NHS Blood and Transplant (NHSBT) is responsible for organ donation in the United Kingdom and manages the NHS Organ Donor Register and national transplant waiting list.

NHSBT publishes data on the transplant waiting list at the link below, including breakdowns by transplant centre:

https://www.organdonation.nhs.uk/about-organ-donation/statistics-about-organ-donation/transplant-activity-report/

However, NHSBT does not publish waiting list data by patients' place of residence and therefore county-level breakdowns are not available.

NHS Blood and Transplant (NHSBT) manages the NHS Organ Donor Register and matches and allocates donated organs across the United Kingdom. NHSBT publishes data on the transplant waiting list at the following link, but this does not include breakdowns by county:

https://www.organdonation.nhs.uk/about-organ-donation/statistics-about-organ-donation/

NHS England does not routinely collect or hold data on the number of patients with blood cancer who do not meet the eligibility criteria set out in its clinical commissioning policies, the numbers who have not been funded to receive treatment under the current commissioning policy, or the number of patients whose disease relapsed under 12 months of a first allogeneic-hematopoietic stem cell transplant.

NHS England recognises the seriousness of relapse following a stem cell transplant and is actively reviewing the current policy, working with clinicians, patients, and charities to assess the latest available evidence. A revised draft policy is expected to undergo stakeholder testing in the new year, with final decisions currently anticipated in late spring 2027.

The ongoing review will consider the latest peer-reviewed clinical evidence, alongside clinical benefit, patient safety, affordability, and the opportunity cost of any new investment. Any changes to commissioning arrangements will be considered through NHS England's established policy development process, which includes an independent evidence review, expert clinical input, patient and public involvement, and stakeholder testing. Stakeholders will have the opportunity to comment on the draft policy through a formal stakeholder testing process before any final decisions are made.

NHS England does not routinely collect or hold data on the number of patients with blood cancer who do not meet the eligibility criteria set out in its clinical commissioning policies, the numbers who have not been funded to receive treatment under the current commissioning policy, or the number of patients whose disease relapsed under 12 months of a first allogeneic-hematopoietic stem cell transplant.

NHS England recognises the seriousness of relapse following a stem cell transplant and is actively reviewing the current policy, working with clinicians, patients, and charities to assess the latest available evidence. A revised draft policy is expected to undergo stakeholder testing in the new year, with final decisions currently anticipated in late spring 2027.

The ongoing review will consider the latest peer-reviewed clinical evidence, alongside clinical benefit, patient safety, affordability, and the opportunity cost of any new investment. Any changes to commissioning arrangements will be considered through NHS England's established policy development process, which includes an independent evidence review, expert clinical input, patient and public involvement, and stakeholder testing. Stakeholders will have the opportunity to comment on the draft policy through a formal stakeholder testing process before any final decisions are made.

No such assessment has been made.

NHS Blood and Transplant (NHSBT) is the organisation responsible for organ donation services in the United Kingdom.

NHSBT, working with the Department and NHS England, delivers a multi‑channel programme of activity to increase organ donation, improve family consent, and maximise the impact of both deceased and living donation. This includes:

• year-round communications and engagement, combining national campaigns, digital marketing, and partnership working. High-profile moments, such as Organ Donation Week, Living Donation Week, and World Kidney Day, are supported by media activity across a variety of channels, directing audiences to trusted information and to register their wishes on the NHS Organ Donor Register;

• partnerships, including with National Health Service organisations, charities, community, and advocacy groups, which aim to reach people at key moments through trusted channels. For example, a functionality has been introduced recently on the front page of the NHS App, making it easier for people to record, review, and share their organ donation decision as part of routine interactions with NHS services;

• targeted community engagement, supported by NHSBT’s Community Grants Programme, helps improve understanding of organ donation and family consent in communities with greater transplant need or lower consent rates; and

• work to maximise the use of donated kidneys, including new assessment and recovery centres, which are currently being piloted and will use machine perfusion technology to preserve and assess kidneys for longer, alongside trust utilisation strategies to help transplant centres and hospitals identify and address local barriers to using suitable organs.

The Government recognises the importance of ensuring timely and equitable access to heart and lung transplantation services and of improving patient outcomes. This response relates to England only.

