NHS Blood & Transplant Disability Equality Scheme

NHS Blood and Transplant (NHSBT) is a Special Health Authority within the NHS, responsible for managing the National Blood Service, UK Transplant and Bio Products Laboratory.

Disability Equality Scheme

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Equality for disabled people

Table of Contents:

1. Statement from the Chief executive
2. Introduction
3. Background
   - NHS Blood and Transplant - who are we?
   - What does NHSBT do?
   - NHSBT - our staff
   - What have we already done and what challenges are we facing
   - How was this disability equality scheme developed?
   - Involving disabled people
4. Our staff and the people who work with us
5. Blood donors, those wishing to enrole on the organ donor register and others who come into contact with NHSBT
6. Appendix 1: HR questionnaire response
7. Appendix 2: Clinical Assessment Panel

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1. Statement from the Chief Executive

The work of NHS Blood and Transplant (NHSBT) touches many people's lives. Donors, patients, staff and many others. As Chief Executive, I am committed to ensuring that our organisation's services are available to all, including disabled people.
As the only provider of donated blood and organs in England and North Wales we are unique. We therefore need to take simple and practical measures to improve accessibility. We will also take more creative steps to find ways to help disabled people who wish to have access to our services.
After involving disabled people we recognise that we have much to do. This Scheme explains the actions we intend to take and when we will take them. To ensure its success, the scheme will be regularly reviewed. This review will allow us to measure our progress and give opportunities to improve the plan, in light of our actual experience on the ground.
By looking at NHSBT services as a whole, not just one area of work, we will deliver accessibility more constantly throughout our organisation. This will give all our donors, patients and staff a more equitable service from us, regardless of any disabilities they may have.

Martin Gorham
Chief Executive, NHSBT

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2. Introduction

The purpose of the NHSBT Disability Equality Scheme (DES) is to explain how the organisation will promote equality for disabled people. The aim of this DES is to remove barriers for all those with disabilities. Many people don't recognise themselves as being disabled. However, they too face discrimination in their everyday life because of their disability. This Scheme address issues such as sensory and physical impairments, deaf people, people with learning difficulties, those with long term mental health problems, people with hidden impairments and those living with HIV/AIDS. For all these people this Scheme will provide real outcomes that will lead to practical improvements. In developing this Scheme we recognise that:

People with impairments are disabled by the attitudes of others and the
environment where they live, work, study and enjoy themselves.

In addition to the commitment from the Chief Executive, disability is also championed on the Board of Directors by Jennie Gubbins, NHSBT Vice Chair and Non-Executive Director.
For more information on this Scheme, or anything else on disability, please contact Rob Warwick (robert.warwick@nbs.nhs.uk) at the Directorate of Strategy Management in NHSBT.

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3. Background

NHS Blood and Transplant - who are we?
NHS Blood and Transplant (NHSBT) is a Special Health Authority within the National Health Service (NHS). Formed in October 2005, it took over the roles of UK Transplant and the National Blood Authority (which managed the National Blood Service and the Bio Products Laboratory).

What does NHSBT do?

Our work is vitally important to the NHS. We need to collect around 8,000 blood donations every day to ensure a constant supply of blood to hospitals. Our work also makes some 5,500 organ and cornea transplants possible every year. In addition, we retrieve and store other tissues like skin and bone, ready for patient use. We manufacture a range of therapeutic products from blood plasma, and provide a number of related specialist services such as solid organ tissue typing and cord blood banking. We are responsible for the NHS Organ Donor Register (which has over 13 million names) and the British Bone Marrow Registry.

