Nudging DVLA applicants to join the Organ Donor Register

From the first of this month, anyone applying online to DVLA for renewal of a driving licence is obliged to answer a question about registering personal details on the NHS Organ Donor Register (ODR).  There are three options along the lines of: yes, I’d like to register OR I’m already registered OR I don’t want to consider this at present.

As Peter Walker reported in The Guardian on July 31: “They can say they would like to sign up there and then, that they are already on the register, or that they would like to think about it on another occasion. A similar question existed previously but it was optional and many applicants missed or ignored it.”

He is, of course, correct that the previous question was not only tucked-into the layout of the DVLA form but its ordering of specific organs was different from their ordering on other sign-ups, as we reported.This muddle had to be sorted in the aftermath of Sir Gordon Duff’s review.

In principle, the revised question allows the NHS ODR to re-contact those already-registered to confirm or update their details – for example if permission was originally restricted. It is not clear whether this will happen, as this would require the passing-on of personal details from DVLA to NHS ODR for those who answer that they are already registered.

In principle, the revised question would also allow an analysis to be made, by somebody, of the characteristics of DVLA online-applicants (who also need to provide photographic identification) who answer:  “I’d like to think about it on another occasion”. The data-file that would facilitate this type of analysis need contain no identifying data (indeed, it should definitely not contain such data). Thus, birth year suffices, sex (not name), first part of postcode (not address), points on current licence, and so on.

It would be good to know if the nudgers have such plans. Indeed, if they have, I’d nudge them into being explicit about it, so that online applicants are aware of which data goes where. The public good that could come from such an analysis is a better understanding of those who defer consideration as against those who opt to register their willingness to donate organs in the event of their death

Each year, precious few of us (at most 1,500) die in intensive care units in a manner that would even allow our heart to be used for transplantation. Ultimately, it is the number of transplanted hearts and other organs, not the number of persons registered on NHS ODR, by which the success of ‘nudging’ needs to be judged. There should be some gentle pick-up because the ordering muddle has been sorted.

The DVLA change has been accompanied by publicity claims that “up to 90 per cent of the public” is willing to donate, but this contrasts starkly with relatives’ refusal rate which has been 40 per cent in the 21st century in contrast to 30 per cent in 1989-90. One in 10 families over-rides the wishes of a brain-stem dead potential donor who had registered on NHS ODR his or her willingness to donate.