The opt-in and opt-out systems

UK countries operate either an opt-out or opt-in system. Under the opt-out system someone is considered to have agreed to be a donor when they die, unless they have recorded a decision not to donate with the NHS Organ Donor Register (or are in an excluded group). Under the opt-in system, people have to register their wish to donate.

  • In England and Wales the opt-out system applies
  • In Scotland the opt-out system will apply from March 2021
  • Northern Ireland has an opt-in system for now

Consulting relatives

Families are always consulted before donation goes ahead, even within an ‘opt out’ system.

If the medical profession is considering using a part of a body, a specialist nurse will talk to close relatives to inform them of what is planned and to discuss whether they support the decision. The faiths and beliefs of the person who died should always be respected.

Organs or tissue are removed with care and do not delay burial or cremation arrangements or affect your ability to see a body.

Donating children’s organs and tissue

If a person has died under the age of 18, the family will be asked to make a decision on donation.

The opt-out system does not apply to children under the age of 18. If a decision about organ or tissue donation is required for someone under 18, the family will be asked to make that decision.

Finding out if donation is possible

If you want to find out if donation is possible, but haven’t been contacted by medical staff, you need to act quickly (usually within 24 hours, although sometimes up to 48 hours, after the death).

  • For organ donation call 0300 123 23 23
  • For tissue donation call 0800 432 0559