Access to transplantation is based on nationally agreed clinical criteria, with donor organs offered, or allocated, through a national system managed by NHS Blood and Transplant (NHSBT) to ensure equity according to clinical need. NHSBT publishes data annually on access and outcomes in its organ-specific reports, with further information available at the following link:

https://www.odt.nhs.uk/statistics-and-reports/annual-activity-report/

This data shows some variation in post-transplant survival rates between centres, but good overall rates. In addition, it shows some geographical variation in lung registration rates and no evidence of variation beyond chance for heart and lung transplantation rates. Further work is needed to understand and address unwarranted variation in access to transplantation.

Variation in patient outcomes, including longer‑term survival and listing outcomes, are reviewed through established NHSBT and NHS England clinical governance processes, including routine outcome reviews and centre‑specific follow‑up where indicated. The National Transplant Clinical Panel has been established to provide expert clinical interpretation of transplant outcome data to support quality oversight, including where issues of statistical variation are identified.

Heart and lung transplant services provide multidisciplinary assessment, ongoing follow‑up, and access to psychological support where clinically indicated, ensuring that care addresses both physical and mental health needs across the patient pathway, before and after transplantation. The quality and effectiveness of care is monitored through national audit, service review, and patient feedback, with oversight provided by the National Transplant Clinical Panel.

To improve equity of access, transplant activity, and outcomes, NHS England has established a national improvement programme, informed by the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise. This programme, alongside NHS England commissioning structures, includes work to improve referral pathways, organ utilisation, and service consistency, through strengthened peer review processes, audit of organ acceptance practices, and work with transplant centres to support consistent decision-making. Further information on the national improvement programme and the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise is available at the following two links:

https://www.england.nhs.uk/blog/from-ambition-to-action-improving-heart-and-lung-transplant-services-in-england/

https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/34815/report-on-uk-heart-and-lung-transplantation-services.pdf

While progress has been made, including increases in transplant activity and reductions in waiting lists, NHS England continues to work with partners and patients to ensure services are consistent, resilient, and able to meet patient need across the country.

The Department is aware of the historical contribution made by Professor Zbigniew Religa to the development of heart transplantation in Poland during the 1980s. As part of NHS England's Heart and Lung Transplantation Transformation Programme, national and international evidence and experience are being considered to inform service development. Further information on the NHS England Heart and Lung Transplantation Transformation Programme is available at the following link:

https://www.england.nhs.uk/blog/from-ambition-to-action-improving-heart-and-lung-transplant-services-in-england/

There are currently no plans to undertake a specific assessment of the merits of adopting elements of the Polish heart-transplant programme established by Professor Religa.

The number of minority ethnic and mixed heritage donors added to the United Kingdom aligned stem cell registry each year are presented in annual State of the Registry Reports, which can be found at the following link:

https://www.anthonynolan.org/what-we-do/our-organisation/annual-reviews-and-reports?page=1

It should be noted that the reports refer to donors ‘made active’, potential donors who have been tissue typed and are searchable on the registry, as opposed to ‘recruited’, when the details of the potential donor are first taken. There is a small delay from recruited to made active.

Data relating to stem cell transplantation, including patient demographic information and clinical outcomes, is collected by transplant centres. The Data Commission, established by the UK Stem Cell Strategic Forum, is working to make collection, availability, and analysis of this data is more consistent throughout the patient pathway from diagnosis to long term follow up.

NHS Blood and Transplant and registry partners continue to invest in digital infrastructure and participate in international initiatives to improve data exchange and streamline donor search and procurement processes. Work is ongoing to modernise registry connectivity through the adoption of new digital platforms and standards, improving end-to-end integration across the transplant pathway. These efforts will need to be complemented by investment in transplant centre data collection and exchange.

The Department has launched a comprehensive review of the current system to ensure stem cell supply and use for transplantation is optimised. Data systems and governance will be considered as part of this review.

Clinical decisions regarding graft-versus-host disease prophylaxis, including the use of post-transplant cyclophosphamide (PTCy), are made by specialist transplant clinicians in accordance with the latest clinical evidence and professional guidance. The Department supports the adoption of evidence-based practice across National Health Service transplant services but does not mandate the use of specific clinical protocols. Recent guidance on the use of PTCy has been published by the British Society of Blood and Marrow Transplantation and Cellular Therapy (BSBMTCT), and is available at the following link:

https://bsbmtct.org/wp-content/uploads/2025/11/UK-Clinical-Community-Consensus-on-the-Emerging-use-of-PTCy-Final-version-November-2025.pdf

There are current United Kingdom trials and rapidly developing BSBMTCT supported algorithms that will support the use of PTCy.