NHSBT - our staff
NHSBT employs approximately 5800 people across the three operating divisions of UK Transplant (UKT), Bio-Products Laboratory (BPL) and the National Blood Service (NBS) and group services such as finance, HR and Estates. Staff work in a variety of locations throughout England and North Wales. These locations include hired venues (such as church halls and community centres) where donors give blood, 13 blood centres from Newcastle to Plymouth, a plasma fractionation pharmaceutical factory at Elstree in Hertfordshire and UKT's headquarters in Bristol. About 65% of staff are female and 35% work part time. Our staff have a variety of jobs including biomedical scientists, doctors, nurses, managers, staff who look after blood donors, marketing professionals, drivers and many more. Our records show that only 82 (1.4%) people at UKT and NBS are disabled. This compares to approximately 10% in the population at large. This scheme seeks to develop a culture at NHSBT where we are positive about disabled people, and we want disabled people to feel that they can discuss their disabilities with their manager and human resources, to ensure that NHSBT proactively makes changes to their environment and way of working, to meet their individual needs.

What have we already done and what challenges are we facing?
NHSBT is not starting with a blank sheet of paper. This section describes what has been happening in the NBS (the largest of the three operating divisions with over 5000 members of staff) as well as the organisation's view of risk and how this influences what we do.
In 2004 Churchill, Minty and Friend, a leader in the field of disability, were asked to undertake a review of the NBS' response to disability. Their brief covered four areas. These were:

• the medical assessment of blood donors
• access for donors to blood collection venues (e.g. church halls and community centres)
• the buildings the NBS owns or manages
• our staff policies.

The report made a series of recommendations that we are still working through, some of which appear within this action plan.
A major influence on the organisation is risk, particularly when it comes to the safety of donors and patients. An example, not related to disability, was the introduction of leucodepletion. This is where we filter out white blood cells from donated blood to reduce the possible transmission of variant CJD (vCJD). When the decision was taken to introduce leucodepletion there was only a theoretical risk and the costs were considerable. Although the costs were high and the risks theoretical it was decided to implement this safety measure (and others) as soon as possible to provide better safety for patients. There are other examples too. The organisation's attitude to risk, for the protection of patients, donors, staff and others will be paramount. This will affect the nature and speed of the decisions we will take.
When it comes to blood donors, the emphasises will increasingly be on developing our staff and giving them the support to assess disabled people as individuals rather than applying blanket prohibitions. This will form a major plank of our action plan.

How was this Disability Equality Scheme developed?
This Disability Equality Scheme has taken several months to prepare and has involved many people, both within NHSBT and outside. These have included disabled people, managers who are responsible for service delivery, doctors and nurses who are responsible for the patients and blood donors, an external consultant who provided advice and a view from outside the organisation. The aim is to provide a Scheme that meets the needs of disabled people and is deliverable in the long term, particularly with respect to changing attitudes and behaviours to disabled people. The development of the Scheme has involved the Board of Directors, with the active and continuing participation of a Non-Executive Director. The Board have and will continue to receive updates on the development and implementation of the Scheme, and this will form part of the Board's performance monitoring.
Many people were involved in the development of this Scheme. Particular mention should go to the Steering Group whose members included:
Dr Margaret Bartle (NBS - Clinical); Jen Barwell (NHSBT - HR); Lindsey Batson (NBS - Donor Services); Phil Friend (Churchill, Minty & Friend), Dr Angela Gorman (NBS - Clinical), Deborah Jennings (NBS - Service Quality), Neil Phillips (NHSBT - Marketing Services), David Shute (UKT), Gill Travis (NHSBT - HR), Rob Warwick (NHSBT - Strategy Management).

Involving disabled people
A key element of this Scheme has been the involvement of disabled people, particularly seeking their views as to what was important, what was less important and where we need to focus in order to achieve the maximum benefit.
With respect to our staff, we wrote to each member of staff who was listed on our human resources database as having a disability. They were asked to complete a questionnaire. This included questions as to the nature of disability, the support they received from their manager and the nature and timeliness of adjustments made to their work. They were also asked if they would like to take part in regular focus groups to monitor future progress - this forms part of our action plan.

