The role of a Designated Individual for Cwm Taf Morgannwg University Health Board

As the Designated Individual (DI) for Cwm Taf Morgannwg University Health Board, I am responsible for the Human Tissue Act (HTA) standards within three busy District General Hospital mortuaries, across a wide geographical area in south Wales.

I have held this role for five years, but most of my 44 years in the NHS have been in mental health services, nursing, education and management.  My transition to DI began during the COVID pandemic when I was delegated post-retirement to manage Pathology, and later I was recommended for the DI role.

Despite the difference between mental health and mortuary services, my transition has been smooth and I progressively adopted the necessary skills to be effective in the role.  I believe this smooth transition is because with the right clinical management experience and a commitment to continual learning, many roles in the NHS have core transferable skills that can be applied in various settings. For example, skills such as evidence-based scrutiny, academic synthesis, implementing quality control systems, fostering cohesive teamwork and principally delivering effective patient-centred care.

The Health Board has significantly invested in my role to the extent that most of my working hours are dedicated to delivering my legal DI responsibilities. Within my role as DI it is not just about having a good working knowledge of the standards expected to maintain our HTA Post Mortem licence, it is equally important to ensure that there is an effective governance framework driving the outcomes and empowering local staff to take ownership and pride in delivering high quality care.

Excellent and robust governance is central to maintaining standards.  A considerable part of my role involves working closely with the operational team on matters such as audit, incident analysis, follow-up, local inspection, training, listening to staff, offering peer support and policy review. Within an effective governance framework, I feel more reassured communicating consistent compliance to both the Health Board and the Human Tissue Authority.

On a quarterly basis I report to our Director-level HTA Board and Corporate Licence Holder regarding compliance against the standards. This accountability really focusses my mind on the legal responsibilities of being a DI, and is easier to fulfil within a governance framework.  A clear line of accountability to the Health Board is essential and equally a responsive communication channel from the Health Board to the DI.

The team and I conduct a Deep Dive on a periodic basis, which is a gap analysis of every single standard within Code A and B published by the HTA. This helps us not only check that our business as usual processes are robust, but also serves to address compliance issues and identify the resources and timescale needed to achieve improved compliance. The aim is not just to be compliant but to excel in every standard.

Having an open communication channel with the Human Tissue Authority is very supportive to my role and I always receive timely responses to questions with sound expert advice. The Health Board recently underwent an unannounced HTA inspection and the feedback was positive. This was testament to the dedication of the Mortuary staff, Pathology managers, Directors and the Health Board in ensuring we consistently provide high-quality, safe and dignified care for our patients and families as part of our normal business.

In the past five years, I have experienced both announced and unannounced HTA inspections, and I have found the latter equally as reassuring. While both types of inspection are thorough, the positive outcome from an unannounced inspection provides an assurance of consistency in meeting standards every day of the year. This validation not only reassures the Health Board and Human Tissue Authority but ultimately benefits the population we serve.

Being a DI is one of the most rewarding roles I have undertaken in my career and one I would recommend to those who may be thinking about accepting this important responsibility.

Dr Paul D Davies

Assistant Director (Operational Support) & Designated Individual (HTA)

Cwm Taf Morgannwg University Health Board