NORS Perioperative Practitioner

The Oxford Transplant Centre currently provides kidney, pancreas, intestinal, uterus and islet cell transplant services and other surgery to support patients at the Oxford University Hospitals NHS Trust (OUH). Our pancreas transplant programme is the most active in Europe. We are the only centre in the UK performing uterus transplantation for women with uterine factor infertility.

The Oxford Abdominal Organ Retrieval Team is one of 10 teams in the UK commissioned to take part in the National Organ Retrieval Service (NORS). Currently, the team is operational three out of four weeks.

NORS is a key component of the Organ Donation and Transplantation infrastructure by providing a national 24-hour service for retrieving organs from deceased donors. NORS teams are made up of highly skilled healthcare professionals led by a senior surgeon. The NORS teams are supported by healthcare professionals fully competent in the perfusion and preservation of retrieved organs, and theatre practitioners experienced in organ donor surgery. They provide expert assistance to the surgical team.

The healthcare professionals who undertake NORS perioperative roles undergo competency-based training following an agreed national curriculum which includes e-learning, face-to-face education, and mentored practice. Final competence is assessed and signed off by the Oxford NORS perioperative lead and the Clinical Lead for Organ Retrieval.

These professionals frequently work unsocial hours in unfamiliar environments at the donor hospitals and are integral in the safe retrieval of high-quality organs. They are exposed to sensitive and sometimes distressing information and will be participating in the care of the deceased patient.

Oxford University Hospitals NHS Foundation Trust is one of the largest NHS teaching trusts in the country. It provides a wide range of general and specialist clinical services and is a base for medical education, training, and research. The Trust comprises four hospitals - the John Radcliffe Hospital, Churchill Hospital, Nuffield Orthopaedic Centre in Headington and the Horton General Hospital in Banbury.

Our values, standards, and behaviours define the quality of clinical care we offer and the professional relationships we make with our patients, colleagues, and the wider community. We call this Delivering Compassionate Excellence, and its focus is on our values of compassion, respect, learning, delivery, improvement, and excellence. These values put patients at the heart of what we do and underpin the quality healthcare we would like for ourselves or a member of our family.

In 2023, NHS England launched its first sexual safety charter, and our Trust proudly signed it. We pledge zero tolerance for inappropriate sexual behaviour and commit to the ten core principles.

Oxford University Hospitals promotes a safe, respectful hiring environment. If you want to make a difference with us, come and join our team. Together, we will uphold the highest standards of care and professionalism.

Donor Organ Retrieval (on-call rota. Activity carried out on a 24-48 hour on-call period)

• Participates in the out-of-hours rota to support the organ retrieval teams.
• Attends organ retrievals in donor hospitals across the United Kingdom and occasionally abroad, travelling by road, sea, or air. The nature of organ donation is inherently upsetting as all the donors are deceased and may be young children and/or they may have died under traumatic circumstances. The post-holder is required to undertake duties under these distressing circumstances.
• Logs into TransplantPath, uses the clinical information regarding the donor circumstances to establish the equipment required.
• Liaises with the Specialist Nurse in Organ Donation (SNOD) at the donor hospital and the Oxford retrieval consultant surgeon to arrange suitable arrival and travel time; contacts retrieval team and prepares all the equipment for retrieval.
• Organises the transport for the retrieval team after notification of a retrieval. This involves liaising with the transport provider to supply details of retrieval time and location. Occasional need to contact third-party transport company when the unit’s provider cannot meet the requirements.
• Prepares and organises the clinical area to receive donors for multi-organ retrievals.
• Safely identifies, prepares, checks, and assembles equipment required for the relevant retrieval. Confirms sterility of equipment and is responsible for the surgical count.
• Provides skilled assistance to the surgeon during the retrieval operation.
• During the retrieval operation, provides general theatres support. Ensures paperwork is done. Organizes and safely packs organs as required by the Consultant Surgeons.
• Accurately assembles and manages organ perfusion machines. These tasks require a high level of dexterity and speed by the operator. Some of these machines are at an early stage of development and automation is minimal.
• Ensures the safe collection of samples necessary to accompany the organs and samples for various research projects, ensuring compliance with the policies of the HTA license.
• Participates in perfusion research projects, learning new techniques and perfusion machines as necessary.
• Receives and processes complex surgical and clinical information from the retrieval surgeon. Relates this information to other professionals including transplant coordinators and NHS Blood and Transplant ODT.
• Ensures operational efficiency of organ perfusion machines. Downloads and analyses data.
• Ensures safe and effective management of organs on return to the Oxford Transplant Centre.
• Disposes of organs which are not suitable for transplantation in accordance with Human Tissue Act guidelines.
• Monitors equipment, ensures data collection and recording of data in the retrieval team database and Transplant Centre databases as required.
• Independently works within the guidelines of Oxford Adaptation of the National Operating Procedures, National Retrieval Standards, and the Quality and Safety of Organs for Transplantation Regulations 2024 (Updated May 2024).
• Responsible for adhering to the Human Tissue Authority codes of practice, standards, and licensing.
• Provides comprehensive training in donor and organ perfusion and the setting up and operation of highly specialised and complex donor and organ perfusion machines for other NORS teams, clinical staff, and new members of the Oxford team.
• May be trained to perform or assist in developing new technologies to monitor transplant patients or transplant function.

Administrative and General Duties (Activities carried out during non-on-call hours)

• Ensures necessary data are recorded and analysed. Reports data to NHSBT and presents data to various groups/meetings.
• Collects and returns organ-specific data promptly for accurate transplant outcomes.
• Maintains clear, full, and accurate records of work carried out.
• Liaises with senior staff concerning problems that may arise.
• Actively participates in governance and team meetings.
• Actively participates in training as appropriate.
• The post-holder may be asked by the Director of the Oxford Transplant Centre, the Clinical Lead for Organ Retrieval, and their appointees to perform reasonable duties relating to this position that are not specifically laid out in this document.
• Acts as a clinical and professional role model at all times and demonstrates specialist knowledge and high standards of clinical practice and provide support or advice when necessary.
• Acts as an ambassador for the Trust and NHSBT. Actively networks to raise the profile of NORS practitioners, including acting as a mentor to students and newly qualified staff including teaching and assessing, upholding the philosophy of evidence-based practice.
• Ensures appropriate quantities of equipment and consumables for retrievals are available at all times.
• Be responsible for the safe transport of high-cost surgical equipment, fluid, and drugs, under the transport of dangerous goods act, therefore adhering to legislation.
• Participates in the sourcing, procurement, and ordering of equipment for the retrieval team. Monitors stock levels and places orders to replenish supplies.
• Researches, investigates, and procures new equipment when required.
• Participates in meetings, delivers activity reports, and assists with unit decisions about retrieval processes.
• Ensures the NORS team’s procedures and paperwork are kept up to date and compliant with HTA standards, continuously evaluating and modifying local policies to ensure compliance.
• Participates in the maintenance and cleaning of specialist medical equipment, reporting any faulty equipment to the appropriate Team Leader or E.M.E. Department.
• Maintains competency in the use of specialist medical equipment appropriate to the clinical setting.
• Multiple roles are being developed and considered regularly that fully include the peri-operative in the working of the Oxford Transplant Centre. Roles are allocated to members of the team based on their knowledge and aptitude.

This job profile is not a definitive or exhaustive list of responsibilities but identifies the key responsibilities and tasks of the post-holder. The specific objectives of the post-holder will be subject to review as part of the Appraisal and Development Plan process.