When it came to blood donors and those wanting to enrol on the Organ Donor Register we involved various disability organisations. Involvement focused on the following five areas:

• Physically disabled - e.g. stick and wheelchair users
• Visual impairments
• Deaf and hard of hearing
• Learning disabilities
• Mental health disabilities

We appreciate that this is just the start of our involvement with disabled people and we have much to learn. The action plan identifies how we will continue to engage with and learn from disabled people. This includes how we can improve clinical practice with the establishment of a Clinical Assessment Panel to consider new clinical issues.
We are also grateful for the involvement of Churchill Minty and Friend for their advice and support, particularly in relation to developing our approach to involving disabled people and developing practical solutions.

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4. Our staff and the people who work with us

Scope
This part of the Scheme covers all NHSBT staff, who work at BPL, UKT and the NBS as well as group services, including human resources, finance, facilities and IT.

Context for the NHSBT Staff
Strategic Objective
Our key strategic objective is:

To remove barriers and make reasonable adjustments to enable disabled people to be
employed, trained, and achieve job satisfaction and career progression within NHSBT.

Involving Disabled People
Questionnaires have been designed and distributed to members of staff who have declared themselves as disabled on the human resources (HR) database. We have also distributed questionnaires to their line managers and also HR staff who have been involved in disability in the workplace. Please refer to Appendix 1 for the findings. Appendix 1 includes important comments and barriers to disabled staff. These are cross-referenced to points in the DES action plan for "Our Staff and the People Who Work With Us."

A summary of recommendations for future involvement include:

• The Diversity Working Group at present does not have a disabled representative. This would be a valuable addition to the group.
• Contact those respondents who stated in the questionnaire that they would be interested in becoming more involved, at least initially with a phone call or email, considering the appropriateness of communication method selected.
• Include a section in our staff survey regarding disabled staff experiences and how disabled staff define themselves as disabled.
• Establish disability focus groups and systems for disabled staff to network, share experiences and establish support mechanisms.
• Use of experts, e.g. Scope, when involving people in impact assessments and identifying priorities, etc.
• Compiling list of useful contacts to be available to HR and managers.
  

Impact assessment summary table

Action plan - our staff

Action plan - purchasing
We recognise that our purchasing choices can make a big impact on disabled people. This section describes the actions we will take to ensure that procurement adequately covers the needs of disabled people.

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5. Blood donors, those wishing to enrole on the Organ Donor Register and others who come into contact with NHSBT

Scope
The following part of the focuses on the National Blood Service (NBS) and blood donors. The Steering Group took the view that there was direct relevance of NBS activities to that of UK Transplant (UKT) and Bio Products Laboratory (BPL). UKT's work with the general public is limited and is largely focused on the Organ Donor Register (ODR). This includes raising awareness of organ donation and UKT's website and call centre to register on the ODR. The Action Plan makes clear the activities that are of relevance to UKT. With BPL contact with patients and the general public is via the medicines it produces. Here there are tight regulations on what information is provided to patients and how. The Action plan on BPL reflects this.

Context for the National Blood Service
The National Blood Service is part of NHSBT, responsible for the provision of a safe and sustainable supply of blood, blood products and tissue to patients in England and North Wales. Our core objective as an organisation is to:

'Save and Improve Patients' Lives'.

We depend entirely on voluntary donations from the general public, and encourage existing donors to give three times a year. There are opportunities to donate blood in a wide variety of venues across England and North Wales - these range from village halls to company offices, to specially equipped mobile collection vehicles (bloodmobiles) and static donor suites.
The blood we supply is robustly screened to ensure it is safe for patients. Every year we collect, test, process, store and issue around two million units of blood and blood products.

Continual research into improving the safety of blood and blood products is an integral part of our work. We also provide specialist medical advice and clinical support to hospitals, as well as educating and training transfusion machine specialists.
This Disability Equality Scheme outlines our plans to meet our legal requirements and corporate objectives to fulfil the Disability Equality Duty with regard to the impact of our policies and procedures on our donors and potential donors.

Strategic Objective
Our key strategic objective is

To remove the barriers which prevent disabled people from donating
blood whilst ensuring safety to both donors and patients.

