The use of video conferencing platforms
We are supporting the use of video conferencing for interviews during this period. Equally, if transplant centres feel they can safely facilitate face to face interviews in line with Government guidance, then that is a decision for them to make. If you have any concerns about conducting face to face interviews you should discuss these with the transplant centre and of course only undertake interviews in an environment in which you are comfortable and feel safe. Now that we have a clearer idea on the situation and the length of time these measures may need to be in place, we do not feel that telephone interviews alone are sufficient.
We understand that there may be some anxieties about using video conferencing technology. This may present challenges, but we hope there are ways of overcoming these. Body language plays an important role and so whilst you may not be able to conduct face to face interviews, we hope that by seeing the people you are interviewing this will go some way in helping to provide some reassurance.
The decision as to which video platform to use will need to be decided in discussion with the transplant centre. Some factors you may wish to consider are:
Liaising with the transplant centre
The video conferencing facility that is used must be supported by local hospital protocol and security. Please discuss the practicalities with the transplant centre as they may have a preferred or existing local platform that they would need you to use.
Logistics such as how to access the video platform will need to be agreed with transplant centres. You will need to agree account details and the use of personal equipment where applicable.
Donors and recipients will need to have access to the video platform that is agreed. This is something we will communicate to Living Donor Coordinators as they will need to communicate details to donors and recipients prior to the interview.
Identity, relationship and joint interviews
At the start of the interview, you can confirm identity and relationships in the usual way by asking to see the relevant ID and evidence of relationship and noting this in your report. We suggest that you ask for the documents to be held up to the camera so they can be seen clearly. Alternatively, the Living Donor Coordinator could securely email a scanned copy of the relevant documents to you prior to the interview.
As usual, you will need to interview the donor and recipient separately and together. We appreciate that using online technology where donors and recipients share the same household could present a challenge. We suggest when conducting separate interviews with the donor and recipient, you make it clear there is an expectation that you will need to speak to each person alone and that you explicitly seek assurance that the individual is alone in the room and document in your report that you received that reassurance. Alternatively, where the individual is comfortable to do so they may show you the room to demonstrate that they are alone.
Where the donor and recipient do not live in the same household, we understand this may bring its own set of challenges. We advise using a platform that allows for more than one participant where possible to allow for a joint interview. This would allow both participants on the call to see each other and for you to observe body language.
Donor declaration form
Donor declaration forms must be signed. The transplant centre may decide to post the form to the donor for them to post back to the centre, who can then email it to the HTA Transplant team or directly to you. During the interview, please confirm with the donor that they have signed the form.
Young or poorly recipients that cannot be interviewed
In instances where the recipient is young / pre-verbal or too ill to be interviewed please follow the same guidelines in place for face to face interviews. Where you have been unable to interview a recipient please clearly document the reasons for this in your report.
It is important that patients are aware of any additional risks relating to COVID-19, therefore we kindly ask you to address this during your interviews for the foreseeable future, clearly documenting the discussion that was had within your report. We will be asking transplant centres to make reference to this within referral letters.
For those donors and recipients that had received HTA approval prior to COVID-19 but where the transplant has not yet taken place we will be asking transplant centres to re-visit consent in the context of COVID-19. The reason for this is because circumstances have fundamentally changed since their consent was provided and all precautions possible are being put in place to protect living donors.
This means you may be contacted to be asked to speak to donors and recipients that you interviewed some time ago. In these cases we need to have confirmation that they have had a conversation with a member of the clinical team and the donor’s consent remains in place.
To ensure we remain as proportionate as possible we are taking a reasonably light-touch approach. It’s therefore acceptable to speak to them on the phone and email details of your discussion to email@example.com. Please include the TXXXX number so that we can identify the relevant case. Please do not use patient names or details in your email. If you don’t have the TXXXX number please call us to let us know which case the email refers to.
On a separate matter, you will also be aware that a system for deemed consent for organ and tissue after death became operational in England on 20 May. As a result, we have separated out our Code of Practice F into two parts. There have been no changes to the information on living organ donation other than it is now called Code of Practice F: Donation of solid organs and tissue for transplantation - Part one: Living organ donation. Part two refers entirely to the new legislative requirements for deceased donation.
We understand there will be ongoing questions about the changes we have outlined above however please be assured that we are here to support you. If you have any questions please don’t hesitate to contact the team on firstname.lastname@example.org.