ISOU – What is it and what has it done?

January 2026

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OUG Vision

The Organ Utilisation Group’s vision is to get a donated organ to the person it was intended for as rapidly as possible, through delivering a transplant service that is:

• Supporting and empowering patients, through improved data, delivered in a time and way that enables patients to understand their options and that better reflects the diversity of those on the transplant waiting list; giving patients a louder voice in shaping the services that they rely on
• Equitable, with people having fair access to transplantation regardless of where they live in the country, their socio-economic status, their health literacy levels or their culture or ethnicity
• Reducing unwarranted variations in practice, by clearer expectations about roles and responsibilities and with the infrastructure required to ensure adherence to best practice
• Driving cost savings to the NHS, through increasing the number of patients that receive a transplant and maximising the efficient use of available resources

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• Honouring the gift from donors, with no opportunity missed for safely transplanting an organ into the intended recipient and maximising the potential for organ transplantation
• Supporting and empowering transplant teams, where transplant clinicians have the data, guidance and training they need, in a way and at a time they need it
• Sustainable, with a workforce that is resourced to deliver the services that patients deserve
• Embedding innovation, through supporting new techniques, technologies and evidence-based best practices, to benefit all those on the transplant waiting list

Publications

Full report

Summary report

Supporting evidence

Written Ministerial Statement

https://www.gov.uk/government/publications/honouring-the-gift-of-donation-utilising-organs-for-transplant

Theme 1: Placing the patient at the heart of the service

The following actions will support the successful delivery of this recommendation:

1. Communication with patients must be provided in a timely manner and in a format that is easily accessible, understandable and appropriate to the patient’s needs. Each transplant centre must provide local relevant data for patients and supports them in understanding and engaging with the information provided.
2. Patients must be supported to understand the care options that are available, both in different forms of transplant (for example living or deceased donation) and alternatives to transplant.
3. Patients must be able to access information about their local centre performance in comparison with other accessible centres.

The following actions will support the successful delivery of this recommendation:

1. Patient preference must be taken into consideration early in the referral process when determining where a transplant may occur, acknowledging that the location may change – potentially at short notice – to ensure that the patient receives a transplant in timely fashion.
2. Any service development must be co-produced with users of the service, including patients, their carers and clinicians.
3. Evaluation of live donor’s/ live and deceased donor family’s/ recipient’s experience and outcomes must be undertaken at all stages of the care pathway.
4. Patients must regularly meet with clinical teams, to provide feedback on the service received. This is particularly relevant for ‘less heard voices’.
5. Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs) must be subject to similar levels of focus and scrutiny as clinical outcomes. Measures must be co-produced with patients and co-publicised with patient representative groups. 

Implementation Steering group for Organ Utilisation (ISOU)

• ISOU oversees and co-ordinates 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.
• There are 12 recommendations across 6 themes:
• Place patients at the heart of the service
• Operational infrastructure that maximises transplant potential
• Create sustainable workforce that is fit for the future
• Data provision that informs decisions and drives improvements
• Drive and support innovation
• Deliver improvements through new strategic & commissioning frameworks

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8

ISOU completion 31^st December 2025

• Established four ISOU sub-groups with a wealth of experience and expertise to lead on specific/complex areas:
• Patient Engagement (Several recommendations in scope with 1 and 2 a particular focus) Jessica Jones and Claire Fuller
• Trust Engagement (Focusing on recommendation 10) Mark Cubbon and Chris Callaghan
• Histocompatibility and Immunogenetics (focusing on recommendation 9) Rommel Ravanan and Rich Battle
• Xenotransplantation (focusing on recommendation 9) Observers from Italy, NZ, Aus, Spain) Sir John Iredale and Anthony Clarkson

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• Established a Stakeholder Forum to ensure key stakeholders from the clinician and patient communities are engaged and can steer implementation activities
• Fiona Loud and Nick Torpey

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9

ISOU completion

• Three further sub-groups/symposia or Workshops
• Assessment and Recovery Centres (ARCs) and national oversight system for innovation (focusing on recommendation 9) New funding and taken forward by NHSBT
• Commissioning – still under discussion
• Digital – Recent – linkage to be improved
• Workforce - An issue across the UK and beyond

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• Some progress on recommendation 5 (review of cardiothoracic services) taken forward by NHSE

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10

What has been achieved?

What has been achieved?

What has been achieved?

Stakeholder Feedback

Positive Stakeholder response

• Patients, clinicians, and ministers have commended the ISOU approach to implementation and patient engagement.
• Feedback highlights improved collaboration, transparency, and patient-centred policy development.

Number of Donors

Consent/Authorisation

Rate

Post COVID

Falling consent but donor numbers restoring slowly to

pre-pandemic levels…

until last year.

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• Comprehensive evidence collation including:
• Literature and data analysis
• Clinical survey – 320 responses
• Donor Family survey – 362 responses
• Discovery meetings with international experts, legal and ethical
• Donor Family Focus Group

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Engagement Activity

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Comprehensive evidence collation including:

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• Literature and data analysis
• Clinical survey – 320 responses
• Donor Family survey – 362 responses
• Discovery meetings with international experts, legal and ethical
• Donor Family Focus Group

Engagement Activity

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• Donor Family representatives on ODJWG
• Donor Family Online Survey
• Focus Groups
• OTDT Donor Family Forum
• Specific meetings with representative groups
• Updates at the ISOU Stakeholder Forum

• International Donation Action Forum
• Discussion with international equivalent organisations
• Discovery meetings with external experts (e.g. marketing for funeral arrangements)
• Updates at ISOU meetings

• Representation on the ODJWG
• Clinical Online Survey
• Donation Teams (nursing; ICU; CLOD; ODC Chair) involvement in International Donation Action Forum
• Discussion at NHSBT’s Donation Advisory Group
• Discovery meetings with ICU teams

Donor Family & Patient Representatives

National and International Experts

Organ Donation Teams