It must be noted that the requirements for patient and donor safety are paramount. Our actions to remove barriers to donating are considered against these fundamental principles. Consequently informed consent by the donor, to ensure the safety of blood for patients, and not compromising the health of the donor by the act of donating are key considerations.
The DES Donor Facing Steering Group was formed at the beginning of 2006 to lead and co-ordinate the work necessary to achieve this objective. The group is comprised of representatives from the Clinical Directorate, Marketing Services, Service Quality and the Donor Services Standards Department.

Success means

• The NHSBT Disability Equality Scheme is commended by disability groups
• Donor feedback about disabled issues reflects the changes that have been implemented

Review of Work to Date
Our starting point has been to identify the main issues for each of the five key disability groups (selected from current donor feedback) within our current donation process. The groups are:

• Visual impairments
• Deaf and hard of hearing
• Physically disabled - eg stick and wheelchair users
• Mental health disabilities
• Learning disabilities
  

The Donation Journey
We reviewed the whole donation journey to identify the parts of the process which may cause difficulties for disabled people. The journey is set out in the flow diagram below.

Donation Journey

Complete DHC - the DHC is the donor health check questionnaire; it may be completed at different stages of the donation journey.

Regional Nurse Clinical Groups (RNCGs) were set up at the beginning of 2006 to review the journey through the donation process and how it impacts on each disability group. This work included an in-depth review of our current policies, procedures and communications. The RNCGs worked in partnership with national and local disability organisations, and existing disabled donors and their relatives. These groups put forward recommendations, based on this partnership working, to the NHSBT DES Donor Facing Steering Group to progress and implement.
There were some key recurring themes throughout the reviews by the RNCGs and the DES Donor Facing Steering Group, which are summarised below.

Common themes

• Staff awareness and training
• Lack of information on donors' individual requirements
• Limitations on disability access and facilities at donation venues
• Communication media restricted access to participation and independence

Context for UK Transplant
UK Transplant (UKT) has a UK-wide remit, to ensure that donated organs are matched and allocated in a fair and unbiased way. Matching, particularly in the case of kidneys, is so important that donation and allocation needs to be organised nationally. The larger the pool the better the likelihood of a good match.
UK Transplant is also in a unique position in that we do not have a direct relationship with patients and do not provide "hands on" care. However, in providing support to transplantation services across the UK, everything we do has an impact on the quality of service delivered to individual patients.
UKT's specific responsibilities include:

• Managing the National Transplant Database which includes details of all donors and patients who are waiting for, or who have received a transplant
• Providing a 24 hour service for the matching and allocation of donor organs and making the transport arrangements to get the organs to patients
• Maintaining the National Organ Donor Register
• Improving organ donation rates by funding initiatives in the wider NHS
• Contributing to the development of performance indicators, standards and protocols which guide the work of organ donation and transplantation
• Acting as a central point for information on transplant matters
• Providing central support to all transplant units in the UK and Republic of Ireland
• Auditing and analysing the results of all organ transplants in the UK and Republic of Ireland to improve patient care
• Raising public awareness of the importance of organ donation.

Strategic Objective
Our key strategic objective is:

To work with colleagues throughout the NHS to do everything reasonable to remove the barriers
which prevent disabled people from accessing the services provided by UK Transplant

Success means

• The NHSBT Disability Equality Scheme is commended by disability groups
• Feedback about disabled issues reflects the changes that have been implemented

Involving disabled people and impact assessment
We have worked closely with disabled donors and disability organisations, involving them in the development of our DES. Through partnership working we aim to provide workable and beneficial changes and improvements to the services we provide, to give as many disabled people as possible the opportunity to donate.

