What is the opt out system in England?

This page provides answers to some of the most common questions about changes to the law around organ donation in England.

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If you would like to speak to somebody about changes in the law, please call our contact centre on 0300 123 23 23.

What has changed?

The law around organ donation in England has changed. All adults in England are now considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate or are in one of the excluded groups.

This is commonly referred to as an ‘opt out’ system. You may also hear it referred to as 'Max and Keira's Law'. You still have a choice whether or not you wish to become a donor.

Why do we need an opt out system?

There has been tremendous progress in organ donation but there is still a shortage of donors. Last year, 408 patients died in the UK on the transplant waiting list.

When did the opt out system start?

The new system came into effect in England on 20 May 2020, after the Organ Donation (Deemed Consent) Bill received Royal Assent on 15 March 2019. 

Will you automatically take my organs if I don't opt out?

No. Your family would always be involved before donation takes place, so it is really important that you choose whether you want to be a donor and discuss what you want to happen with your family, so your decision is clear and they can have peace of mind knowing that your decision is being honoured. 

Your faith and beliefs will also always be taken into consideration before organ donation goes ahead.

Get the facts about organ donation. 

Am I losing control of what happens to my body?

No. It will still be for you to choose if you want to be an organ donor. And if you don’t want to donate, it’s really quick and simple to record your decision on the NHS Organ Donor Register. The quickest and easiest way to do this is online, but if you don’t have internet access you can call our contact centre on 0300 123 23 23.

Get the facts about organ donation.

Will you still ask my family's permission?

Yes. Families will continue to be involved before organ donation goes ahead. 

Do these changes affect my children?

The opt out system does not apply to children under the age of 18 years old.

In circumstances where a donation decision is required for someone under 18, the family will be asked to make that decision and provide consent.

What you need to know about the law change if you're under 18

Will my funeral plans be affected?

Our specialist nurses always speak to the family to see if there are considerations around someone’s faith, beliefs or culture in respect to funeral plans. For example, a quick burial or open casket. 

Is there a deadline for registering my decision?

There is no deadline to make your decision. You are free to register your decision whenever you like, and organ donation remains your choice.

What happens if I don't register a decision?

If you have not expressed your decision to opt out of donation and are not in an excluded group, it will be considered that you consent to donate your organs. So even if you don’t record that you want to be an organ donor, it is important to let your family know what you want.

If you have specific instructions about which organs you would or would not like to donate, you should provide this information when you record your donation decision on the NHS Organ Donation Register

Can I change my mind?

Yes. If you have recorded an organ donation decision on the NHS Organ Donor Register and want to update your details, or change or reaffirm your decision, you can complete the Amend your details form or call 0300 123 23 23.

It is important to share your decision to be an organ donor with your family. This will give them more confidence that they know that you wanted to donate and make it easier for them to honour your decision.

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Want to talk to us about the opt out system?

0300 303 2094

Mon – Fri: 8am - 8pm 

Sat and Sun: 8am - 4pm

Text relay: 18001 0300 1232323

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