HTA Online Survey – Professional Groups - Ipsos · HTA Online Survey – Professional Groups Report Prepared for The Human Tissue Authority October 2010

HTA Online Survey – Professional Groups Report Prepared for The Human Tissue Authority October 2010

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Contents

Summary ..........................................................................................2

Introduction .....................................................................................6

Background and Objectives...........................................................6

Methodology ....................................................................................7

Main Findings ................................................................................13

Sample Composition ................................................................................ 13

Reputation......................................................................................19

Knowledge of the HTA ............................................................................. 19

Favourability towards the HTA ................................................................. 20

Advocacy of the HTA ............................................................................... 23

Change in the HTA in the last three years ............................................... 26

Detailed perceptions of the HTA .............................................................. 28

Principles of Good Regulation.................................................................. 30

Importance and efficacy of HTA activities ................................................ 32

Regulation......................................................................................36

Communications ...........................................................................38

Types of communication and their relative usefulness............................. 38

Perceptions of the HTA website ............................................................... 41

The use of social media ........................................................................... 41

Keeping stakeholders informed................................................................ 42

The HTA’s Codes of Practice ................................................................... 44

Overall communications with the HTA ..................................................... 46

Sector-specific Questions ............................................................51

Appendices ....................................................................................66

Appendix 1 - Profile of sample ................................................................. 66

Appendix 2 - Topline results..................................................................... 68

1 © 2010 Ipsos MORI.

Summary


Summary Awareness of the HTA is high, with more than nine in ten believing that they know at

least “a fair amount” about it (including 36% who know it “very well”).

Overall, nearly seven in ten have a favourable opinion of the HTA. Those in the

Transplant (solid organ) sector are most likely to hold this view: 88% say so, against

just 10% unfavourable. Among the licensed groups, most positive are those in

research (80% favourable, 8% unfavourabler) whereas post mortem sector

respondents are relatively less favourable. (Among all sectors and groups, however,

those favourable clearly outnumber those unfavourable - by between around 2:1in the

post mortem sector (49% favourable vs 27% unfavourable), up to 3:1 among

Designated Individuals [DIs] (60% vs 20%), and by around 10:1 among Independent

Assessors [IAs] (88% vs 9%).

Likewise, approaching three in five (58%) would speak highly of the HTA. This

compares to an average of only 47% of stakeholders from other public sector

organisations overall (from a range of separate Ipsos MORI projects). It is again

transplant (solid organ) participants who are most likely to be advocates (82%,

against just two per cent potentially critical) and post mortem respondents who are

somewhat more split (42% positive vs 29% negative). Responses from the human

application and research sectors are almost wholly positive (a total of just six of the

96 people interviewed being potential critics: the others being either positive [55] or

neutral [35]).

Almost half of respondents believe that the HTA’s performance has improved in the

last three years, a quarter (26%) think that it has stayed the same - and only 8% that

it has worsened. The pattern is positive - to varying degrees - among all groups: DIs

perceive improvement rather than deterioration by a ratio of 5:1 (50% vs 10%). The

respective post mortem figures are 2:1 (40% vs 20%) - but in most other cases they

are nearer 10:1.

The most widely-held perceptions of the HTA are that it is ‘professional’, ‘informative’

and ‘accessible’. Somewhat more mixed views surround its ‘flexibility’ (primarily in

the post mortem sector and among DIs - both of which are broadly split on this) and

‘proportionality’. In this case, post mortem respondents are clearly the most

equivocal (35% say the HTA is proportionate, 34% say not), and DIs too - the

predominant respondent type - account for almost all those who voice discontent.


Approaching nine in ten have “a great deal” or “a fair amount” of confidence in the

HTA as a regulator. Although there is again a particular contrast between the

transplant (solid organ) and post mortem sectors (the former being relatively most

positive, the latter least so), overall the balance of opinion is clearly positive

irrespective of sector or respondent type. (For the post mortem sector, the figures are

76% confident / 20% not confident, for research they are 90% / 6%, and for DIs 84% /

12%).

Furthermore, nearly two in five say their confidence in the HTA as a regulator has

increased in the past three years. This is far more than the nine per cent overall who

report a deterioration (and of these 32 individuals, 28 are DIs and 20 from the post

mortem sector - with the rest thinly spread across other areas). Overall, many people

(43%) say there has been no change.

Most of the communication stakeholders have with the HTA is electronic, and this is

broadly welcomed. However, people rate the usefulness of face-to-face and

telephone communications more highly.

The HTA scores highly on keeping its professional stakeholders informed. This is in

comparison to other public sector organisations whose professional stakeholders

Ipsos MORI has surveyed. (Eighty-four per cent of the HTA’s professional

stakeholders rate the organisation as keeping them very or fairly well informed. This

places the HTA second, out of seventeen public sector organisations measured).

Those in the transplant (solid organ) sector are most positive out of all sectors (93%).

Nearly all stakeholders claim to have read / referred to their sector-relevant codes of

practice - and more than nine in ten (93%) find them useful. Likewise, the majority of

licensed sectors read the summary of compliance reports for their sector (particularly

so the post mortem sector respondents). Overall, nearly nine in ten respondents

(86%) found them useful. The most popular suggestions for improving these reports

are by including more case studies and by reducing their length.

In the post mortem sector, more than four in five (84%) feel that the communications

they received about ‘General Directions’, in a regulatory alert issued in December,

were clear.

The human application sector respondents were asked how clear they felt

communications were about cord blood collection, after concerns that umbilical cord

blood donation may be taking place unlawfully. Just over half expressly thought that


these were clear, while most others (43%) did not know - perhaps as they did not

receive or recall the communication (which was not sent to all DIs in the human

application sector).

Research sector respondents were asked how they thought the findings from the

evaluation conducted in 2009 were used. The most common answers to this were ‘to

improve the HTA’s advice and guidance for the research sector’ (61%) and ‘to ensure

researchers understand the requirements of the HTA’s regulation’ (53%).

More than seven in ten of the transplant (solid organ) sector respondents agree that

the IAs available to their transplant unit satisfy its organ donation activity. ‘Workload’

was given as the most common potential barrier to sustaining the IAs available, with

just over half citing this as a reason.

Stakeholders would most like the feedback from this evaluation to be used to feed

back via e-newsletter and the website (74%) - and also see some potential for it to

improve HTA’s communications.

Many similarities can be found between the results of this survey and the qualitative

research conducted among key opinion leader (KOL) stakeholders. Where

comparisons can be made, they are mentioned throughout this report.


Introduction


Introduction

Background and Objectives

Overview

The HTA was established under the Human Tissue Act 2004 (HT Act) to regulate activities

concerning the removal, storage, use and disposal of human tissue. Its role is to support

public confidence by ensuring that the public’s wishes are respected and that human bodies

and tissue are treated ethically and safely. The HTA is an Executive Non-Departmental

Public Body (ENDPB) sponsored by the Department of Health.

There are several statutory functions:

- to inform the public, professionals and the Secretary of State for Health about issues

within its remit. This is done (for professionals) by providing guidance - including

codes of practice - to support good practice; and (for the public) by providing

information to help people make informed decisions

- to regulate, through licensing organisations that store and use tissue for purposes

such as research, patient treatment, post-mortem examination, teaching, and public

exhibitions. (There are currently more than 800 licensed organisations)

- publish standards that licensed establishments must meet: on consent; governance

and quality systems; premises; facilities and equipment; and disposal

- inspect organisations to check that they maintain good standards and follow

appropriate procedures. Organisations considered to be highest risk are among the

first to be inspected

- the regulation, through an independent assessment process, of the donation from

living people of solid organs, bone marrow and peripheral blood stem cells for

transplantation into others. The HTA also regulates living donation, in compliance

with Scottish legislation, on behalf of the Scottish Government

As well as licensing under the HT Act, which covers England, Wales and Northern Ireland,

the HTA is the Competent Authority in the UK responsible for ensuring the safety of human


tissue and cells used for patient treatment, in compliance with the European Union Tissue

and Cells Directive (EUTCD).

The HTA also oversees the consent requirements of the HT Act for deceased organ

donation.

