • Click here for 2016 Organ Retrieval Masterclass information

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