Abstract
Background Around 53% of the world’s population have no access to the benefits of sight saving and sight restoring transplantation surgery due to a short fall in the supply of ophthalmic tissue that is only available via eye donation (ED). In England the National Health Services Blood and Transplant (NHSBT) seeks to have a consistent and sustained supply of eye tissue to satisfy current demand, however, historically and currently there is gap between supply and demand. Data reports that between April 2020 - April 2021, 3,478 corneas were donated a 37% decrease on the previous year figure of 5,505 corneas. In view of this shortfall other routes to supply are needed with Hospice Care and Hospital Palliative care settings being a potential route.
Aim As Health Care Professionals (HCPs) are the gatekeepers to the option of ED being raised with patients and family members this presentation will share findings from a national survey carried out with HCPs across England between November/December 2020 seeking knowledge related to i) current practice across the ED pathway, 2) views of HCPs toward embedding ED in routine end of life care planning; and 3) what current informational, training, or support needs are reported by survey participants.
Findings One hundred and fifty-six participants completed the online survey, representing an 8% response rate (of n=1894 approached). Responses to a 61-item questionnaire indicated that: the majority of respondents were aware of ED as an end-of-life option, however, despite the reported perception of most participants that discussing ED was not distressing to patients and family members the option of ED was only discussed IF the patient or family member first raised the topic. Currently most care settings do not actively encourage the option of ED being discussed with patients and/or their family members, nor is ED routinely discussed in multi-disciplinary meetings. Furthermore, when asked about training related to ED, 64% of participants (n = 99/154) said they had unmet training needs.
Conclusion Findings from this survey indicate a paradoxical stance toward ED among HCPs in hospice and palliative care settings; that is, substantial support for and positive attitudes toward inclusion of ED in end-of-life planning (including within their own practice), aligned with low levels of activity in offering the option. There is very little evidence of eye donation being embedded in part of ‘routine’ practice, and this may be linked to unmet training needs.