HTA’s overall goal is to create a regulatory system for the removal, storage, use and disposal

of human tissue and organs that is clear, consistent and proportionate - and in which

professionals, patients, families and members of the public have confidence.

Opinion Research

This report represents the findings of a survey conducted by Ipsos MORI on behalf of the

Human Tissue Authority (HTA). The project will build on the HTA’s public and professional

evaluation work with Ipsos MORI in 2007, and evaluation of the research community with

Opinion Leader (OLR) in 2009.

The work is also related to the action in the Hampton Implementation Review of the HTA

(July 2009) which states: “The HTA should monitor the effectiveness of its regulatory activity

by commissioning surveys of public perception around handling of human tissue at regular

intervals”.

Throughout the report references are also made to the qualitative component of this

research, conducted in June, which involved interviewing nineteen Key Opinion Leader

(KOL) stakeholders on similar issues.

Methodology

Online survey among professional stakeholders

An online methodology was chosen as the most effective and cost-effective way to provide a

representative and credible understanding of the HTA’s relationships with its professional

stakeholders. Also, it is the most economically advantageous method of achieving a good

spread of participants across the professional roles and sufficient numbers in each to enable

analysis across sub groups.


Sampling

All professional stakeholders on the HTA’s database (768) were emailed a link to the survey

to ensure that the greatest number of responses possible were achieved across all sectors,

thus providing the most robust and representative data possible.

Response rates

In order to maximise the level of response, we took the following actions:

- Initial checks of the database, to ensure that sample data were as accurate as

possible, and that response rate calculations were not distorted by the inclusion of

invalid email addresses;

- An engaging invitation email was sent to all potential respondents, ensuring that the

email headline and subject were clear to encourage participation;

- A unique link was provided so that each respondent could complete the interview in

their own time, stopping and starting as desired;

- Follow up reminder emails were sent out weekly to non-responders after the initial

invitation email, indicating the importance of the survey and how much stakeholders’

views on the subject would be appreciated.

- The questionnaire was kept to a minimum possible length so it would take no more

than 15-20 minutes - to encourage as many respondents as possible to take part.

- Potential participants were assured of the objectivity and confidentiality of the

research. Often the Ipsos MORI name itself attracts high participation rates among

key audiences and indeed some of the respondents were already Ipsos MORI

respondents for this type of exercise.

The overall response to the survey was 349, this equates to a response rate of 46%, which is

a good response for this type of survey (the response rate was adjusted due to some

‘bounce backs’).


Questionnaire design

The questionnaire was designed in collaboration with the HTA and it broadly covered the

following key areas:

The HTA’s reputation;

Areas of HTA regulation;

Communications;

A number of sector-specific questions.

Ipsos MORI is absolutely robust in its questionnaire design because of the crucial part that it

plays in the whole research project. The following key aspects were particularly focused on

at the questionnaire design stage:

Balance: ensuring that the questions in the survey were worded in an objective

manner and also that the research as a whole was presented in a balanced way.

Content: the questions were decided in close collaboration with the HTA.

Comparability: where possible and appropriate, comparisons were made to

normative data and links were made to the qualitative stakeholder project also

conducted as part of this work for the HTA.

Information: Ipsos MORI aimed to maximise the ease with which information was

sought from respondents, making it as easy as possible for them to give their

responses.

Administering the survey and the deliverables

The survey was scripted into an online CAWD (Computer Aided Web Design) format and an

invitation and a unique link to the survey were emailed to all named contacts in the sample.

Respondents were able to save draft versions and return to the questionnaire at a later date;

final submission required completion of all sections of the survey. This web-based approach

allowed researchers to identify the email address from which a survey response had been

received. It therefore allowed them to identify those who have completed the survey, those

who have started but not yet completed it, and those who have not yet clicked on the survey

link at all. Reminder messages were only sent to respondents who have not completed the

survey.


The process also guards as far as possible against multiple responses.

During fieldwork, Ipsos MORI monitored the number of responses from each sector and sub-

group within, where relevant. Ipsos MORI and the HTA were able to access ‘live’ results - i.e.

a link which allowed them to see anonymised survey responses as they came in.

This meant that response rates could be monitored, and any poorly performing areas

targeted with further email reminders.

A marked up ‘topline’ questionnaire showing results at the overall level and for each type of

respondent was provided to the HTA, along with data tables, including the aggregated data

and any relevant sub-groups, a full SPSS1 of the dataset and an Excel file containing the

verbatim stakeholder feedback from open-ended questions.

Along with this report, a combined summary of all three components of the project (this

aspect, the KOL stakeholder qualitative survey and a quantitative survey on the general

public) will be provided to the HTA later this month. Where appropriate, comparisons have

been made to the KOL stakeholder project in this report as well.

Weighting and representation of the wider profession/s

This is the process whereby the statistical influence or ‘weight’ of each individual response is

if necessary altered, to correct for any discrepancy between the survey sample profile and

that of the ‘universe’. (For example, a general public survey sample comprising 50% men

and 50% women would usually be weighted to reflect that the actual proportions within the

full GB population are 48% men and 52% women. This then allows the survey to be

considered precisely representative of the population as a whole).

In this online stakeholder survey for the HTA, it was decided not to weight the results in any

way, as the sample profile was deemed to be representative by job role and sector when

comparing it with the ‘universe’ profile’ (i.e. the profile of all eligible people).

Ultimately, though, the process is ‘self-selecting’, and so we cannot guarantee that the views

of those responding will fully match those who did not take part.

1 SPSS (originally, Statistical Package for the Social Sciences) is a computer programme used for statistical analysis.


Acknowledgements

We would like to thank Dr Shaun Griffin and Dr Laura Nelson at the HTA for their help with

this project - and of course also the 349 stakeholders who took part.

Michele Corrado

020 7347 3441

Adam Palenicek

020 7347 3173

Georgia O’Grady

020 7347 3383


Main Findings


Main Findings

Sample Composition

The survey comprised the following:

Professional Sectors

(The number of responses is shown in brackets - from the total of 349).

(Descriptions are primarily taken from HTA’s website):

1. Licensed Sectors

Post Mortem (86)

Those from establishments carrying out post mortems, storing human bodies or organs, tissues or cells from a deceased person and / or removing relevant material from a deceased person other than in the course of a post mortem

Human Application (47)

Establishments storing human tissue for human application

Research (49)

Establishments storing human organs, tissues and cells for research purposes other than for a specific ethically approved research project

Public Display (9)

Establishments storing bodies or organs, tissues or cells obtained from a deceased person for the purpose of public display - eg museums

Anatomy (13)

Establishments carrying out anatomical examinations or storing anatomical specimens

2. Non-Licensed Sectors

Transplant (Solid Organ) (88)


Those people (primarily Independent Assessors [IAs] and Living Donor Co-Ordinators - see below) who are responsible for assessing and co-ordinating transplants of human organs involving living people. IAs submit a report to the HTA with their recommendations

Transplant (Bone Marrow or Stem Cell) (34)

Those people (primarily Designated Individuals [DIs], Accredited Assessors [AAs] or Stem Cell Co-Ordinators - see below) who are responsible for overseeing, assessing and co-ordinating all donations of bone marrow / PBSC on behalf of donors or children without the capacity / competence to consent. AAs submit their recommendations to the HTA

Professional Roles

Designated Individual [DI] (230)

Designated Individuals (DIs) are the person under whose supervision the licensed activity is authorised to be carried on. They have the primary (legal) responsibility under Section 18 of the HT Act to secure:

• that suitable practices are used in undertaking the licensed activity

• that the other persons who work under the licence are suitable

• and that the conditions of the licence are complied with.

The DI might be a head of department, clinician, scientist or manager.

Independent Assessor [IA] (64)

The HTA trains and accredits Independent Assessors (IAs) to assess certain types of living organ transplantation in the UK.

IAs are usually, but not exclusively, based in hospitals with transplant units. They act as a representative of both the donor and the HTA in order to help the HTA ensure the requirements of the Human Tissue Act 2004 have been met. IAs submit a report of their assessment to the HTA - and the HTA then makes the decision whether or not to approve the proposed donation.


Accredited Assessor [IA] (14)

The HTA trains Accredited Assessors (AAs) to assess potential bone marrow and PBSC donations from adults who lack capacity and children who lack competence to consent.

