REIMBURSEMENT OF A LIVING ORGAN DONOR’S EXPENSES BY THE NHS

High-visibility version

by Dr Peter Doyle, Department of Health (UK)

The position of the Department of Health in relation to reimbursement of a living organ donor’s expenses is as set out below.

The Human Organ Transplants (HOT) Act, 1989 forbids the offer or payment of any inducement for the supply of a human organ. However, it does not prohibit the payment of reasonable expenses to a donor for travel and accommodation and any loss of earnings incurred if directly attributable to his/her donation of an organ.

NHS Trusts, Health Authorities and PCTs are permitted to make such payment and should do so if the live transplant is permitted under the HOT Act. The NHS is not legally obliged to make such payments. However, as a renal transplant is the most cost effective treatment for end stage renal failure (and may be the only treatment available for some other live donation procedures) payment of the cost of the donor operation, with or without expenses, is justified.

Renal transplantation now comes under the regional specialised services commissioning arrangements. Whether the NHS Trust, the Health Authority or the PCT actually refunds the donor is a matter for those commissioning arrangements but should be agreed beforehand and the method of making a claim and receiving payment explained to all concerned. The service agreement should be explicit about how any such payments are to be made, whether by the Trust or by an application to the Health Authority or the Primary Care Trust.

The level of any reimbursement will depend on any other sources of reimbursement available to the donor. Absence from work could be 6-12 weeks and those in employment may not be entitled to be paid their full salary (or even a reduced/basic rate) for all periods of sickness absence. An employer may not be willing to pay anything for “voluntary sickness” (although many employers will wish to fully support such a generous act). Some may be able to claim statutory sick pay but will probably wish to contact their local DSS office as well as discussing it with their employer. If the donor is a member of a union they may want to seek advice on their rights from their union. It may be more difficult to calculate expenses and travel costs when the donor is coming from abroad.

It is of particular importance that any such expenses are only reimbursed by an HA or Trust and not by the family of the recipient. Any payment, even of reasonable expenses, by the family could be interpreted as an inducement.

The final decision as to whether expenses will be paid rests with the commissioners following consultation with the Trust.

DR PETER DOYLE
Senior Medical Officer
Department of Health (UK)

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.

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