Visual Impairments
Partnership Involvement
We worked closely with the following organisations throughout our review:

• Guidedogs for the Blind Association
• Royal National Institute for the Blind (RNIB)
• Southampton Society for the Blind
• Hampshire Association for the Care of the Blind
• Isle of Wight Society for the Blind
• Blind donors
• Action for Blind People
• Department for Work and Pensions

Visual Impairments
Impact Assessment
The key areas of impact for visually impaired people who want to donate are:

• Lack of recruitment information for potential donors. This limits the opportunity for visually impaired people to become donors.
• Invitation letters, general communication materials and documentation on session are in unsuitable formats. Donors may require another person to read the material to them with the resultant loss of independence and confidentiality.
• Lack of confidentiality when completing our donor health check questionnaire (DHC). The Health Care Professional (HCP) may need to ask the donor personal and intimate questions when assisting in completing the DHC, which might be overheard, as the DHC is not available in a suitable format.
• Staff's lack of clarity regarding whether guide dogs are allowed in the donation area which is a clinical environment. Donors with guide dogs may be turned away from session.

Deaf and hard of hearing
Partnership Involvement
We worked closely with the following organisations throughout our review:

• Royal National Institute for the Deaf (RNID)
• Hampshire Deaf Association (HDA)
• Happy Tots - Deaf Mums with hearing children.
• Remark - Provider of sub-titles.
• Deaf potential donor
• HAD, Deaf Awareness and Communication Tactics information sheet
• Inclusive Technology (www.inclusive.co.uk)
• British Deaf Association (www.bda.org.uk),
• Deafsign (www.deafsign.com)
• Centre for Professional Ethics, Keele University
• Plymouth Guild of Voluntary Service/ Hearing and Sight Centre

Deaf and hard of hearing
Impact Assessment
The key areas of impact on hearing impaired people who want to donate:

• Lack of awareness of availability of Minicom system at the National Contact Centre (NCC). Limited opportunity for hearing impaired donors to donate.
• Communication difficulties during health screening interview. Donors may be turned away inappropriately.
• Moving around the venue where donors are called by name. Hearing impaired donors may not hear and be aware that they have been called through to donate and
• embarrassed or inconvenienced, or miss their opportunity to donate.
• Lack of appropriate emergency procedures. Donors may be turned away inappropriately on Health and Safety grounds.
• Third party interpreters or signers are not allowed to participate in the health screening interview. Donors may be turned away from session.

Physically disabled
Partnership Involvement
We worked closely with the following organisations throughout our review:

• Department of Transport
• Churchill, Minty & Friend - training and disability consultancy
• Disabled Living Foundation
• Drivers Jonas - building consultancy
• RoSPA - People Handling Training
• Dr Rick Fox, Royal National Orthopaedic Hospital
• Dr Hari Boralessa, NBS Brentwood

Physically disabled
Impact Assessment
The key areas of impact on disabled people with physical or mobility difficulties who want to donate are:

• Venues with poor access for wheelchair users or disabled people with mobility difficulties. Donors may be unable to gain access to the blood donation session.
• Venues with poor facilities (eg parking or disabled toilets) for wheelchair users or disabled people with mobility difficulties. Donors may be unable to donate.
• Lack of clarity about the clinical impact of sitting in a wheelchair for donors who experience adverse reactions (eg fainting) either during or post-donation, or after leaving the session. Donors may be turned away.
• Staff's lack of clarity about how much assistance they are able to offer to donors who cannot get onto the donation bed unaided. Donors may be embarrassed and/or inappropriately turned away.
• Lack of appropriate emergency procedures. Donors may be turned away inappropriately on Health and Safety grounds.

