Al-Haboubi Mustafa, McLaughlin Leah, Williams Lorraine, Noyes Jane, O'Neill Stephen, Boadu Paul, Bostock Jennifer, Mays Nicholas
Policy Innovation and Evaluation Research Unit, Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
School of Medical and Health Sciences, Bangor University, Bangor, UK.
BMC Health Serv Res. 2025 Jan 31;25(1):183. doi: 10.1186/s12913-025-12224-8.
In May 2020 during the COVID-19 pandemic, England implemented a 'soft' opt-out system of consent to deceased organ donation. As part of a wider evaluation, this analysis focused on the perceptions of health care professionals, specifically their experiences of implementation.
Mixed-methods study informed by Normalisation Process Theory, based on two national surveys of health care professionals and interviews, observations and document analysis, across two case study sites. Routine NHS Blood and Transplant's audit data provided context.
70 interviews with 59 staff and 244 first and 738 second surveys. COVID-19 affected every aspect of implementation. Although supportive in principle, many staff were unconvinced that legislative changes alone would increase consent rates. Many staff were redeployed or left their jobs. As a result, staff were not able to work collectively as intended for implementation. Staff received routine donor audit data suggesting the law was yet to make a difference to consent rates, reducing their enthusiasm and commitment.
Implementation could have been more impactful if delayed. The National Health Service needs to reprioritise organ donation and relaunch the implementation plan in the post-pandemic period, though it is unlikely the changes will bring about a significant increase in consent rates.
2020年5月新冠疫情期间，英国实施了死者器官捐赠的“软性”退出同意系统。作为更广泛评估的一部分，本分析聚焦于医疗保健专业人员的看法，特别是他们的实施经验。
基于常态化过程理论的混合方法研究，以对医疗保健专业人员的两项全国性调查以及在两个案例研究地点进行的访谈、观察和文件分析为基础。英国国家医疗服务体系血液与移植部门的常规审计数据提供了背景信息。
对59名工作人员进行了70次访谈，以及244份首次调查和738份二次调查。新冠疫情影响了实施的各个方面。尽管原则上表示支持，但许多工作人员并不相信仅靠立法变革就能提高同意率。许多工作人员被重新调配或离职。因此，工作人员无法按计划集体开展实施工作。工作人员收到的常规捐赠者审计数据表明，法律尚未对同意率产生影响，这降低了他们的积极性和投入度。
如果推迟实施，可能会产生更大影响。英国国家医疗服务体系需要重新确定器官捐赠的优先次序，并在疫情后重新启动实施计划，不过这些变革不太可能使同意率大幅提高。
