THERE are fewer than 300 days to go until Wales becomes the first country in the UK to introduce an opt-out system for organ donation. Health reporter ANDY RUTHERFORD looks at how people in Wales are being urged to clarify their decision on the issue, and to share it with their families.

WALES is currently in the midst of another concentrated phase of awareness raising around the issue of organ donation and a fundamental change to the system to be introduced next December.

A comprehensive advertising campaign is in full swing on television, press, radio, online, and on the sides of buses, bus stops, trains, and in shopping centres and university sites.

The message is simple – it is time to talk about organ donation – to decide whether you want to be an organ donor or not, and crucially, whatever your decision, to tell your nearest and dearest.

Understanding the implications of the new system, which comes into effect on December 1, is vital, but so is the ‘talk’ part of the message.

The new system, known as a ‘soft’ opt-out system, changes completely the emphasis of organ donation so that unless you formally opt out – register a decision not to be an organ donor in the event of your death – your consent will deemed.

There will also be the option of formally opting in and registering a decision to be an organ donor.

The current advertising campaign, as well as intending to boost awareness that a change is on the way, also aims to provide more detail on choices available, and of the implications of doing nothing and not formally opting out or in.

Doing nothing means that from December 1 you may still become and organ donor as your consent will be deemed to have been given, though families will be able to influence the matter if they can provide evidence of you having indicated a wish to, or not to, be an organ donor after your death.

That will be a great challenge post-December 1, and the first months, probably years, after the new system is introduced will be unknown and sensitive territory for the medical profession and the families they deal with.

Clinicians involved in making decisions on donation will have to tread especially carefully. Some potential donations may not go ahead because family distress will be great enough to rule them out.

The law was passed in July 2013, and a long run-in to introduction was seen as vital, despite the issue having provoked impassioned debate and widespread coverage for several years.

The images currently all around us – of people with digital timers on their bodies over the areas under which lie vital, transplantable organs – are a powerful reminder that organ donation saves and changes lives.

But in most of these cases too, the donor will have lost theirs, and a decision will have been made – either by them in life, by making it known they would wish to donate their organs in the event of their death – or by their family, usually based on knowledge of their loved one’s wishes.

Under the new system, clarity about those wishes will be key, and talking about them the way to achieving it.

“We hope this new law will help save more lives and transform attitudes towards consent to organ donation here in Wales,” said health minister Mark Drakeford.

“While awareness and understanding of the legislation continues to increase, the percentage of people who have talked about their organ donation wishes remains low.

“Finding ourselves in the position of being a donor is rare and often families do not expect to be approached about donating a relative’s organs. But when they know each other’s wishes, more families feel able to carry out what their loved ones wanted. The new law will make the decision to be a donor the default position unless the person said otherwise.”

l The current phase of the awareness raising campaign, called Time to Talk, will continue until May, when the emphasis will switch toward encouraging people to choose whether or not they wish to be an organ donor.

This is intended to coincide with the launch of a new organ donation register which will enable people to formally register their wishes.

By the end of March, more than £1million will have been spent on the awareness raising campaign, and as the clock ticks down to December 1, that figure is set to more than double.

A report for the Assembly last autumn indicated that planned spending during 2015/16, which will also include an element of post-introduction work, is set to be around £2.2million.

The aim is to, as far as possible, remove elements of doubt that will arise if people do nothing, which after December 1 will mean their consent is deemed.

The family of any potential donor will continue to have a major role to play in organ donation under the new system and will be involved in any discussions about organ donation.

The new law will respect the wishes of the deceased, however relatives or friends of long-standing may object to consent being deemed if they know their relative or friend did not want to be a donor.

The new system for organ donation aims to increase the number of donated organs available for transplant.

In the period April 2014-January 2015, there have been 2,852 deceased donor organ transplants in the UK 3.6 per cent fewer than in the same period the previous year.

At February 5, there were 6,848 people awaiting a transplant in the UK, almost 5,400 of whom need a new kidney.