AAs act as a representative for the donor and the HTA.

Following an assessment, AAs submit a report of their assessment to the HTA. The HTA makes the decision whether or not to approve the proposed donation

Living Donor Co-Ordinator (38)

Work alongside the clinicians of the donor, and the IA, ensuring co-ordination of the process from initial referral

Stem Cell Co-Ordinator (3)

Work alongside the clinicians of the donor, and the AA, ensuring co-ordination of the process from initial referral

*************


Two thirds (66%) of stakeholders who responded to the survey were Designated Individuals

(DIs). With this weight of numbers, the DIs’ views strongly colour the overall findings - but we

highlight where their views markedly differ from others’.

The remaining third of the sample comprised Independent Assessors (IAs - 18%), Living

Donor Co-ordinators (11%), Accredited Assessors (AAs - four per cent) and Stem Cell Co-

ordinators (one per cent).

66%

18%

4%

11%

1%

Role/ relationship with the HTA

Designated Individual (DI)

Q Please specify your relationship with the HTA

Base: All HTA Stakeholders (349), fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI

Independent Assessor (IA)

Accredited Assessor (AA)

Living donor coordinator

Stem cell coordinator

In terms of sector representation, a quarter (25%) each primarily work in the post mortem

and transplant (solid organ) sectors. Fourteen per cent were in the research sector, 13% in

human application and 10% in transplant (bone marrow or stem cell).

Relatively few worked in the anatomy sector (four per cent) or public display (three per cent).

Since the base sizes for these groups are very low, their findings should be treated

throughout as indicative only.

Please refer to the table above for the cross-cutting professional composition of each sector.


25%

25%

14%

13%

10%

4%

3%

7%

Sectors

Transplants – solid organ donation

Q In which sector do you primarily work?


Post mortem

Research

Human application

Transplants – bone marrow or stem cell donation

Anatomy

Public display

Other

The stakeholders surveyed came from a range of areas around the UK - most commonly

London (21%), the South East (14%), the North West (13%), West Midlands (11%) and the

South West (10%). Wales, Scotland and Northern Ireland accounted for five per cent, four

per cent and three per cent, respectively.

Length of Time in Post

Overall, the majority (79%) had been working in this role for between one and five years -

though a fair number (15%) started more recently.

Service of over five years is rare and is confined only to living donor coordinators and stem

cell coordinators.


15%

79%

4%3%

Length of service

Less than 1 year


Q How long have you been working this role?

Between 1 and 5 years

Between 6 and 10 yearsMore than 10 years


Reputation

Knowledge of the HTA

Awareness of the HTA is high. Virtually all stakeholders say they know at least something of

what it does - with nine in ten (91%) knowing at least “a fair amount”, including 36% who

claim to know it “very well”.

36%

55%

8% *%*%

Knowledge of the HTA

Very well


Q How well do you think you know what the HTA does?

A fair amount

Not very wellJust a little

Don’t know

DIs are significantly more likely than other professional groups to know the HTA “very well”

(45%), while among sectors the two transplant-related areas tend by contrast to be less

aware - and more likely to know the HTA “fairly well” or “just a little”.

Please note, though, that because the base sizes for some groups / sectors are low (Stem

Cell Co-Ordinators, AAs, public display and anatomy), these results are indicative only.

The results of questions asked of all (349) respondents will tend to be disproportionately

affected by the DIs’ findings, as they are numerically the predominant group (230 of the 349

total). A full breakdown is provided at Q1 and Q3 in the full data tables.


2 (N)

32%

11%

45%

2 (N)

8 (N)

53%

80%

49%

1 (N)

4 (N)

16%

9%

5%**

Knowledge of the HTA by role

Designated Individual

% Very well % A fair amount % Heard of HTA, but know nothing about it% Just a little % Not very well

Q How well do you think you know what the HTA does?

% Don’t know

Base: All HTA Stakeholders, fieldwork dates: 14th June – 2nd July 2010 Where the overall number of respondents (N) is 30 or less the absolute number of respondents is stated Source: Ipsos MORI

Independent Assessor

Accredited Assessor



38

14

64

230

3

Base

Favourability towards the HTA

Overall, most have a favourable opinion of the HTA (68%) - though those who are very

favourable account for a quarter overall (26%).

Expressly negative views account for 17% - comprising 10% ‘mainly’ and seven per cent

‘very’ much so. Fourteen per cent are neutral.


26%

42%

14%

1%10%

7%

Favourability towards the HTA

Very favourable


Q How favourable or unfavourable is your overall opinion of the HTA?

No opinion

Mainly favourable

Neither/nor

Mainly unfavourable

Very unfavourable

Although DIs have a significantly greater knowledge of the HTA than other stakeholders, it is

Independent Assessors (IAs) that are the most favourable (88%, compared with 60%) of

DIs).

Correspondingly, DIs are marginally more likely to be unfavourable (20%, compared to 17%

overall).


3

3

7

3

6 (N)

18%

34%

50%

1 (N)

5 (N)

43%

47%

38%

2 (N)

2 (N)

19%

1

13%

2

13%

8%

*

*

*

Favourability towards the HTA by role


% Very favourable % Mainly favourable % Neither/nor% Mainly unfavourable % Very unfavourable


% No opinion


Accredited Assessor



38

230

14

64

3

Base


DIs are considerably less positive than either Living Donor Co-Ordinators or (particularly) IAs

- and as usual the DIs’ weight of numbers has a considerable impact on the overall results.

The results for AAs and Stem Cell Co-Ordinators are again indicative only (and expressed in

the chart as actual numbers, not percentages, due to their very small numbers).

There is also variation in levels of favourability between sectors.

Of the statistically robust sectors, post mortem is relatively the most negative and transplant

(solid organ) the most positive. In all cases, positive ratings outnumber negative views - but

the latter are not confined to just the post mortem sector, with ‘unfavourable’ scores of 10%+

being evident in the human application and transplant (bone marrow or stem cell) sectors -

(15% and 26%).


1

4

2

1

2

2 (N)

15%

29%

17%

22%

43%

4 (N)

6 (N)

34%

29%

51%

57%

44%

4 (N)

3 (N)

24%

15%

17%

10%

1(N)

2 (N)

19%

15%

13%

4

1

8%

12%

9%

Favourability towards the HTA by sector

Post Mortem

Human Application

Research

Public Display

Anatomy

49

88Base

Transplants – Bone Marrow or Stem Cell Donation

Transplants – Solid Organ Donation

47

34

86

13

9Base: All HTA Stakeholders, fieldwork dates: 14th June – 2nd July 2010 Where the overall number of respondents (N) is 30 or less the absolute number of respondents is stated Source: Ipsos MORI

% Very favourable % Mainly favourable% Mainly unfavourable % Very unfavourable


% No opinion% Neither/nor

The in-depth qualitative interviews among key opinion leaders (KOL) gave us insight into why

people held the views they did. The overall opinion of the HTA was again favourable - in part

based on a very strong sense that the HTA is a necessary body and is there for a good

reason. (Indeed, there were frequent references back to Alder Hey and events that led to the

creation of the Human Tissue Act). KOL stakeholders see that having a structured framework

in place not only protects them but protects the public as well.

Overall in these in-depth interviews, the post mortem sector again appeared to hold relatively

less positive views than did other sectors. Where this was the case, the events in Cardiff

were often cited.

Advocacy of the HTA

Another important measure when monitoring an organisation’s reputation is advocacy -

whether or not an individual would speak highly or critically of it, with or without being asked

to do so.


Around three in five professional stakeholders would “speak highly” of the HTA. This is high

compared to most other organisations for which Ipsos MORI has benchmarks – the chart

below shows where the HTA scores in relation to these other organisations2.

Further to this, nearly three in ten (28%) would be neutral about the HTA and thirteen per

cent would be expressly critical of it.

(Most of those taking part in the in-depth interviews for HTA said they would be willing to

speak highly of it if asked - or in some cases without being asked).

Regional body

2626

2732

4136

4442

48524852545455585659

6469

Advocacy is high compared to other organisations for which Ipsos MORI has benchmarks

% Advocates

Which of these phrases best describes the way you would speak of the …. to other people?

