• Why are you doing this?
• What exactly are you doing?
• Why are you doing this now?
• Who does it affect?
• From what period do the body parts date?
• How do people get in touch and what information do they need to give you?
• How quickly will people learn if they have loved ones’ body parts with you?
• What information will people receive?
• How quickly will they get organs or tissue back?
• If people have enquired in the past about body parts and been told that you held nothing, should they contact you again?
• Were these body parts taken with consent?
• How were these body parts taken, and why?
• What will happen to the unclaimed parts?
• Will there be a ceremony for the unclaimed parts?
• Have you consulted with local or national parent groups about doing this?
• What is the organ retention policy now?
• Which other Trusts have been doing this?

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Why are you doing this?
A five year national moratorium was imposed by the Department of Health following publication of the Redfern Report, and prohibited the disposal of organs and tissues obtained at post-mortem examination prior to that date, unless appropriate consent of the next of kin was obtained. The moratorium provided time for concerned relatives to make enquiries from relevant organisations about the retention of post-mortem organs or tissue samples.

The moratorium was lifted in July 2006 and allows all NHS organisations to begin the process of respectfully interring any unclaimed organs and tissue samples according to the Human Tissue Authority’s Code of Practice (2006).

Those organs or tissue samples which are now being released for respectful interment are identifiable but about which no enquiry has been received.
 

What exactly are you doing?
From 30 June 2009, the Trust is providing a final opportunity for relatives to make contact with us and find out if we have organs or tissue of their deceased family member.

We are making every effort to be as respectful and as sensitive as possible.
The window for relatives to come forward and make contact with us will last for six months until 30 December 2009. After that, we will begin the process of respectfully disposing of any unclaimed organs and tissue samples in accordance with the Human Tissue Authority’s Code of Practice (2006).

We would like to reassure everyone that the Trust doesn’t wish to cause further distress to bereaved relatives. However, it is necessary to implement a public information process to give those who did not come forward before a chance to do so now before the tissues are disposed. We are following HTA guidelines very closely and have been speaking to other Trusts which are further down the line with this programme to learn from them and gain a better understanding of best practice.

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Why are you doing this now?
The practice prior to the Redfern Report was to retain organs or tissue samples for 10 or 15 years prior to disposal, in case they were required to be re-examined for the benefit of the family.

We need to do this at a time when it is correct to dispose of all the tissues that we hold, so we are going ahead now as it is approximately ten years since organs and samples were retained without clear consent or knowledge of the next of kin.

This window will last for six months until 30 December 2009. After that, we will begin the process of respectfully disposing of any unclaimed organs, and tissue samples according to the Human Tissue Authority’s Code of Practice (2006).
 

Who does it affect?
This programme will be of interest to relatives of children and adults who had a post-mortem examination at QMC or City Hospital mainly between 1978 and 1999. However, we will undertake investigations on behalf of anybody who is concerned about organ retention.
 

From what period do the body parts date?
The organs and tissue samples date mainly from between 1978 and 1999. They were collected from post-mortem examinations carried out during this period.

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How do people get in touch and what information do they need to give you?
If someone wishes to get in touch with us they should call the helpline number on 0800 9175174. This is a dedicated and free telephone number and those people manning the line will be able to best direct enquiries. It will be available to call 24 hours a day, seven days a week.

Anyone can make an enquiry but information will only be given to close family members, the parents of a child or the next of kin. It may be advisable for people to discuss making an enquiry with other family members before deciding to go ahead. Once they have decided, they may want to agree within the family who is the best person to make the enquiry.

Callers should have the details (name, date of birth, address) of the deceased to hand, as well as a pen and paper to make any notes. Details will be taken from callers at this initial stage and passed on to the department at the Trust that will be dealing with enquiries. This department will then make contact with those people who have called in.

The questions that may be most often asked by relatives once they speak to the Trust are:

• Was there a post mortem examination?

• What organs and/or tissues have been kept?

• Whose decision was it to keep organs or tissue?

• Why were they kept?

• Why wasn’t my consent sought?

• Are they still kept at the hospital?

• Have they been taken to another hospital?

• Can I have the organs and/or tissue returned to me?

• How is the issue of organ retention being dealt with now?

Families can ask for copies of medical records and post mortem examination reports. These might be distressing and in some cases quite technical. We will do everything that we can to help families to minimise distress and to ensure that they get the appropriate support.
 

How quickly will people learn if they have loved ones’ body parts with you?
It depends on the number of enquiries that are received as to how long it will take to deal with the enquiries. If there are not many enquiries then it will be a matter of weeks. This is to enable thorough checking of the records and to enable us to be absolutely sure that the correct information is given.

Further information about this process is available at www.nuh.nhs.uk or by calling the free helpline number on 0800 917 5174 where they will be guided through the process. It will be available to call 24 hours a day, seven days a week. Details will be taken from callers at this initial stage and passed on to the department at the Trust that will be dealing with enquiries. This department will them be back in touch with those people who have called in.

Nottingham University Hospitals will ask enquirers how they would like to receive the information. It will be either by letter, telephone or at a meeting. They can choose the method that is best for them. All information given verbally will be confirmed in writing by the Trust.

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What information will people receive?
They should receive information that will say that:

• no post mortem examination was carried out; or

• a post mortem was carried out and, if so, whether any organs and tissue were kept, and what may have happened to the organs and tissue.
   

How quickly will they get organs or tissue back?
It is difficult to give a set time frame as individual cases are likely to differ. We will endeavour to keep people who make enquiries as informed as possible with developments.
 

If people have enquired in the past about body parts and been told that you held nothing, should they contact you again?
If someone has previously been in touch with us and was told that we didn’t hold anything, it is unlikely that the situation would have changed. We would not recommend calling.
 

Were these body parts taken with consent?
The organs and tissue were either taken under the authority of the coroner – for which consent was not required, or taken with consent to a post mortem examination. However, it is now accepted that most people didn’t understand to what they were consenting. This was common practice across the country and not unique to our hospitals. The items were taken for the purposes of diagnosis and research.

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How were these body parts taken, and why?
Organs or tissue would have been taken during post mortem examinations carried out by a pathologist (a doctor who specialises in the diagnosis of disease by studying tissues).

They would have been taken for further examination for diagnosis and to help with research into a range of diseases and illnesses.
 

What will happen to the unclaimed parts?
At the end of the six-month period where people have the opportunity to come forward, items not claimed will be disposed of according to hospital policy, which is via incineration with other human tissues only.
 

Will there be a ceremony for the unclaimed parts?
We do not know the religious persuasion of any of the families involved and to perform any form of ceremony could potentially cause offence.
 

Have you consulted with local or national parent groups about doing this?
Most of the national parent groups that were active at the time of the Alder Hey enquiries are now discontinued. We are following national guidance very closely and are taking a measured and proportionate approach to awareness-raising. We have also been in discussions with other NHS trusts which are further down the line with this programme. We are listening to them to gain a better understanding of best practice and are following this guidance at every stage of the process.

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What is the organ retention policy now?
The Trust’s Consent to Post Mortem examination policy accords with the Human Tissue Act. NUH must have full, clear consent from relatives before we can retain organs and tissue from a post mortem examination to which they agree. The Trust has been very proactive in working with local coroners to ensure that next of kin are clearly informed where tissue is retained under a coroner’s authority and that appropriate choices are offered for what happens to the tissue once the coroner’s has completed his investigations.
 

Which other Trusts have been doing this?
We aren’t the first Trust to be undertaking this programme. Several others across the country are also conducting this programme and are at various stages of progression. We do believe we are the first in the East Midlands to begin this.