Professor Derek Manas, medical director of NHS Blood and Transplant, has written to NHS England and a small group of patient advocates blaming the national management body for creating a 'fragmented' transplant system with 'poor accountability', 'few consequences for poor performance' and operations cancelled 'last-minute', according to a leaked letter seen by the BBC.
Senior NHS doctor blames NHS England for transplant service failures in leaked letter
Professor Derek Manas, medical director of NHS Blood and Transplant, has written to NHS England and a small group of patient advocates blaming the national management body for creating a 'fragmented' transplant system with 'poor accountability', 'few consequences for poor performance' and operations cancelled 'last-minute', according to a leaked letter seen by the BBC.
The number of heart and lung transplants carried out annually by the NHS has not increased in 30 years. The NHS transplants one in 10 donated lungs and one in seven donated hearts — half the proportions seen in some other countries, according to the BBC's earlier reporting in March.
NHS Blood and Transplant manages organ donations and supports transplant centres, but services are commissioned and paid for by NHS England. Manas said the arrangement had produced a 'mismatch' between each hospital's waiting lists, organ availability, capacity to carry out surgeries and the availability of operating theatres, 'leading to last-minute cancellations [and] unpredictable utilisation of donated organs'.
Waiting times for donated hearts vary from eight months to four-and-a-half years depending on the hospital. Manas said NHS England had 'never actively managed' waiting lists and had 'seldom' tried to make them fairer.
Half of the six UK heart and lung transplantation centres have lost their top surgeon in the past two years, with those medics seeking opportunities abroad. Manas described workforce planning as 'inadequate', saying it had led to 'burnout among transplant surgeons and teams, recruitment and retention difficulties [and] increasing reliance on goodwill', adding: 'We have a system that assumes the consultant workforce will absorb pressure indefinitely.'
Wales and Northern Ireland do not have a heart and lung transplant centre, meaning patients from those nations commonly travel to England for surgery. There is one heart transplant centre in Scotland.
Problems in heart and lung transplantation were first set out in a 2024 report by international experts commissioned by the then-Conservative government. NHS England was tasked with implementing the report's recommendations.
- The specific date on which Manas wrote the letter is not stated.
- The identities of the patient advocates who received the letter are not disclosed.
- The precise recommendations made in the 2024 international experts' report, and which of those NHS England has or has not implemented, are not detailed.
- The total number of patients currently on heart and lung transplant waiting lists in England is not given.
- The names of the top surgeons who have left their posts, or the countries to which they have moved, are not provided.
- Whether Manas sent the letter in an official capacity or independently is not specified.