Base: Various user and stakeholder surveys of public sector organisations

Regulator

Regulator

Govt DeptGovt Dept

Govt DeptGovt Dept

Govt DeptRegional body

Regional body

NDPB

Regional body

HTA

NDPB

Regional bodyRegional body

Regional body

Regional body

NDPB

Again it is IAs who are the most positive among the online respondents, with 83% saying that

they would “speak highly” of the HTA. They are also more likely to advocate on behalf of the

HTA without being asked (30%, compared to 14% overall). Living Donor Co-Ordinators also

score highly on advocacy measures (82% overall) – while once again it is DIs who are the

most critical (19% expressly so, compared to 13% of the overall sample, and with very few

willing to spontaneously ‘advocate’ the HTA: seven per cent).

2 Each blue line is a (different) organisation taken from Ipsos MORI’s user and stakeholder studies among various public sector organisations. (None of these is an employee study).


2

41

3 (N)

7%

24%

30%

4 (N)

42%

58%

53%

3 (N)

7 N)

31%

16%

13%

15%

3

Advocacy towards the HTA by role


% Speak highly without being asked % Speak highly of if asked% Be critical if asked % Be critical without being asked

Q Which of these comes closest to describing how you would speak about the HTA? Would you . . .

% Neutral% Don’t know/No opinion


Accredited Assessor

Living donor coordinator 38

14

3

64Base


230


A similar pattern emerges for advocacy as for favourability in the sector-specific replies.

Transplant (solid organ) respondents are significantly more likely to speak highly of the HTA

(82%, compared to 58% overall) and post mortem respondents are more likely to be critical

(29%, compared to 13% overall).

As is almost always the case, willingness to advocate an organisation is founded on a range

of positive views towards it. In this case, potential HTA advocacy (58% overall) is more

prevalent still among:

• Those who are favourable to the HTA (76%)

• Those saying the HTA’s performance has improved in the last three years (73%)

• Those with at least a fair amount of confidence in the HTA (66%)

• Those who feel well informed about the HTA (65%)

• Those who feel it is easy to understand how to comply with HTA standards (65%)


1

6

1

4

2

3

6

1

4

3 (N)

6

18%

4

12%

26%

1(N)

4 (N)

36%

32%

53%

45%

56%

6 (N)

3 (N)

29%

35%

34%

35%

15%

2 (N)

3 (N)

23%

12%

Advocacy towards the HTA by sector

Post Mortem

Human Application

Research

Public Display

Anatomy

49

88Base



47

34

86

13


% Speak highly without being asked % Speak highly of if asked% Be critical if asked % Be critical without being asked

Q Which of these comes closest to describing how you would speak about the HTA? Would you . . .

% Neutral% Don’t know/No opinion

Change in the HTA in the last three years

On balance, stakeholders clearly perceive an improvement in the HTA’s recent performance:

half (49%) say that it has improved, against only seven per cent who feel it has worsened - a

ratio of exactly 7:1.

A quarter (26%) think it has stayed the same, and one in ten (11%) do not know (with the

latter heavily drawn from those in post for less than a year).


13%

36%

11%

26%

6%

6%

2%

Change in opinion over the last three years

Improved a lot


Q And in your opinion, has the overall performance of the HTA improved, worsened or stayed about the same over the last 3 years? Is that a lot or slightly . . .

Don’t know

Improved slightly

Worsened slightly

No opinion

Stayed about the same

Worsened a lot

The balance of opinion (that HTA’s performance has improved) holds true across all groups

and sectors - but there are some variations. Relatively least positive is the post mortem

sector (40% perceive an improvement, 20% a deterioration - 2:1). DIs’ views tend to reflect

the overall pattern (50% ‘improved’ vs 10% ‘worsened’: 5:1). Regional results are generally

based on small numbers, so not robust. Anecdotally, those in the North West and South

West appear relatively less positive than elsewhere.


4

2

2

1

5

62

1

510%

15%

14%

26%

18%

2 (N)

8 (N)

29%

29%

38%

34%

43%

6 (N)

4 (N)

27%

24%

22%

21%

27%

15%

9%

9%15%

1(N)

9%

10%

22%

9%

Change in opinion over the last three years by sector

Post Mortem

Human Application

Research

Public Display

Anatomy

88

34

Base



13

49

86

47


Q And in your opinion, has the overall performance of the HTA improved,worsened or stayed about the same over the last 3 years?Is that a lot or slightly . . .

% Improved a lot % Improved slightly% Worsened slightly % Worsened a lot

% Stayed about the same% No opinion % Don’t know

Detailed perceptions of the HTA

People were asked about their perceptions of the HTA on a range of (positive)

characteristics.

The Authority is most widely seen as ‘professional’ (85%), ‘authoritative’ (77%), ‘focused’

(77%), ‘reliable’ (74%) and ‘supportive’ (72%). Stakeholders are also broadly positive about

its communications style, with 83% agreeing it is ‘informative’, 82% ‘accessible’, 79%

‘responsive’ and 62% ‘transparent’.

Some areas yield slightly more mixed views: firstly in relation to the Authority’s perceived

proportionality (where 46% view it as a ‘proportionate’ organisation, and 16% disagree – but

the latter view particularly evident in the post mortem sector: 34% disagree).

Although on balance the Authority is seen as ‘accountable’ (58% agree, 11% disagree),

around three in ten do not commit themselves here, suggesting some lack of awareness.

Nor is the Authority always viewed as flexible (45% agree it is, 22% expressly say not).

However, ‘flexibility’ could be taken as a positive or negative attribute - and so the

implications of this finding are not clear-cut.


Perceptions of the HTA

Q In your experience, please indicate the extent to which you agree or disagree with each of the following descriptions of the HTA.

85

83

82

79

77

77

74

72

71

69

66

64

62

61

61

58

46

45

4

6

6

6

4

4

3

11

5

10

10

11

10

11

4

11

16

22

% Agree % Disagree


Accessible

Accountable

Authoritative

Consistent

Effective

Efficient

Engaging

Flexible

Focused

Informative

Modern

Professional

Proportionate

Reliable

Responsive

SupportiveTargeted in its actions

Transparent


Principles of Good Regulation

Five key characteristics make up “good regulation”. That an organisation be:

• transparent

• accountable

• proportionate

• consistent

• targeted – only at cases where action is needed

Over three in five (62%) say the HTA is transparent and only one in ten (10%) expressly

disagree - a ratio of 6:1. Among post mortem respondents, the figures are also clearly

positive: 53% vs 13%, or 4:1 - and the pattern is also evident across all the other sectors and

respondent types.

Having said that, almost one in three (28%) do not commit as to the HTA’s degree of

transparency.

The tone of responses in the KOL study (with in-depth interviews) tended to be different, with

stakeholders often more critical (although with the most vehement comments often relating

specifically to Cardiff - not to the Authority as a whole). Some in the post mortem sector still

want to see the HTA being more transparent in its activities - but overall the online results

paint a generally positive picture.

Similarly, the HTA is widely seen as accountable across all sectors and by all respondent

types. For example, 72% of IAs rate it so, against eight per cent who expressly do not. The

equivalent figures for the transplant (solid organ) sector are 76% and 7%.

DIs and those in the post mortem sector are slightly less positive - but even here the balance

of opinion is favourable: among DIs by a ratio of over 3:1 (50% agree the Authority is

accountable, 14% say not) and among post mortem respondents by 2:1 (44% vs 21%).

Overall, 31% are unsure / uncommitted as to whether the HTA is accountable.

In regards to the HTA being proportionate, just under half (46%) feel it is, 16% expressly

disagree - and 37% are in some way uncommitted / unsure. These overall figures are

negatively coloured by the views of DIs - 42% of who say the Authority is proportionate, 23%

say not - and also by post mortem sector respondents (35% and 34% respectively).


The most positive groups are IAs (56% vs three per cent), Living Donor Co-Ordinators (63%

vs three per cent) - and among the sectors the transplant (solid organ) respondents are

especially upbeat: 58% say the Authority is proportionate, while only three per cent expressly

disagree.

