Implementation Steering Group for Organ Utilisation
The Department of Health and Social Care established the Implementation Steering Group for Organ Utilisation (ISOU) to oversee the implementation of Organ Utilisation Group's recommendations.
On this page
The ISOU concluded its work in December 2025 and the Group was disbanded. The final reports and supporting documents were published in Spring 2026. Responsibility for the delivery of ISOU recommendations has transitioned to the Department of Health and Social Care, NHS England, NHS Blood and Transplant and individual Trusts.
Closure Report
The ISOU Closure Report summarises the work of the ISOU, detailing progress made across all recommendations and the transfer of ongoing delivery to relevant organisations.
Aims of the group
Set up by the Secretary of State for Health and Social Care, the Group aimed to oversee and coordinate the implementation of the recommendations set out in the Organ Utilisation Group (OUG) report , Honouring the gift of donation: utilising organs for transplant, which was launched on 21 February 2023.
The ISOU was established with a remit to:
- Bring together those with a role in leading implementation of the OUG recommendations
- Prioritise and align implementation activity
- Provide updates on progress, including to Ministers
- Monitor implementation activity
- Identify and address issues with implementation
ISOU was co-chaired by a senior DHSC official and an independent senior clinical leader in the field of transplantation.
It brought together organisations with a leading role in delivering the OUG recommendations and included patient and lay representation, as well as representation from the devolved governments as well as the key organisations involved in delivering the transplant service, to increase collaboration and ensure that all patients have fair and equitable access to transplant services, regardless of their background, ethnicity or where they live.
The first meeting of ISOU took place on 18 April 2023.
The challenge
When the group was established, there had been significant improvements in organ donation, with deceased donor numbers increasing by 95% since 2008. While there were also been improvements in the transplant rate, this had not kept pace with the increase in donation.
At the time the ISOU was established, the waiting list had started to rise again, meaning that the shortfall in the availability of organs for transplant was worsening. Between 1 April 2021 and 31 March 2022, 429 people died while on the transplant waiting list. A further 644 people were removed from the waiting list due to deteriorating health – these patients could no longer safely receive a transplant. Sadly, many of these patients would have died after being removed from the list.
Much of the increase in the waiting list can be explained by the increasing age and co-morbidities of deceased donors, meaning that organs are harder to successfully transplant. However, other countries experiencing similar difficulties, sustained higher transplant rates than those in the UK, with no worse outcomes for patients. There was also significant variation between UK transplant centres regarding what organs they were willing to accept for transplant.
It was clear that more needed to be done to fully honour the gift of donation and support transplant teams. This was needed to ensure that all organs suitable for transplant were used to save the lives of those on the waiting list.
The ISOU brought together the key organisations involved in delivering the transplant service, to increase collaboration and ensure that all patients have fair and equitable access to transplant services, regardless of their background, ethnicity or where they live.
Membership
The number of members on the ISOU was limited to retain focus and drive.
Building on the experience of the OUG, an ISOU Stakeholder Forum was established with patient and clinical Co-Chairs. The ISOU Stakeholder Forum supported ISOU’s work and ensured key stakeholders - including patients and clinicians – were able to steer implementation activities and remain engaged as the work progressed.
Reflecting the breadth of the OUG recommendations and the need to draw in expertise from a wide variety of perspectives, the ISOU also created a series of sub-groups to support implementation. The sub-groups worked alongside existing expert/advisory groups and reported into the main ISOU. They helped to commence work in some of the more complex areas that required collaborative input from across the organ donation and transplant community.
Sub-groups
In 2023, the Department of Health and Social Care (DHSC) established a new fixed-term Implementation Steering Group for Organ Utilisation (ISOU) to drive the delivery of the 12 recommendations set out in the Organ Utilisation Group’s (OUG) report 'Honouring the gift of donation: utilising organs for transplant'.
Given the cross-cutting themes and co-dependencies within the OUG report recommendations, fixed-term ISOU subgroups were established to provide strategic steers to aid implementation, particularly on some of the more complex areas of work.
There were 5 main ISOU sub-groups:
The Stakeholder Forum
The Stakeholder Forum ensured the ISOU understood the views of partners and enabled them to contribute to and/or influence the work of the Group and implementation of the OUG recommendations.
View the Terms of Reference for the ISOU Stakeholder Forum (PDF 96KB)
Timescales
It was anticipated that delivery of all 12 OUG recommendations would take several years. The ISOU met at least 4 times a year and notes of the meetings are published on this page.
Implementation plan
The implementation plan, as of January 2026, can be found in Annex D of the ISOU Closure Report. This plan will be updated annually and published here.
The previous implementation plan, as of October 2025, can be found here: ISOU implementation plan October 2025 (PDF 299KB)