The number of minority ethnic and mixed heritage donors added to the United Kingdom aligned stem cell registry each year are presented in annual State of the Registry Reports, which can be found at the following link:

https://www.anthonynolan.org/what-we-do/our-organisation/annual-reviews-and-reports?page=1

It should be noted that the reports refer to donors ‘made active’, potential donors who have been tissue typed and are searchable on the registry, as opposed to ‘recruited’, when the details of the potential donor are first taken. There is a small delay from recruited to made active.

Data relating to stem cell transplantation, including patient demographic information and clinical outcomes, is collected by transplant centres. The Data Commission, established by the UK Stem Cell Strategic Forum, is working to make collection, availability, and analysis of this data is more consistent throughout the patient pathway from diagnosis to long term follow up.

NHS Blood and Transplant and registry partners continue to invest in digital infrastructure and participate in international initiatives to improve data exchange and streamline donor search and procurement processes. Work is ongoing to modernise registry connectivity through the adoption of new digital platforms and standards, improving end-to-end integration across the transplant pathway. These efforts will need to be complemented by investment in transplant centre data collection and exchange.

The Department has launched a comprehensive review of the current system to ensure stem cell supply and use for transplantation is optimised. Data systems and governance will be considered as part of this review.

The Government recognises the challenges faced by heart and lung transplant services, as highlighted in the BBC File on 4 Investigates programme. Clinical teams have continued to improve activity and patient outcomes, reflecting their expertise and commitment. However, challenges remain and further work is needed to address variation in access, workforce pressures, and the complexity of organ acceptance and allocation.

NHS England is working closely with the Department, NHS Blood and Transplant (NHSBT), and transplant centres to address these issues. The concerns raised in the programme are consistent with challenges previously identified by the Organ Utilisation Group and explored through the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise. This has informed NHS England’s clinically led national improvement programme for heart and lung transplant services, which brings together clinicians, patients, and patient organisations to co-design solutions to improve services in these key areas.

In parallel, NHSBT is delivering a Department funded programme of Assessment and Recovery Centres (ARC), including lung ARC pilot schemes launched in February 2026, to improve the preservation and utilisation of donor organs for transplantation.

While it is encouraging that activity has increased and waiting lists have reduced, the Government recognises that continued work is needed to ensure services are consistently accessible and resilient. Work will continue with patients, partners, and local centres to ensure care is personalised, equitable, and sustainable, and to address challenges facing the transplant workforce.

Non-Emergency Patient Transport Schemes (NEPTS) often provide funded transport where a medical condition means that a patient would struggle to safely attend their treatment independently.  NEPTS can be provided by ambulance trusts or other providers depending on local arrangements.

In May 2022, NHS England set out eligibility criteria, which includes disability criteria, available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/B1244-nepts-eligibility-criteria.pdf

NHS England has worked closely with a range of kidney patient groups, renal professionals, integrated care boards (ICBs), and other stakeholders to develop a dialysis transport support framework which has been made directly available to ICBs. The 2022 updates to the eligibility criteria included where patients are travelling to or returning from in-centre haemodialysis, in which case specialist transport, non-specialist transport, or upfront/reimbursement costs for private travel will be made available.

NEPTS in England is an operational matter for the National Health Service, and how the NEPTS guidance is implemented at a local level is determined by ICBs and their partners, including local ambulance trusts. There are no current plans to update the eligibility criteria further.

Non-Emergency Patient Transport Schemes (NEPTS) often provide funded transport where a medical condition means that a patient would struggle to safely attend their treatment independently.  NEPTS can be provided by ambulance trusts or other providers depending on local arrangements.

In May 2022, NHS England set out eligibility criteria, which includes disability criteria, available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/B1244-nepts-eligibility-criteria.pdf

NHS England has worked closely with a range of kidney patient groups, renal professionals, integrated care boards (ICBs), and other stakeholders to develop a dialysis transport support framework which has been made directly available to ICBs. The 2022 updates to the eligibility criteria included where patients are travelling to or returning from in-centre haemodialysis, in which case specialist transport, non-specialist transport, or upfront/reimbursement costs for private travel will be made available.

NEPTS in England is an operational matter for the National Health Service, and how the NEPTS guidance is implemented at a local level is determined by ICBs and their partners, including local ambulance trusts. There are no current plans to update the eligibility criteria further.

The Government recognises the importance of ensuring timely and equitable access to heart and lung transplantation services and of improving patient outcomes.

Heart and lung transplant services provide multidisciplinary assessment, ongoing follow‑up, and access to psychological support where clinically indicated, ensuring that care addresses both physical and mental health needs across the patient pathway, before and after transplantation. The quality and effectiveness of care are monitored through national audit, service review, and patient feedback.