Mental health disabilities
Partnership Involvement
We worked closely with the following organisations throughout our review:

• Mind
• Local Community Psychiatric Nurses
• Rethink
• Launch Pad - local mental health group

Impact Assessment
We recognise that this takes many different forms and these are the categories we have considered:

• Schizophrenia and paranoia
• Depression
• Bipolar disorder
• Anxiety or fear
• Dementia
• Obsessive compulsive disorder

Mental health disabilities
Impact Assessment
The key areas of impact on people with mental health disabilities who may want to donate are:

• Memory loss/concentration. This may cause a misunderstanding of the process and make it difficult to give informed consent
• Anxiety or fear. This may cause nausea, diarrhoea and vomiting and an urgent need to visit the toilet; also a possible loss of concentration. These could result in disruption of the donation process
• Anger. This could lead to difficulties in communicating with staff and donors being turned away
• Understanding the donation journey and how it will affect them. This may result in anxiety, make it difficult to give reliable informed consent and cause disruption to the donation process
• Medication. Blood donation may disrupt the stability of the medication or condition with a consequent impact on the donor's well-being

Learning disabilities
Partnership Involvement
We worked closely with the following organisations throughout our review:

• RCN Learning Disability Forum
• Campaign for Plain English
• Relatives of adults with learning disabilities
• Foundation for People with Learning Disabilities (www.learningdisabilities.org.uk)
• Mental Health Foundation (www.mentalhealth.org.uk)
• Dyslexia Action (www.dyslexiaaction.org.uk)
• Learning about Intellectual Disabilities and Health (www.intellectualdisability.org)
• Making Decisions Alliance (www.makingdecisions.org.uk)
• Department of Health (www.doh.gov.uk/consent)

Learning disabilities
Impact Assessment
We recognise that this takes many different forms and these are the categories we have considered:

• Down's Syndrome and other chromosome disorders
• Autism
• Asperger's Syndrome
• Dyslexia/dysphasia

The key areas of impact on learning disabled people who may wish to donate are:

• Possible misunderstanding of health screening interview. This may make it difficult to give informed consent and lead to risk for donor or recipient
• General communication during donation process . This may lead to risk for the donor as they cannot inform staff of any difficulties they are experiencing
• Staff may not have adequate training or experience of relating to learning disabled people. Donor does not receive appropriate response and may be deferred inappropriately
• Donor may experience adverse reactions (eg fainting) after leaving the session and be unable to communicate this to others. Donor's health is put at risk

Conclusion
Donor safety and blood safety are our overriding priorities and these are reflected in the donor selection guidelines which must be applied to all potential donors. There are some people we are currently unable to accept as donors because of possible risks to their health. Additionally we must have informed consent to ensure the safety of blood for patients. This raises other issues around effective communication and understanding.
From our work with organisations representing disabilities across physical, mobility, learning and mental health we recognise that there are a wide range of disabilities and differing needs. The work has identified a number of existing aids and good practice which need to be advertised and shared across the NBS and with our donors.
However, it has also identified that our knowledge and our approach across the organisation is not consistent to the differing needs of actual or potential donors and this needs to be addressed. In the past we have applied a very broad-brush approach to our donor selection guidelines. The result has been that many disabled people have been excluded from becoming blood donors because of their disability. There is currently some inconsistency in the application of the donor selection guidelines and responses to queries (for example on grounds of donor understanding or safety) which clearly lead to frustration for all concerned.
We are committed to further improve our knowledge of the different disability issues, facilitate people from these groups to safely donate and robustly support our staff in doing so confidently and professionally.

Clinical Assessment Panel
The Clinical Assessment Panel (CAP) was set up in 2006 to consider the current donation guidelines and in particular their application to disabled people who want to donate. The CAP will identify best practice and the reasonable adjustments that can be made, and provide clarity about the approach that safely meets the requirements of the DDA and DES. They will be the 'collective memory' for the NBS, ensuring that expertise and experience is widely shared around the country.
The Panel will provide help to doctors and nurses around the country for queries and help in dealing with the individual cases that need to be managed on session, or through feedback from donors. We recognise that many disabled people may be able to donate and they should be considered on an individual basis to give them the best possible opportunity to do so.
The CAP comprises two NBS doctors and two Regional Nurses who will link in with and take advice from relevant disability organisations or consultants specialising in the relevant field as appropriate. See Appendix 2 for more details.

