Review of the implementation of the national reform agenda on organ and tissue donation and transplantation

Page last updated: 01 February 2016

Review of the implementation of the Australian Government’s national reform agenda on organ and tissue donation and transplantation, with reference to the role of the Australian Organ and Tissue Donation and Transplantation Authority (known as the Organ and Tissue Authority, OTA) and the wider health system’s response.


Final Report


The Minister for Rural Health, Senator the Hon Fiona Nash, announced the public release of the Final Report of the Review of organ and tissue donation and transplantation on 2 February 2016. The Review’s Final Report, conducted by Ernst and Young, examines the effectiveness of the implementation of the national reform agenda on organ and tissue donation and transplantation.
The Final Report is available now below:
Review of the implementation of the national reform agenda on organ and tissue donation and transplantation (PDF 802 KB)
Review of the implementation of the national reform agenda on organ and tissue donation and transplantation (Word 2569 KB)
The report contains 24 recommendations, including:
    • Strategies to increase organ donations
    • Governance arrangements for the OTA
    • Audit of donation practices
    • Funding policy, and
    • Awareness and donor family support strategies
A Government response to the recommendations of the Review is soon to be released and the Department of Health will be working with the Australian Organ and Tissue Donation and Transplantation Authority, state and territory governments and other key stakeholders as to next steps.

Review Terms of Reference

A. Having regard for the objectives and elements that were agreed by COAG when endorsing the national reform agenda in 2008 (see below), and the goals that governments subsequently endorsed, the review will investigate and report on:
    1. How effectively the programme has been:
      (a) led by the OTA, particularly through:
        i. translating the national agenda into programmes;
        ii. communicating programme aims, and negotiating programme methods with states and territories and other relevant stakeholders; and
        iii. monitoring and reporting on performance.
      (b) translated into policy and practice by state health authorities and DonateLife agencies; and
      (c) delivered by hospitals and DonateLife and other staff directly involved in the donation or transplantation of organs.
    2. The key factors that have influenced the pace and extent of the achievements to date.

    3. The relevance and utility/value of: the performance and progress reports issued about the Programme, and; the measures used to assess and report on performance, progress and achievement against targets.

B. In light of findings in relation to A., the review will make recommendations on any changes in the design, administration, delivery, monitoring, reporting, or other aspect of the Programme that would improve:
  1. progress towards, and achievement of, the national goals and targets; and/or
  2. value for money.

C. The review will have regard to:
  • Australian Healthcare Associates, Organ and Tissue Donation Reform Package, Mid-Point Review Report, July 2011.
  • Australian Government, Response to the Mid-Point Implementation Review of the National Reform Agenda – a World’s Best Practice Approach to Organ and Tissue Donation in Australia.
  • Australian National Audit Office, Report No.33, 2014–15, Performance Audit Organ and Tissue Donation: Community Awareness, Professional Education and Family Support, Australian Organ and Tissue Donation and Transplantation Authority, April 2015.

D. In addition to reviewing relevant data and written information, the reviewers will consult with:
  • The Chief Executive Officer and the Chair and members of the Advisory Council of the AOTDTA;
  • Relevant executives in State and Territory Departments and Ministries of Health;
  • Relevant executives in Local Hospital Networks and public hospitals;
  • Relevant lead clinicians in participating public hospitals; and
  • Other key stakeholders as identified by the reviewers.

Appendix National reform programme

On 2 July 2008 the Australian Government announced a national reform programme to implement a world’s best practice approach to organ and tissue donation for transplantation, which was endorsed by the Council of Australian Governments on 3 July 2008.

The Australian Government aims to improve access to life-transforming transplants for Australians through a sustained increase in the donation of organs and tissues by implementing a nationally coordinated approach to organ and tissue donation.

Evidence from comparable countries demonstrates that a coordinated national approach, focused on clinical practice reform, improves organ donation and transplantation rates.
The twin objectives of the national reform programme are to:
  • increase the capability and capacity within the health system to maximise donation rates; and
  • raise community awareness and stakeholder engagement across Australia to promote organ and tissue donation.
The nine key elements of the national reform programme are:
  • Establish a new national approach and system for organ and tissue donation: a national authority and network of organ and tissue donation agencies;
  • Establish specialist hospital staff and systems dedicated to organ donation;
  • Provide new funding for hospitals;
  • Provide national professional education and awareness;
  • Provide coordinated, ongoing community awareness and education;
  • Provide support for donor families;
  • Establish a safe, equitable and transparent donation and transplantation network;
  • National eye and tissue donation and transplantation; and
  • Undertake additional national initiatives, including living donation programs.
These activities are managed by the AOTDTA through the DonateLife Network, in partnership with state and territory governments, eye and tissue banks, community organisations and the broad donation and transplantation clinical sectors.