Liver Advisory Group


Terms of Reference for Organ Specific Advisory Groups - Liver Advisory Group

The major role of the organ advisory groups is to advise NHSBT is to help promote all aspects of organ transplantation and ensure equity of access and best outcomes for all patients.

Membership

Chair:

Appointment: applications will be invited from transplant health care professionals and the Chair will be appointed by NHSBT after consultation with the relevant Advisory Group.

Tenure: The Chair will be appointed for 3 years in the first instance, with the possibility of renewal for a subsequent term.

Remuneration: The Chair will receive from NHSBT a Special Duty Payment.

Support: The Chair, and the Advisory Group, will have defined administrative and statistical support from NHSBT to help deliver the aims of the group.

Appraisal: the Chair will meet the Associate Medical Director for Organ Donation and Transplantation every year for a formal review of progress made, to agree targets for future work and a work plan.
Members:

Membership of the Advisory Group will include:

Chair

Associate Medical Director ODT

Relevant NHSBT Statistician

Voting members:
Two clinicians from each Liver Transplant Centre

One representative for paediatric recipients
Non-voting members:
Representative from NCG/commissioning groups

Representatives from the national Departments of Health
Others who may attend:
Representation from the Clinical Effectiveness Unit, Royal College of Surgeons

Representatives from the Republic of Ireland

Director of Organ Donation and Transplantation (ODT)

Associate Director for Statistics and Clinical Audit

Assistant Director, Organ Donation (ODT)

Head of Nursing Development, (ODT)

Clinical Leads for Retrieval and for Donation
The Chair, in discussion with voting members of the Group, may include other representatives from relevant professional bodies, societies and Colleges

Members will be responsible for bringing to the Advisory Group any relevant concerns or suggestions from the centres they represent and items for the agenda. They are also responsible for circulating minutes and other items of relevance within their organisation (to clinicians, managers and other relevant parties)

Members of the Group will also be responsible for responding to relevant items on the agenda brought forward by the Chair or Associate Medical Director (ODT).

Deputy Chair: the Advisory Group will agree a Deputy Chair who will assume the role and duties of the Chair when the Chair is unavailable or when there are possible conflicts of interest or at the request of the Chair.
Voting:

Each unit and the paediatric representative will have one vote each. If an agreement cannot be reached by consensus, a vote will be taken: a majority will be binding.

The Chair will have a casting vote but will not take part in the initial vote.
Frequency of meetings

The Advisory Group will meet at least twice a year at a venue to be agreed.
Sub-committees

It is anticipated that the Advisory Groups will have sub-committees to address specific aspects of transplantation or issues; the nature, membership, frequency, lifetime and venue of these meetings will be at the discretion of the Advisory Group. Teleconference work is encouraged.

These sub-committees will report formally to the Advisory Group.

It is anticipated that the Advisory Groups will wish to have sub-committees to address specific aspects of transplantation or other issues; the nature, membership, frequency and venue of these meetings will be at the discretion of the Advisory Group. These sub-committees will report formally to the Advisory Group.

LSAWP: The Liver Selection and Allocation Working Group (LSAWP) will meet usually six times per year; each centre will send at least one representative. Statistical support from NHSBT, Republic of Ireland representatives and others may come as observers, but the recommendations of LSAWP will be agreed by the member centres.

R&D: The Advisory Group will appoint a sub-group which will be responsible, to the Advisory Group and to ODT, for assessing applications for data that is held by ODT: the Group should assess the scientific validity of the request, the analytical methodology, the output and ensure that all interested parties are in support of the application and are recognised in any output (such as an abstract or manuscript); the sub-group should also indicate the priority of each application so that the Associate Director of Statistics and Clinical Audit can prioritise the available resources. This group will also be responsible for assessing aspects of research, research grants and supporting clinical research.

Governance: The Advisory group will appoint a sub-group which will meet as required to discuss issues of governance. The group will work closely with the ODT Clinical Governance Monitoring Group and assess, and, if appropriate, investigate, all relevant instances of non-compliance, errors and near-misses.
Minutes

The minutes of each meeting will be taken by the NHSBT Secretariat.

The minutes and all papers of the Advisory Group meetings that could be requested under the Freedom of Information Act will be published (when approved) on the NHSBT website, unless they contain patient-identifiable material.

Minutes will be circulated electronically to units.
Budget, Statistical and Analytic support

The group will be allocated an agreed budget, administered by NHSBT, which will include travel expenses, hosting of meetings, working parties, consensus meetings and other relevant activities. Accountability for the budget will be with the Chair of the Group but the budget will be held within ODT.

Each Advisory group will be allocated an agreed level of support from NHSBT Directorate of Statistics and Clinical Audit to support the activities of the group: this support will be used for analysis of outcomes, audit, governance issues, service evaluation, modelling of alternative methods of service delivery and other projects, agreed with the Chair of the Advisory Group, the Associate Director of Statistics and Clinical Audit and the Associate Medical Director ODT.

The Chair of the Group, Associate Director of Statistics and Clinical Audit and Associate Medical Director will meet at least every 6 months to agree the agenda, new projects agreed by LSAWP and LAG and assign priorities.

Administrative Support

The Corporate Services section of ODT will provide an agreed level of administrative support, to help with the planning and organisation of meetings, minute-taking and other relevant matters.
Role of Advisory group

The Advisory Group will:
  1. Consider formally at each 6-monthly meeting and advise NHSBT on operational aspects of transplantation including
    • organ retrieval
    • recipient selection criteria
    • methods of organ allocation
    • data analysis with respect activity and outcome
  2. Recommend, as necessary, promote and implement changes to the nationally agreed protocols
  3. Advise NHSBT and other bodies on appropriate methods of monitoring outcomes and interpretation of findings
  4. Monitor and report on clinical governance with especial reference to:
    • Outcomes and deviations from expected outcome
    • Deviation from agreed protocols in selection and/or allocation
    • Equity of access of patients to transplantation throughout the UK
    • Evaluation and comments on issues raised by investigations into triggers from outcomes analysis, investigations and other issues
  5. Identify and promote areas of audit and research.
  6. Remit to ODT matters of practice or policy that require consideration within a broader framework.
  7. Liaise as necessary with the British Transplantation Society and other professional bodies in the development of national standards
  8. Provide 6 monthly reports of clinical governance
  9. Respond to and advise on implementation of aspects of donation and transplant policy that arise from legal and/or policy developments both within the UK and more widely.

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