Evidence has identified variation in how aspects of service specifications and patient engagement are implemented across transplant services. This was highlighted in the Implementation Steering Group for Organ Utilisation’s Improving Patient Engagement in Organ Transplantation: Recommendations for Best Practice report, which sets out areas for improvement in consistency and patient experience. This report is available at the following link:

https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/36473/improving-patient-engagement-in-organ-transplantation_recommendations-for-best-practice.pdf

NHS England is working with patient representatives, NHS Blood and Transplant, and transplant centres through a national improvement programme which includes work to address unwarranted variation and strengthen holistic, patient‑centred care before and after transplantation, in addition to wider work to improve access, workforce sustainability, and service resilience.

The Government recognises the importance of ensuring timely and equitable access to heart and lung transplantation services and of improving patient outcomes.

Access to transplantation is based on nationally agreed clinical criteria, with organs allocated through a national system managed by NHS Blood and Transplant (NHSBT) to ensure equity according to clinical need. NHSBT publishes data annually on access and outcomes in its organ-specific reports, which are available at the following link:

https://www.odt.nhs.uk/statistics-and-reports/annual-activity-report/

This data shows good overall post-transplant survival rates, alongside some variation between centres. In addition, the data shows no evidence of geographical variation beyond chance for heart and lung transplantation rates, and some variation in lung registration rates. Further work is needed to understand and address unwarranted variation in access to transplantation.

Variation in patient outcomes, including longer‑term survival and listing outcomes, are reviewed through established NHSBT and NHS England clinical governance processes, including routine outcome review and centre‑specific follow‑up where indicated. The National Transplant Clinical Panel has been established to provide expert clinical interpretation of transplant outcome data to support oversight where issues of statistical variation are identified.

To improve access and outcomes, NHS England has established a national improvement programme, informed by the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise. This programme, alongside NHS England’s commissioning structures, includes work to improve referral pathways, organ utilisation, and service consistency, through strengthened peer review processes, an audit of organ acceptance practices, and work with transplant centres to support consistent decision-making. Further information on NHS England’s national improvement programme and the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise is available, respectively, at the following two links:

https://www.england.nhs.uk/blog/from-ambition-to-action-improving-heart-and-lung-transplant-services-in-england/

https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/34815/report-on-uk-heart-and-lung-transplantation-services.pdf

While progress has been made, including increases in transplant activity and reductions in waiting lists, NHS England continues to work with partners to ensure services are consistent, resilient, and able to meet patient need across the country.

The Government recognises the importance of ensuring timely and equitable access to heart and lung transplantation services and of improving patient outcomes.

Access to transplantation is based on nationally agreed clinical criteria, with organs allocated through a national system managed by NHS Blood and Transplant (NHSBT) to ensure equity according to clinical need. NHSBT publishes data annually on access and outcomes in its organ-specific reports, which are available at the following link:

https://www.odt.nhs.uk/statistics-and-reports/annual-activity-report/

This data shows good overall post-transplant survival rates, alongside some variation between centres. In addition, the data shows no evidence of geographical variation beyond chance for heart and lung transplantation rates, and some variation in lung registration rates. Further work is needed to understand and address unwarranted variation in access to transplantation.

Variation in patient outcomes, including longer‑term survival and listing outcomes, are reviewed through established NHSBT and NHS England clinical governance processes, including routine outcome review and centre‑specific follow‑up where indicated. The National Transplant Clinical Panel has been established to provide expert clinical interpretation of transplant outcome data to support oversight where issues of statistical variation are identified.

To improve access and outcomes, NHS England has established a national improvement programme, informed by the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise. This programme, alongside NHS England’s commissioning structures, includes work to improve referral pathways, organ utilisation, and service consistency, through strengthened peer review processes, an audit of organ acceptance practices, and work with transplant centres to support consistent decision-making. Further information on NHS England’s national improvement programme and the Implementation Steering Group for Organ Utilisation’s Cardiothoracic Information Collation Exercise is available, respectively, at the following two links:

https://www.england.nhs.uk/blog/from-ambition-to-action-improving-heart-and-lung-transplant-services-in-england/

https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/34815/report-on-uk-heart-and-lung-transplantation-services.pdf

While progress has been made, including increases in transplant activity and reductions in waiting lists, NHS England continues to work with partners to ensure services are consistent, resilient, and able to meet patient need across the country.