Meet an Independent Assessor - Paul Cousins

  • Living organ donation approvals


Meet an Independent Assessor

Hi, I’m Paul and I have been an Independent Assessor for just over three years. I’m a Performances and Operations Manager for an acute trust in Bristol and in early 2019 one of the consultants who I worked for was telling me how the trust needed another Independent Assessor.  The consultant was aware I had a keen interest in surgery and thought I would be perfect for this role and I had the right skill set to undertake this vital role and represent the trust.  After researching the role and completing the application, I went to HTA HQ in London to complete my training with a group of other potential Independent Assessors.  Within two weeks of the training I was confirmed as an accredited Independent Assessor. 


Prior to my first solo donor and recipient interview I shadowed another Independent Assessor within my hospital to see how they conduct their interviews and work out my style of interviewing and in October 2019 I was finally ready to undertake my first solo interview.  It was a great feeling, a little nerve-racking, but great to push out of my comfort zone.


My role

Once a suitable donor or pair has been identified I receive an email from the Living Donor Coordinator who will organise for the interview to take place at the hospital or remotely at a time that is suitable to the donor or pair and myself. Prior to the interview the donor will be required to read the guidance for living organ donors and will need to sign a donor declaration to confirm that the organ is being given as a gift, with no reward of any kind offered or asked for.


Before an interview can take place, a referral is sent to myself so I can review and build up a background of the donor I will be interviewing.  The referral is a statutory part of the process and provides essential information such as health details, their understanding of the process and risk, recovery support and confirmation of their wishes of what they would like to happen if for any reason their kidney can’t be transplanted into the intended recipient.


As part of my role I’m required to ask several questions to confirm that both the donor and recipient are fully aware of the risks associated with the planned surgery, they have the capacity to make that decision and that both parties are entering into this of their own free will with no promises of any reward or gift in exchange for their kidney as this is unlawful.


The interview process usually lasts 30 – 60 minutes depending on the complexity of the situation. Once the interview is completed, I have 10 days to write my report and outline any concerns I might have which could affect the transplant going ahead.  Once the report is finished this will be submitted via the portal to the HTA for them to decide whether the donation can go ahead based on my report and the criteria set out by law.


Why I’m an Independent Assessor and why you should sign up

I continue to be an Independent Assessor as it’s a real privilege to know I’m a small part of the process and that I have helped to save a life or improve a patient’s health and the reward of receiving an email from the HTA when a case has been approved is the best feeling.  Meeting donors and recipients for the first time, hearing their stories and how they got to this point and seeing their excitement about the next step of the process. 


I would encourage people to sign up to become an Independent Assessor as it is very rewarding and is not a massive time commitment.  Many cases from interview to submitting your report can be maximum of 2 hours of your time and you can use your transferable skills such as excellent interpersonal and oral and written communication skills.


Paul Cousins 

Independent Assessor


If you would like to know more about becoming an Independent Assessor please email: or read our guidance on living organ donation assessments.


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