The more things change, the more they remain the same

  • Inspections
  • Bone marrow and PBSC donations
  • Human application
  • Licensing
  • Living organ donation approvals
  • Organ donation and transplantation
  • Post mortem
  • Public display
  • Removal
  • Research
  • Transplant approvals

Our Chief Executive Allan Marriott-Smith takes a look back over the last decade of the HTA.

I’m sure I’m not alone in the thinking that coming to the end of another decade has relatively few highlights. I can say for certain that in January 2020 I’m older, greyer and wrinklier than in 2010, and my knees have seen better days.

One of my few enjoyable activities at the decade’s end was reading ‘best of’ lists and articles that looked back at what the last ten years held and reflected on what we learnt from them. So, when it was suggested that I write a blog about the HTA’s decade in review, I was very keen to add my contribution to the genre. This is not so much the HTA’s greatest hits of the 2010s, more a brief personal reflection on the ‘tenties’.

I joined the HTA in May 2009, which makes me one of the relatively few members of the team who were around for the whole decade. In principle this places me in an ideal position to reflect, but did I mention that my memory isn’t what it was?

Thankfully our history is chronicled very effectively in our annual reviews. It’s been a really enjoyable trip down memory lane to look back on these. I was struck both by how much change we have experienced, but also by how much has stayed the same, and by the symmetry in the way the decade was book-ended. When you’re in the thick of day-to-day organisational life, change can feel pretty constant and relentless. It is true that a lot has changed, yet many things feel reassuringly familiar.

As we entered 2010, we had found our feet as a regulator. We had just published the second edition of our Codes of Practice, which built on our growing experience of regulating under still relatively fresh legislation. We had also just been confirmed as the new Competent Authority for the Organ Donation Directive taking on new responsibilities under European legislation. This theme of constantly refining and improving our approach and taking on new responsibilities has been a consistent feature of this period.

As the decade closed, we were putting the finishing touches to another Code of Practice to advise practitioners on the introduction of Deemed Cosent for organ donation in England in spring 2020. The Government has consistently relied on our expertise to advise on important issues in the use of human organs, tissue and cells.

If I were asked to identify the single force which has shaped our decade the most, I would have to say innovation. New technologies, new therapies and new business models have kept us agile. While our underpinning legislation has remained static, we have needed to adapt to these changing circumstances and advise our regulated sectors on the standards they need to achieve. The HTA was created as a response to practices which damaged public confidence, and we have consistently acted in collaboration with those we regulate to maintain and grow that confidence for the public benefit.

Our distinctive regulatory approach has continued to serve us well. We have always taken our statutory duty to provide advice and guidance extremely seriously, working collaboratively with those we licence to achieve compliance, as opposed to relying heavily on regulatory sanctions when things go wrong. In my view this is at the heart of our success. Over the decade, we have consistently received feedback that this approach is both effective and valued. We are currently embarking on a stakeholder evaluation, and we look forward to hearing what they have to say.

At the end of 2019, we completed an exercise to review our organisational values. While the words we now use to describe them (Professionalism, Expertise, Agility and Respect) have changed, they express fundamental beliefs about what makes us successful, not only over the last decade, but since the HTA came into existence.

At the start of 2010, we were planning a move at the end of that year from our premises in Holborn to new offices in Victoria. At the start of 2020, we are planning another office move, this time to Stratford in east London. In November we will be collocating to a shared office space with a number of other health sector regulators, providing greater opportunities for collaborative working for the benefit of the public and those we regulate.

Similarly, on the 1 January 2010 we welcomed a new Chair to take us from initial set up into the next phase of our development. At the start of 2020, we have just welcomed Lynne Berry, a new Chair with a huge breadth of experience, to steer the Board and the Executive through an increasingly complex and challenging operating environment.

I won’t attempt to predict what the twenties might hold for us, although I think it would be a fair assumption that my knees will become even less reliable. I am however assured that the HTA is an organisation with a demonstrable track record of embracing and thriving in whatever circumstances it is faced with.

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