Those with longer periods in post also have a better view of HTA’s proportionality -

suggesting perhaps that a longer professional perspective casts the Authority in a more

favourable light (albeit that the HTA itself is a relatively new body).

In the qualitative KOL work, some felt the HTA to have an inappropriately “light touch”, while

others thought it excessively “heavy-handed”.

Indeed, some of these qualitative participants called for more inspections - believing they are

currently conducted only in times of crisis. A few stakeholders from different sectors believed

there was some inconsistency in the inspections from different inspection teams, which may

lead to a lack of clarity in the process. The people responding here may not have been

subject to an inspection themselves, but included stakeholders from the human application

and the post mortem sectors.

Often in the in-depth KOL interviews, negative perceptions of proportionality appeared to be

related to fees; those who had seen increased licensing fees wanted to know what this

money is spent on - if not increased numbers of inspections. More clarity and transparency is

seen to be needed in this area.

(The HTA has recently conducted a consultation on licence fees).

Around two thirds (66%) view the HTA as consistent. This is a solid score, but not one that

represents a key perceived strength. As is common, those not convinced tend to be

undecided or neutral - not expressly critical.

In this case, neither the DIs nor post mortem sector are strongly dragging down the overall

score - while IAs and transplant (solid organ) respondents are notably positive, with well over

80% of each saying the Authority is consistent.

Seven in ten (71%) see the HTA as targeted in its actions, and just 5% say not. These

overall scores disguise very little variation by group or sector. The respective findings among

DIs are 68% and 7%, and among post mortem respondents 67% and 9%. IAs and transplant

(solid organ) participants are similarly positive.


This final set of data illustrate that the variations in attitudes towards the HTA occur on a

case-by-case basis. Specific concerns among specific groups do not inevitably ‘contaminate’

these groups’ ratings of HTA’s other characteristics.

Where there are variations in views between different sectors and respondent types, they

most notably take one of two forms:

• Post mortem respondents are relatively less likely to view the HTA as accountable,

efficient, engaging, flexible, proportionate or supportive than are other DIs. By

contrast, the human application sector is overall the most positive DI-based group

(most notably in relation to the HTA’s perceived effectiveness [68% agree], efficiency

[66%], ability to engage [68%], flexibility [55%], professionalism [87%], proportionality

[62%], reliability [74%], supportiveness [79%] and being targeted in its actions [81%]).

• Designated Individuals as a whole voice slightly greater doubt as to the HTA’s ability

to engage, its flexibility, proportionality and supportiveness. Far more positive are

those from the transplant (solid organ) sector - who are not DIs - who hold the single

most positive opinions in relation to many aspects of HTA’s work, including its

accessibility (94%), accountability (76%), consistency (88%), effectiveness (90%),

professionalism (95%), reliability (93%), responsiveness and supportiveness (each

89%). What particularly marks out the transplant (solid organ) sector is its strength of

view, with a generally far higher proportion strongly agreeing with the various

propositions.

Importance and efficacy of HTA activities

Respondents were asked how important they believe a range of activities are for the HTA to

conduct - and then asked for each how effective they feel the Authority is in that area. By

comparing the two, we can identify any areas of (perceived) shortfall.

In the graph below these importance and efficacy scores are mapped against each other: the

activities in the top right hand corner are seen as important and effective - and so show the

areas of greatest achievement / strength for the HTA. Encouragingly, most activities fall into

this segment. They include ‘providing codes of practice’, ‘overseeing the consent

requirements of the Human Tissue Act’, ‘giving advice and guidance on interpreting relevant

legislation’ and ‘providing an effective website’.


Many of these also came out of the qualitative work with KOL stakeholders. Practically all

such stakeholders claimed to know the codes of practice well and many had been directly

involved in putting them together. They were generally considered to be useful.

Likewise, there was positive feedback among the KOL stakeholders on the efficacy and

presentation of the HTA website - and most stakeholders were shown to be very happy to

use electronic means of communication.

Perhaps of more significance in the graph below, however, is the highlighting of activities that

stakeholders see as important but less effectively conducted (the bottom right hand corner).

These include ‘providing value for money for the taxpayer’, ‘working with other organisations

to ensure joined-up regulation, ‘advice and guidance’, ‘ensuring dignity and respect for the

deceased’, ‘ensuring the safety of human tissue and cells’ and ‘improving public confidence’.

In absolute terms, the HTA is felt to be least effective in ‘supporting business and innovation’,

‘reducing the burden on your sector’, ‘ensuring access to samples / bodies’ and ‘providing

value for money for the taxpayer’. Although generally among the areas of perceived lesser

importance, these may nonetheless be important to monitor to ensure that the relative

balance of HTA’s activites continues to match professionals’ expectations and priorities.

In considering which areas are most or least important / effective, we should be mindful that

the differences are relative; no activities are completely unimportant.

Effectively then, the chart below identifies a potential ‘hit list’ for prioritisation in the future -

with due consideration of the nature and targeting of that response.


10

20

30

40

50

60

70

80

90

100

40 50 60 70 80 90 100

% E

ffect

ive

% Important

Effective vs. importance

Improving public confidence

Providing an effective website

Providing training events and workshops

Ensuring medical schools and surgeons have access to bodies for education and training

Providing licences

Producing codes of practice

Providing value for money for the tax payer

Improving professional confidence

Ensuring safety of human tissue and cells

Overseeing the consent requirementsof the HT Act

Working with other organisations to ensure joined up regulation, advice and guidance

Inspecting to ensure good standards

Giving advice and guidanceon interpreting relevant legislation

Ensuring researchers have access to high quality samples

Reducing the burden on your sector

Supporting business and innovation

Ensure dignity and respect for the deceased

Working with Govt and Europe to implement legislation

Understand the risk of organ or bone marrow donation

Among the various sectors and respondent types, there are no fundamental disagreements

on the relative importance of these aspects. Even where the issues are somewhat sector-

specific, there is general unanimity. (The research sector, for example, no more emphasises

the importance of “access to high quality samples” than do others: 67% in each case).

A few differences are worth noting, however: Post mortem respondents are slightly less

convinced of the importance of the HTA “improving professional confidence” (26% say this is

“not important” against 14% overall - though possibly the question was taken by some as the

perceived importance from the HTA’s point of view).

“Access to bodies for education and training” is also slightly less important for the post

mortem sector - 29% say “not important” against 17% overall - but slightly more so (85%

“important”) for those involved in human application (who also particularly advocate

“supporting business and innovation”, at 53%). Finally, Independent Assessors are (even)

more focused on the need to provide the taxpayer with value for money than are DIs – even

though IAs are not charged fees by the HTA.

In terms of the HTA’s perceived effectiveness in these areas, there are again some

variations within a generally consistent picture.


Overall, the post mortem sector and DIs tend to be relatively less positive in a number of

areas - in particular:

• Improving professional confidence (post mortem respondents in particular, with 49%

saying “effective” and 45% “not effective”)

• Ensuring dignity and respect for the deceased (the post mortem score is 26% “not

effective” against 10% overall)

• Providing value for money for the taxpayer (“not effective” scores of 48% [post

mortem], 36% [DIs] and 25% [overall])

• Reducing the burden on your sector (“not effective”: 73% post mortem, 61% DIs and

46% overall. In each case, more people rate the HTA ineffective than effective (46%

vs 31% overall).

• Working with others to ensure joined-up regulation / advice guidance (post mortem in

particular - 37% “not effective” against 20% overall)

More positive findings include the fact that none of the Living Donor Co-Ordinators are critical

of the HTA’s role in ‘improving public confidence’ (whereas 17% of DIs and 21% of post

mortem respondents are).

HTA’s ‘advice and guidance on interpreting relevant legislation’ is especially well-regarded by

transplant (solid organ) respondents, while there appears concern among anatomists (albeit

based on very small numbers) that access to bodies for medical schools / surgeons could be

improved in their view.

While the research sector does not particularly emphasis the importance of access to high

quality samples, it does feel the process somewhat lacking in practice: indeed, the 49

research respondents are almost equally split on HTA’s performance here - 37% say it is

effective, 35% say not - while respondents overall are positive by almost 2:1 (31% to 17%).

