Senior doctor criticises NHS over transplant service failures
A leading transplant specialist has accused NHS England of creating a fragmented and underperforming system for heart and lung transplants, citing workforce burnout, last-minute cancellations, and inadequate investment. The doctor calls for systemic reforms to improve outcomes and fairness for patients.
A senior doctor has criticised NHS England for systemic failures in the country’s heart and lung transplant services, calling for urgent reforms to address long-standing issues. Professor Derek Manas, medical director of NHS Blood and Transplant, highlighted problems including workforce burnout, last-minute cancellations of surgeries, and a lack of accountability in a leaked letter to NHS England and patient advocates.
## Systemic inefficiencies and workforce strain
Manas blamed NHS England for creating a "fragmented" system with poor coordination between organ availability, surgical capacity, and waiting lists. This mismatch, he said, leads to unpredictable use of donated organs and frequent cancellations. The UK, once a leader in transplantation, now lags behind other Western nations in heart and lung transplants, though it performs better in kidney transplants.
The NHS transplants only one in ten donated lungs and one in seven hearts-a rate half that of some other countries. Contributing factors include outdated technology, insufficient theatre space, and a shortage of staff and intensive care beds. Wales and Northern Ireland lack dedicated heart and lung transplant centres, forcing patients to travel to England for treatment. Scotland has just one heart transplant centre.
| **Issue** | **Details** | |---|---| | **Waiting times** | Vary from 8 months to 4.5 years depending on the hospital | | **Surgeon turnover** | Half of the six UK heart and lung transplant centres lost their top surgeon in the past two years | | **Workforce challenges** | Burnout, recruitment difficulties, reliance on goodwill |
Manas also criticised NHS England for failing to actively manage waiting lists or ensure fairness in organ allocation. He warned that "inadequate" workforce planning had led to burnout among surgeons and teams, with many seeking opportunities abroad.
## Calls for reform and centralised management
The problems were first highlighted in a 2024 report by international experts, commissioned by the Conservative government. While NHS England has taken steps to improve outcomes, progress has been slow, according to surgeons and campaigners. Dr. Zubir Ahmed, a former health minister and kidney transplant surgeon, argued that the system should be centralised under NHS Blood and Transplant to allow for better patient mobility and resource allocation.
Ahmed, who resigned from Sir Keir Starmer’s government in May, praised aspects of the UK’s transplant system, such as its accessibility, but called for a "holistic, national system" to prevent cancellations due to capacity issues. He suggested that patients should be moved swiftly to centres where organs are available.
NHS England acknowledged the complexity of transplant services but stated that it was "working hard to improve these life-saving services." The organisation pointed to ongoing efforts to increase transplant numbers, reduce variation, and improve patient access.
