Ocular Advisory Group
Terms of Reference for Organ Specific Advisory Groups - Ocular Advisory Group
The major role of the Ocular Tissue Advisory Group is to advise NHSBT to help promote all aspects of ocular tissue transplantation and ensure equity of access and best outcomes for all patients.
Appointment: applications will be invited from transplant health care professionals and the Chair will be appointed by NHSBT.
Tenure: The Chair will be appointed for 3 years in the first instance, with the possibility of renewal for a subsequent term of two years.
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.
The Chair, together with the Associate Medical Director, will meet, at least annually, with relevant, interested parties, including patient representative bodies, patient groups and disease-specific patient bodies.
Membership of the Advisory Group will include:
Representation from ocular tissue transplanting centres within each designated strategic regional health authorityNon-voting members:
Two representatives from the Eye Banks (one from the CTS eye bank and one from the non-CTS eye banks
Two representatives from the Royal College of Ophthalmologists (RCO) (nominated by the RCO Ocular Tissue Transplant Standards Group (OTTSG)).
Eye Retriever Representative
Representative from commissioning groupsThe Chair, in discussion with members of the Group, will co-opt other appropriate members.
Representatives from the national Departments of Health
Director of Organ Donation and Transplantation (ODT)
Associate Medical Director ODT
Chair of the SACT-TTP
Associate Director of Statistics and Clinical Studies
Representative from NHSBT Tissue Services
Transplantation Support Services Management Lead
Other members co-opted by the Advisory group
Members will be responsible for bringing to the Advisory Group any relevant concerns or suggestions from the centres they represent: where possible this should be in writing so that the paper can be circulated prior to the meeting. Members are also responsible for circulating minutes and other discussion items and items of relevance within their organisations (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.
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, when there are possible conflicts of interest or at the request of the Chair.
There will be members representing the designated eye transplant units (within each SHA). The representatives will be chosen by the groups they represent. Each representative will be appointed for a period of 3 years but may be re-elected.
To ensure continuity of the work of OTAG, the selection process will be held so that one third of the regions select or re-select representatives each year on a rotational basis.
Each representative is responsible for passing on the concerns of all the units they represent and passing back recommendations of OTAG.
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.
The Advisory Group will meet at least twice a year at a venue to be agreed.
There will be four standing sub-groups of OTAG:
This group will review reported adverse events and reactions and outcomes, review action plans), review applications for access to data and research proposals. The group will also review existing guidelines on selection, allocation and monitoring of outcomes and collaborate with OTTSG in the establishment, development and implementation of clinical standards
Audit, Clinical and Research Sub-group
This sub-group will be responsible to OTAG for suggesting and coordinating audits, review and approve (where appropriate) applications for access to data and review and initiate clinical research studies and make recommendations to OTAG. This subgroup will liaise with the OTTSG to deliver the above.
Ocular Tissue Retrieval and Allocation sub-group
This group will develop and review policies for donor and recipient selection, and selection and allocation of donated ocular tissue
Eye bank sub-group
This group will develop and review the standards and functioning of eye banks and eye retrieval teams.
Because the Ocular Tissue Retrieval and Allocation sub-group and Eye Bank sub-group will overlap in some activities, it is suggested that either there is formal representation from one sub-group on the other or that the two groups amalgamate for some of their work
The frequency of the sub-group meetings will be at the discretion of the Sub-group and reviewed every three years.
Memberships of sub-groups
The Chair and membership of each sub-group will be determined by OTAG. 4.3.2 The Chair of OTAG will not normally be Chair of a Sub-group but may attend as a non-voting member.
Each sub-group will have one representative from the RCO (nominated by the OTTSG) and one representative from the Eye banks.
These sub-groups will report formally to each meeting of OTAG.
Policies and standards will be proposed to OTAG and, when accepted, will be forwarded to the Clinical Governance Committee of ODT and then to the ODT Senior Management Team and Transplant Policy Review Committee for formal endorsement by NHSBT.
Advisory groups will hold open meetings where there will be a wider representation of the transplant community.
The minutes of each meeting will be taken by the NHSBT (ODT) Secretariat and consist of a brief summary and action points rather than full, detailed minutes.
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 web-site, unless they contain patient - identifiable material.
Minutes will be circulated electronically.
OTAG 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.
Statistical and analytical support
OTAG will be allocated an agreed level of support from the Directorate of Statistics and Clinical Studies 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 Studies and the Associate Medical Director ODT.
The Chair of the Advisory Group, Associate Director of Statistics and Clinical Studies and Associate Medical Director will meet at least every 6 months to agree the agenda, new projects and assign priorities.
The Clinical and Support 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.
The Advisory Group will:
- consider formally at each 6-monthly meeting and advise NHSBT on operational aspects of transplantation including
- donor selection criteria
- recipient selection criteria
- methods of tissue allocation
- data analysis with respect to activity and outcome
- outcomes and deviations from expected outcome
- deviation from agreed protocols in selection and/or allocation
- equity of access of NHS entitled patients to transplantation throughout the UK
- evaluation and comments on issues raised by investigations into triggers from outcomes analysis, investigations and other issues
Consideration of selection and allocation will require clarification of the aims of the processes, proposals to measure the outcomes and regular audit to ensure the criteria are followed and adjusted as indicated.
Protocols and policies agreed by the Advisory Group will, prior to implementation, need ratification by the Board of NHSBT.
Equity (in the context of this document) implies that a potential NHS entitled recipient anywhere in the UK will have the same likelihood of being placed on the transplant list and a patient on the transplant list has the same probability of receiving a graft, wherever in the UK he/she resides and at whichever transplant centre the patient is registered. The chance of death and/or removal from the list is irrespective of location and the outcome after transplantation (both short and long-term) will not be affected by centre.
OTAG will identify areas where new or revised national guidelines relating to transplantation are needed; where appropriate, NHSBT will then commission the appropriate professional body to develop the guidelines and, if adopted, these guidelines will be endorsed by NHSBT. These guidelines must be patient, rather than centre, focused and consistent with all current national legislation. Next section: Transplant Policy Review Committee