Action plan

How will we put our scheme into action?
We will be reviewing the Disability Equality Scheme at least annually. Regular reports and updates on the development and implementation of the scheme will be made to the NHSBT board, forming part of their performance monitoring.
We will undertake a complete review of the scheme after three years, learning from our experiences and feedback, to ensure that the content and direction of the scheme are still focussed on delivering improvements.
We will continue to work closely with disabled people, not only at the formal review, but involving them in our planning and decisions, to ensure that we deliver changes that are important, relevant and are of maximum benefit.

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6. Appendix 1: HR questionnaire responses

Comments and barriers from questionnaire respondents, cross-referenced to action plan

DES questionnaire analysis

HR questionnaire feedback

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7. Appendix 2: Clinical Assessment Panel

What is the Clinical Assessment Panel?
A small group of two doctors and two regional nurses comprise the Clinical Assessment Panel, set up in August 2006 to develop clear organisational guidelines that will support disabled persons to donate safely whenever possible.

Why has the Panel been formed?
The Disability Discrimination Act 2005 requires NHSBT, as a service provider, to promote equality of opportunity and make 'reasonable' adjustments to overcome institutional discrimination.
As a public authority we also have a specific duty to provide a Disability Equality Scheme by 4th December 2006. In brief the scheme must outline how we have involved 'stakeholders', and prioritised actions and resources to focus on effective change.
The Clinical Assessment Panel has been formed to support the work of the DES Donor Facing Steering Group in researching, prioritising and organising the many actions that need to be undertaken to help us meet these statutory requirements.

What will the Panel Do?
The panel will consider the current donation guidelines and in particular their application around the country. They will identify best practice, the reasonable adjustments that could be made and provide clarity about the approach that safely meets the requirements of the DDA and DES. They will be the 'collective memory' for the NBS, ensuring that expertise and experience is widely shared.

• Importantly the panel is a resource for doctors and nurses around the country for queries and help in dealing with the individual cases that need to be managed on session or through feedback from donors.
• Individual HCPs need not feel they must decide locally or on the day but can defer and then refer to the panel, with appropriate explanation to the potential donor.
• The panel also wants to be informed of local solutions so these can be added to the organisation's 'collective memory' and the development of best practice.

At present there is some inconsistency in the application of donation guidelines and responses to such queries (for example on grounds of donor understanding or safety) which clearly lead to frustration for all concerned. These probably result from the general culture and approach that have developed within the organisation towards donors and potential donors who do not meet the 'usual donor profile'. However it must be recognised that there are areas of excellence around the country where extra efforts are made to support donors with physical, sensory or learning disabilities in making successful donations

What is the DES Donor Facing Steering Group doing?
Identifying the key issues for donors or potential donors with disabilities and how the organisation can safely meet its statutory requirements. This is much broader than clinical considerations and covers practicalities of access and communication methods prior to, during and after donation. Although many adjustments are long term projects which need careful planning, some short term practical quick wins will be implemented in the next six months. Work includes:

• Venue Assessments (VA) - a building consultant specialising in disability access has reviewed our current VA paperwork on session and will be making recommendations as to possible changes; the key here will be 'reasonable' adjustments.
• Resource Packs to guide and support session staff produced by local groups led by regional nurses, with the involvement of local disability groups
• A new short training pack which aims to incorporate disability awareness into daily activities and give staff confidence in dealing with disability issues.

How does this affect me?

• Please ensure your management teams and all HCPs are aware of this briefing and in particular the existence of the panel, the reasons why it has been formed and the contact details.
• The panel exists as support for staff facing new circumstances and individual donors' requests under the DDA. No individual or team should feel they are alone when dealing with a DDA issue and can contact or refer issues to the panel directly.
• We also ask that you ensure Disability Issues are a regular feature of local collection and management meetings.

Contact Details.
Linds Batson (Chair of DES Donor Facing Steering Group)
Clinical Assessment Panel:
Dr Angela Gorman, Donor Services Consultant
Dr Margaret Bartle, Donor Services Medical Officer
Trudy Redford, Regional Nurse
Hilary Horrobin, Regional Nurse