Human application respondents (again relatively few in number: 47) are slightly less

praiseworthy than others on HTA’s training events and workshops (64% rate them “effective”

against 76% overall).

There are unusually sharp difference in views of the HTA ‘working with other groups to

provide joined-up regulation, advice and guidance’. Among Living Donor Co-Ordinators,

71% say it does so effectively (and nobody is expressly critical). Among human application

respondents, just 43% are positive and 38% critical.


Finally, IAs (who felt providing value for the taxpayer was important) generally do not know

whether the HTA does provide such value - but those with a view more often think it does

(31%) than does not (8%). (It should be noted that IAs do no pay licence fees). DIs are much

more split on the question of taxpayer value, with 32% rating the HTA effective here and 36%

expressly not.

Regulation

Confidence in HTA regulation

Encouragingly, 86% of stakeholders have “a great deal” or “fair amount” of confidence in the

HTA as a regulator of the removal, storage, use and disposal of human tissue. The 41% with

“a great deal” of confidence represents a particularly strong finding.

41%

45%

7% 2%2%3%

Confidence in the HTA as a regulator

A great deal


Q To what extent, if at all, do you have confidence in the HTA as a regulator of the removal, storage, use and disposal of human tissue?

Don’t know

A fair amount

Not very muchNot at all

No opinion

Although results are fairly consistent across sectors, those (again) in post mortem are less

positive - with 20% having “not very much” or “no” confidence (against nine per cent overall).

The human application and research sectors are both more positive, with 90% in each

voicing confidence in the Authority. The transplant (solid organ) sector contains around half

with “a great deal” of confidence (53%), as does the human application sector (49%).


4

6

6

3

1

2

4

2

3

3

5

1

2 (N)

7 (N)

27%

44%

53%

29%

49%

6 (N)

5 (N)

49%

41%

34%

61%

43%

1(N)

14% 6

6

2 3*15

Post Mortem

Human Application

Research

Public DisplayAnatomy

49

47Base


Transplants – Solid Organ Donation 88

34

86

139


Confidence in the HTA by sector

% A great deal % A fair amount% Not very much % Not at all

Q To what extent, if at all, do you have confidence in the HTA as a regulator of the removal, storage, use and disposal of human tissues?

% Don’t know% No opinion

Two in five (39%) say their confidence in the HTA as a regulator has increased over the last

three years - against only 9% who report it to have declined. (This latter figure is 23%

among the post mortem respondents, and so to some extent is affected by that). However,

the single largest group overall (43%) say their level of confidence is unchanged.

This overall ‘net’ improvement of +30 percentage points (39% minus nine per cent) is higher

still among human application and research respondents - at +49% and +45%, respectively -

but lower in post mortem at +17%.

There is of course a close correlation with wider views of the HTA. Larger-than-typical jumps

in confidence are evident among those who feel well-informed about the HTA, its potential

advocates, and those generally favourable towards it. (Reported ‘changes’ in for example,

confidence tend to reflect people’s view about an organisation at a given point in time as

much as they do any perceived improvement over time).


Change in confidence over the last three years


Q Has your confidence in the HTA as a regulator of the removal, storage, use and disposal of human tissue increased, decreased or stayed the same over the last three years? Would you say it has . . .

9%

30%

43%

9%

5%4%

Increased a lotDon’t know

Increased a little

Stayed about the same

Decreased a lotDecreased a little

Communications

Types of communication and their relative usefulness

As was also found among KOL stakeholders, the most commonly used communication

channels appear to be electronic.

All have had some form of contact in the past year - 93% via email, 87% via the HTA

website, and 71% through an e-newsletter or bulletin. However, some other forms of contact

remain frequent as well. Around half have had contact with the HTA by telephone (55%) or

face-to-face (52%) - the latter comprising 46% through conferences / events and 26% at

meetings.

About quarter (26%) have contributed to consultation/s. On top of this, a third (35%) have

had written contact and a fifth (22%) involvement in training.


1%6%

12%22%

26%26%

35%46%

55%71%

87%93%

Communications with the HTA

Q Which, if any, of the following forms of communications with or from the HTA have you had in the past 12 months?


EmailHTA website

Received e-newsletter or bulletinTelephone call

Conferences or eventsLetter

Face-to-face meetingsContributed to consultation

Training

Press releaseInspection

Other

The nature of contact does not change dramatically across the sectors / professional groups

- but those working in human application have far higher telephone contact than do most

others, while training is of course more prevalent among those new in post.

One clear message from the qualitative research was a greater call for face-to-face and

telephone contact with the HTA. Being able to put a name to a face and meeting individuals

in person or through a telephone call could be an improvement to the general relationship

between the HTA and the organisations. (This view almost always emerges when

professionals are asked how to improve relationships with organisations).

In the online survey, nearly all (97%) report finding face-to-face meetings useful (71% “very

useful”) and the same proportion feel similarly about telephone calls (73% “very useful”).

While 95% and 90% respectively find email and e-newsletters or bulletins useful, a smaller

proportion find them “very useful” (54% and 34% respectively).

Once again, the inference is that electronic communications should ideally complement not

replace more traditional communications channels - again a very familiar theme from other

research among professionals.


7371

7754

4758

3447

3824

20

242618

4147

3456

4147

5556

2

5456

88

814

11

1

1

112

4

13

1112355

9

*

Usefulness of HTA communications

Training

Conferences or events

Face-to-face meetings

% Very useful % Fairly useful % Don’t know/No opinion% Not very useful % Not at all useful

Q How useful, if at all, do you personally find the following forms of communication with the HTA?

Base: All who mentioned each of the communications, fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI

Base

8922

324302

77249162123

192

9142

Telephone call

Letter

Email

Contributed to consultation

HTA website

Press release

Received e-newsletter or bulletin

Inspection

Again, the pattern tends to be consistent across sectors and groups - and indeed the

usefulness of electronic communications extends across those with different levels of

experience (and by implication, of different ages).


Perceptions of the HTA website

HTA stakeholders have a positive view here. Three quarters believe the homepage gives a

clear overview of what can be found on the site, and two thirds (65%) think that the design

and layout are user-friendly (14% disagree).

Slightly fewer (57%) believe that the search function returns relevant results. However, this

appears to reflect the higher incidence of ‘don’t know’ responses for this question (16%) -

presumably as not all respondents have used the function.

17

14

9

58

51

48

15

18

19

7

12

7

1

2

1

3

3

16

Perceptions of the HTA website

The homepage gives a clear overview of what can be

found on the site

% Strongly agree % Tend to agree % Neither/nor% Tend to disagree % Strongly disagree

Q To what extent, if at all, do you agree or disagree with the following statements about the HTA website?

% Don’t know

The design and layout is user friendly

The search function returns relevant results


The use of social media

The use of social media for professional purposes is still a minority activity among our online

respondents here. About seven in ten (71%) do not use any. Relatively most popular is

LinkedIn (11%), while seven per cent use Facebook and six per cent YouTube. Twitter

usage is currently at two per cent, and blogs at three per cent.


However, the findings in relation to email are difficult to interpret. The definition of

‘professional purposes’ is subjective, as is that of ‘social media’. Only two per cent say they

use email for professional purposes - whereas we saw previously (on the “Communications

with the HTA” chart) that over nine in ten have had email contact with the HTA in the past

twelve months. This contradiction could be due to the fact that respondents do not

necessarily see email as a form of social media.

71%

1%

1%

2%

2%

3%

6%

7%

11%

Use of social media

Q Do you use any of the following social media for professional purposes?


LinkedIn

None/don’t use any

Facebook

YouTube

Blogs

Twitter

Email

Google

Doctors.net

By way of context: In a previous study conducted by Ipsos MORI in October 2009, 89% of

home internet users had sent or received email in the last three months, and half (49%)

visited social networking sites such as MySpace, Bebo, Facebook and Friends Reunited.

However, this was for general use - rather than for ‘professional purposes’.

Keeping stakeholders informed

Stakeholders appear generally happy with the level of information they receive from the HTA.

Over four in five (84%) feel informed about its work generally - and although ‘only’ one in five

(22%) are “very well informed”, this compares very well with the public sector normative

figure of eight per cent from our comparable surveys about other organisations. (See chart

below).


