On behalf of the Board of the Organ and Tissue Authority (OTA), I am pleased to present the OTA's Annual Report 2019-20.
I am proud to reflect on the agency’s efforts to save and improve the lives of more Australians by delivering a national program to increase organ and tissue donation and improve opportunities for transplantation. The Australian Government, through the OTA, remains committed to increasing the capability and capacity within the health system to maximise donation rates, and to raising community awareness and stakeholder engagement across Australia to promote organ and tissue donation.
In 2019 the lives of 1,444 Australians were saved through transplantation due to 548 deceased organ donors. Additionally, eye and tissue donation changed the lives of more than 12,000 Australians who benefited from eye and tissue donation.
Our key focus areas in 2019–20
Further increases to organ and tissue donation rates rely on more individuals and their families agreeing to donate. In 2019–20 we continued our focus on increasing the consent rate for donation, and converting the high level of public support for donation into registration and family discussion.
Consideration of organ and tissue donation comes at an intensely emotional time for families, and is usually associated with the unexpected death of their loved one. When donation is a possibility in the hospital setting, more families consent to donation when their family member is a registered donor. This leaves the family in no doubt they wanted to be a donor, and families take comfort from honouring their loved one’s wishes.
In 2019 nine out of 10 families agreed to donation when their family member was on the donor register. Consent for donation was given in seven out of 10 cases when the family had prior knowledge of their loved ones wishes. However, it dropped to only six out of 10 families when the family was unaware of what their family member wanted. We can continue to raise the consent rate if more Australians register and talk about donation.
In Australia we have a nationally coordinated system based on world’s best practice. This includes a network of 265 DonateLife donation nursing and medical specialists working across 95 hospitals. Data shows us that more families say yes to donation when they are well informed and supported by a donation specialist. Involving a donation specialist when the opportunity for donation is raised with the family in hospital is a key component of clinical best practice. In 2019 a donation specialist was involved in seven out of 10 family conversations about donation. We can continue to increase consent for donation by involving a donation specialist in every donation conversation with families. We can also provide training to further enhance the skills of donation specialists supporting families to make an informed decision at this difficult time.
We have continued to engage with the community to promote awareness of organ and tissue donation. This includes encouraging more Australians to register to be a donor on the Australian Organ Donor Register (AODR) and, just as importantly, to let their family and friends know they want to be a donor when they die.
We encourage the community to act on their support for donation by registering and letting family members know their wishes. We have continued to promote online registration through www.donatelife.gov.au, emphasising that the online form makes registration easy and takes less than a minute. There were 221,641 new registrations on the AODR in 2019, 9% more than new registrations the previous year.
Strategic direction for 2020–21
Future health policy, budget, and service delivery will inevitably be impacted by the effects of COVID-19, making future planning complex. Recognising the current environment, our focus for 2020–21 includes supporting and collaborating with the clinical sector in order to be responsive to future uncertainties, including national or localised COVID-19 outbreaks. We will continue to focus on our key objectives, acknowledging there will be impacts from COVID-19, to increase donation opportunities for transplantation; provide specialist support for families involved in the donation process; increase consent through registration and family discussion; and enhance systems to support donation and transplantation.
Donation and transplantation services will continue to be impacted as the pandemic continues, as a result of pressures in hospitals and ICUs, and logistical challenges arising from border closures for interstate retrieval teams and organ transport across jurisdictions. We will see ongoing changes to the delivery of services within and across jurisdictions as a result. It is anticipated the full 2020 donation and transplantation outcomes will be significantly impacted.
Our goal for the next 12 months is to continue to facilitate the safe delivery of donation and transplantation services for all Australians, with a focus on the 1,700 people currently on organ transplant waiting lists in Australia.
The COVID-19 pandemic has brought family and friends to the forefront of our minds. I encourage you to take this opportunity to register to be an organ and tissue donor and save lives. If you are already registered, talk to your friends and family and let them know you want to be a donor, and encourage them to have the discussion and register too.
Following the initial outbreak of COVID-19 in Australia, renal transplantation services were suspended for a seven-week period from March 2020. This was due to the unknown risks of COVID-19 to patient safety and the risk of COVID-19 infection during the post-transplantation phase. This has significantly impacted year-to-date donation and transplantation rates. During the suspension, potential organ donors continued to be referred to DonateLife Agencies to provide life-saving liver, lung and heart transplants for critically urgent patients and paediatric patients.
The progress of two key government reviews over the next 12–18 months may also have significant implications for the OTA and our role across organ donation retrieval and transplantation, and eye and tissue donation. We will continue to work closely with the Department of Health and jurisdictions on the National Eye and Tissue Sector Policy Framework and to progress outcomes from the Review of the Australian organ donation, retrieval and transplantation system. This will include development of a future strategy for retrieval and transplantation in Australia and delivery on agreed priorities across the sector, building on the success and learnings of the national donation program.
Financial performance 2019–20
The OTA’s operating result for 2019–20 was a deficit of $0.153 million. The OTA is committed to delivering the program of Government and ensuring that resources are appropriately allocated to optimise our performance. The OTA remains in a net asset position at 30 June 2020.
Administered expenditure for 2019–20 was $46.523 million towards the delivery of the national reform program, including $44.871 million grants expenditure, the majority of which was provided towards dedicated organ and tissue donation specialists in hospitals and organ and tissue donation agencies.
Increasing donation and transplantation requires close collaboration and cooperation with our many stakeholders, and I wish to acknowledge those who have contributed to the success of the national program in 2019–20.
First and foremost, the Board acknowledges and sincerely thanks every donor and their family for making such a generous decision during a very difficult time in their lives.
We thank the individuals and organisations from the community who volunteer their time and energy to partner with the OTA to promote awareness of organ and tissue donation and encourage more Australians to register and talk about donation.
Under exceptionally difficult circumstances this year, our recognition and gratitude go to the DonateLife Network hospital and agency staff; health professionals; eye and tissue bank staff; and our colleagues in the retrieval and transplant sector – surgeons, physicians and coordinators – who make donation and transplantation happen.
Finally, we thank the OTA's CEO and team whose professionalism and hard work have again made a significant contribution to our program in 2019–20.
On behalf of the Board, I am very pleased to present the OTA’s 2019–20 Annual Report.