In regard to more specific subjects, 86% feel informed by the HTA on changes to forthcoming

regulation / legislation (with 36% very well informed). Seven in ten (69%) say the HTA keeps

them informed on why its takes specific decisions - and 19% in this case report being very

well informed. (Relatively, though, this is the weakest area of the three - with 26% feeling

poorly informed).

The few Living Donor Co-Ordinators here in particular appear to praise the HTA’s

performance.

36

22

19

50

62

50

9

10

21

2

2

5

4

4

6

Information levels

Its work generally

% Very well informed % Fairly well informed % Don’t know/No opinion% Not very well informed % Not at all well informed

Q How well informed, if at all, do you feel HTA keeps you about . . . ?

Why it takes specific decisions

Forthcoming changes to regulation/legislation


In the KOL in-depth stakeholder interviews there were mixed opinions on information levels.

Many said they are updated very regularly and there is no room for improvement, whilst

others still wished to see more. There did not appear to be great differences between sectors

in this regard - but it appeared more to reflect personal preference.


The HTA scores highly on keeping its professional stakeholders informed, in comparison to

other public sector organisations whose key stakeholders Ipsos MORI has surveyed. The

chart below shows where the HTA ranks on this scale.3

26

4439

5447

56

5757

58585961

6764

718486

Keeping stakeholders informed – high, compared to Ipsos MORI benchmarks

% Informed

How well informed, if at all, do you think… keeps you about its work?

Base: Various user and stakeholder surveys of public sector organisations

Regulator

RegulatorNDPB

Govt Dept

Regional body

Regional bodyRegional body

Regional body

Regional bodyRegional bodyRegional bodyRegional body

Regional body

Govt Dept

NDPB

NDPB

HTA

The HTA’s Codes of Practice

Almost half (45%) claim to have read ‘all or nearly all’ of the sector-relevant HTA codes of

practice, and a further three in ten have read ‘most’ of them. Only five per cent say they read

just a few pages / glanced at them, and about one in five refer to them when they have a

specific query.

Most strikingly, only two per cent of respondents claim never to have read them – one

indication of how tightly the various professions are bound in with the HTA from an

information viewpoint.

3 Each blue line is a (different) organisation taken from Ipsos MORI’s user and stakeholder studies among various public sector organisations. (None of these is an employee study).


1%

1%

19%

1%

4%

30%

45%

Reading the HTA’s Codes of Practice

Q As you may know the HTA provides Codes of Practice. Thinking about the most relevant code/s to your area, would you say you . . .

Read all or nearly all of them

Read most of them

Just glance at them

Refer to them when you have a specific query

See them but never read them

Have never seen them

Read a few pages


This reflects the qualitative findings, where practically all those interviewed claimed to know

the codes of practice well, and indeed a large proportion had been directly involved in putting

them together.

The KOL stakeholders also widely viewed the codes as useful - and similarly in the online

survey 93% of those having read them agree (including 50% saying very much so). Only one

in twenty (five per cent) do not find them useful.

Two groups appear to express particular praise for the codes: Living Donor Co-Ordinators

(68% of whom think them very useful) and transplant (solid organ donation) practitioners

(60%). (Please note that the first score is based on a small number of respondents: 37).


50%

1%

43%

4%1%

Usefulness of the HTA’s Codes of Practice

Base: All those who have read the codes of practice (345), fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI

Q How useful, if at all, do you find the HTA’s Codes of Practice?

Don’t know

Very usefulFairly useful

Not very usefulNot at all useful

Overall communications with the HTA

Stakeholders are very positive about their overall communications with the HTA. Over four in

five (85%) rate them as good - including two in five (41%) saying “very good”.

Even more significant perhaps is the fact that only three per cent would describe

communications with the HTA as “poor”. This represents 11 individual respondents - eight of

whom are DIs, ten of whom have between one and five years in post - but only two of whom

work in the post mortem sector.


41%

44%

2%1%

1%12%

Overall communications with the HTA


Q And overall, how would you rate your communications with the HTA? Would you say they are . . .

No opinion

Very good

Fairly good

Neither/nor

Fairly poorVery poor

IAs are even more likely to rate communications with the HTA as good overall (95%,

compared to 85% across the full sample) - and like Living Donor Co-Ordinators they also

more often think it ‘very’ good’ (53% among IAs, 63% for Living Donor Co-Ordinators, and

41% overall).


Overall communications with the HTA by role



22

2

2

3

21

53%

63%

33%

9 (N)

2 (N)

3 (N)

42%

26%

48%

1 (N)

2 (N)

15%

8%

Base

% Very good % Fairly good% Fairly poor % Very poor

% Neither/nor% No opinion



Accredited Assessor



38

230

14

64

3

Across the sectors, transplant (solid organ donation) stakeholders are the most likely to rate

communications as good (93%). This compared to 85%* of the transplant (bone marrow or

stem cell donation) sector, 84%* of research, 83%* of human application and 80% of the

post mortem sector. (* = small base).


Overall communications with the HTA by sector



5

2

4

2

3

2

213 (N)

29%

51%

18%

56%

58%

4 (N)

8 (N)

51%

32%

65%

29%

35%

4 (N)

2 (N)

16%

11%

14%

12%

1(N)

Base

34

49

47

88

13

Post mortem

Human application

Research

Public display

Anatomy

Transplants – bone marrow or stem cell donation

Transplants – solid organ donation

86

9

% Very good % Fairly good% Fairly poor % Very poor

% Neither/nor% No opinion

Stakeholders were also asked to give their suggestions for improvement of HTA

communications. As shown below, nearly seven in ten (68%) believe that no improvements

are necessary (or could not think of any ‘on the spot’ - which is often the case with such

questions).

Of those who do have suggestions, the most common are having ‘information specific to

ones’ sector’ (six per cent) and ‘quicker response time to email and written queries’ (four per

cent). These are both absolutely typical of professional / stakeholder responses, and do not

mark out the HTA as deficient in these areas.

A further four per cent commented that they are ‘happy / satisfied with communication’.


6%4%4%

2%2%2%1%1%1%1%1%3%

68%8%

Information specific to me/my/each sector

HTA is dictatorial/inflexible


How communications could be improvedQ How, if at all, could the communications you receive from the HTA

be improved?

Quicker response time to e-mailed/written/queries

Nothing/Satisfied/Happy with communicationBetter search facilities on the website/more user

friendlyAble to contact a specific person/telephone contact

Less/detailed information/shorter communications

Frequency/More frequent newsletters/emails/updates to website

They are an unnecessary burden/disband

Less jargon/clear responses

Staff are pleasant/polite/friendly on the phone

Other

Nothing in particular

Don’t know


Sector-specific Questions

Ease of compliance

Generally, stakeholders find it easy to know what they have to do to comply with the HTA’s

standards. The transplant (solid organ donation) sector respondents are most satisfied with

this, with over nine in ten (92%) reporting it easy - and far more than in any other sector

rating it ‘very’ easy.

Two thirds of the research and transplant (bone marrow or stem cell donation) sectors find

understanding compliance easy (65% and 68% respectively), along with 56% of the post

mortem sector and 55% of the human application sector.

However, some attention may be needed in the post mortem and human application sectors,

where about a quarter in each find it difficult to know what to do. This is also an issue in the

transplant (bone marrow and stem cell donation) sector.

6

5

1

1

6

1

1

1(N)

4 (N)

7

10%

18%

43%

2 (N)

6 (N)

49%

49%

55%

50%

49%

4 (N)

2 (N)

21%

17%

24%

9%

2 (N)

17%

16%

10%

12%

9%

9%

Ease of compliance with the HTA’s standards

Post Mortem

Human Application

Research

Public Display

Anatomy 13

9

Base


Transplants – Solid Organ Donation 88

86

49

47

34

Base: All in the . . . , fieldwork dates: 14th June – 2nd July 2010 Where the overall number of respondents (N) is 30 or less the absolute number of respondents is stated Source: Ipsos MORI

Q How easy, if at all, is it to know what you have to do to comply with the HTA’s standards in the . . . sector

% Very easy % Fairly easy% Fairly difficult % Very difficult

% Neither/nor % No opinion% Don’t know


Summary of compliance reports

While the post mortem sector expressed some difficulty in knowing what to do about

compliance in their sector, it is the most likely to have read the most recent summary of

compliance report.

6

6

1

2

5

6

2

2 (N)

5 (N)

21%

27%

40%

1(N)

6 (N)

40%

29%

37%

4 (N)

21%

20%

9%

2 (N)

12%

1(N)

11%

1(N)

4

Summary of compliance reports

Post Mortem sector

Human Application sector

Research sector

Public Display sector

Anatomy sector 13

Base

86

9

47


Q As you may know, the HTA provides summary of compliance reports for the . . . Thinking about the most recent summary of compliance report, would you say you . . .

% Read all or nearly all of it % Read most of it% Just glanced at it % Saw it but never read it% Don’t know/can’t remember

% Read a few pages% Did not see it

49

Those who have read their most recent report have generally found it useful. This applies to

nearly nine in ten (86% each) of the post mortem and human application sectors, along with

over four in five (83%) of those in research.

Although the post mortem sector has often been one of the most negative towards the HTA,

this is an exception.


1

13

1

2

1 (N)

5 (N)

23%

29%

33%

4 (N)

6 (N)

60%

57%

53%

2 (N)

12%

10%

10%

5

2

Usefulness of summary of compliance reports

Q How useful, if at all, did you find it?

Base: All in the . . . and who read the most recent summary of compliance report, fieldwork dates: 14th June – 2nd July 2010 Where the overall number of respondents (N) is 30 or less the absolute number of respondents is stated Source: Ipsos MORI

% Very useful % Fairly useful% Not very useful % Not at all useful

% No opinion

Post Mortem sector


Research sector


Anatomy sector

43

13

Base

79

7

42

% Don’t know

Stakeholders were also asked how they thought the summary of compliance reports could be

improved. To each of the (five) sectors’ respondents, we presented a consistent list of

options and asked them to choose which one/s they thought applicable.

Generally the most popular idea is to include more case studies (42% of the post mortem

sector cited this, 36% of human application and 35% of the research sector). Some

stakeholders also believe that reducing the length of the reports would be an important

improvement. Nearly two in five (38%) of the human application sector mention this (their

single highest-scoring suggestion). One in five of the post mortem and research sectors also

see this as a priority (21% and 20% respectively).

Other suggestions are making changes to the layout of the reports (20% of research and

17% of human application) and the inclusion of more data (12% of the post mortem sector).

The charts below show in turn the full results for the three most robust sets of data - those

from the post mortem, human application and research sectors. The other sectors’ results

(anatomy and public display) should be treated as indicative only


42%21%

12%9%

7%7%6%6%

0%5%

30%9%

Include more case study examplesDecrease length

Include more dataDecrease frequency

Include more diagramsAppearance (more use of colour, graphics etc)

Layout (better mix of text and charts)Increase frequency

Increase lengthOther

Nothing in particularDon’t know

Improving summary of compliance reports for the Post Mortem sector

Q How, if at all, can summary of compliance reports be improved?

Base: All in the Post Mortem sector (86), fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI

38%36%

17%11%11%

9%4%4%

0%4%

19%15%

Include more case study examplesDecrease length

Include more dataDecrease frequency

Include more diagramsAppearance (more use of colour, graphics etc)

Layout (better mix of text and charts)

Increase frequencyIncrease length

OtherNothing in particular

Don’t know

Improving summary of compliance reports for the Human Application sector

Q How, if at all, can summary of compliance reports be improved?

Base: All in the Human Application sector (47) , fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI


35%20%20%

12%8%

6%4%

2%0%2%

29%16%

Include more case study examples

Decrease lengthInclude more data

Decrease frequencyInclude more diagrams

Appearance (more use of colour, graphics etc)

Layout (better mix of text and charts)

Increase frequencyIncrease length

Other

Don’t know

Improving summary of compliance reports for the Research sector

Q How, if at all, can they be improved?

Base: All in the Research sector (49), fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI



Feedback following site-visit inspections

The majority of stakeholders from all sectors would prefer to provide this by email (over

seven in ten of the research and human application sectors, and two thirds of post mortem).

Other suggested methods - again chosen from a consistent ‘pre-coded’ list - are telephone,

via the HTA website and by letter. The full breakdown is shown in the chart below.

29

34

23

2

2

14

23

22

4

4

22

19

17

2

2

3

1

26

5

1

4

3

5

11

66

72

73

3

6

Feedback on site-visit inspections

Post Mortem sector


Research sector


Anatomy sector 13

9

Base

86

49

47


Q The HTA would like to increase the amount of feedback it receives following inspections. How, if at all, would you prefer to provide feedback to the HTA following a site-visit inspection?

% Email % Telephone call% Face to face visits % Other

% Via the HTA website% Don’t know% Prefer not to feed back

% Letter % Survey


General Directions for the post mortem sector

Respondents from the post mortem sector (only) were asked about a specific alert from the

HTA, as follows:

In December, the HTA issued a regulatory alert to Designated Individuals in the post mortem sector on compliance reporting and the retention of tissue and organs following post-mortem examination. The alert gave DIs advance notice of HTA General Directions issued on 30 April 2010 requiring them to audit relevant material from the deceased and submit results to the HTA.

In total, over four in five (84%) felt that the communications were clear - with one in five

saying “very clear”. The thirteen per cent who did not think them clear represented 11

individual respondents: all of whom had been in post for up to five years.

20%

64%

3%10%2%

Communications about General Directions

Base: All in the Post Mortem sector (86), fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI

Q How clear, if at all were the communications you received from the HTA about the General Directions?

Very clear

Don’t know

Fairly clear

Not very clearNot at all clear


Communications about cord blood collection in the human application sector

In the human application sector (only), respondents were asked how clear they felt

communications were from the HTA regarding the following:

In March the HTA wrote to more than 150 organisations following concerns that umbilical cord blood collection may be taking place unlawfully. This followed a number of incidents where unlawful cord blood collection by parents or untrained staff could have compromised safety and quality standards.

Half (51%) thought that these were clear (including 17% “very clear”). Only six per cent did

not find them so to any degree. However, over two in five (43%) answered ‘don’t know’ -

presumably because they were not involved in this activity.

17%

34%

43%

4%2%

Communications about cord blood collection

Base: All in the Human Application sector (47), fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI

Q How clear, if at all were the communications you received from the HTA about regulation of cord blood collection?

Very clear

Don’t know

Fairly clear

Not very clearNot at all clear


Last year’s (2009) evaluation of the research sector

Last year an evaluation was conducted of the research sector. In order to follow up on this,

respondents from this sector (only) were asked how they think the HTA has used the

findings. Again, we used a ‘pre-coded’ list of possible answers, from which respondents

were asked to choose ‘as many as apply’.

The two most frequent responses were ‘to improve the HTA’s advice and guidance for the

research sector’ (61%) and ‘to ensure researchers understand the requirements of the HTA’s

regulation’ (53%). One in three mentioned ‘contributing to other organisations’ advice and

guidance for the research sector’.

6%

18%

27%

33%

53%

61%

Use of the evaluation last year

Q As you may know, last year the HTA conducted an evaluation of the research sector. As far as you know, how do you think the HTA has used the findings of this evaluation?

Base: All in the Research sector (49), fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI


To improve the HTA’s advice and guidance for the research sector

To ensure researchers understand the requirements of the HTA’s regulation

To contribute to other organisations’ advice and guidance for the Research sector

To streamline its regulatory approach with other organisations

Don’t know


IAs available to the transplant unit

All respondents in the transplant (solid organ donation) sector were asked about the

Independent Assessors (IAs) available in their transplant unit.

Over seven in ten (72%) agree that the IAs available satisfy their transplant unit’s organ

donation activity. Hardly any expressly disagree - but one in five (22%) have no opinion.

‘Workload’ is the most commonly-perceived potential barrier to sustaining the IAs available to

the transplant unit: Half (51%) cite this from the list provided. A quarter (27%) think that

‘constraints in the NHS’ is a barrier and nearly a quarter (23%) identify ‘lack of funding’ as a

reason.

30%

42%

3%

22%

10%2%51%

27%

17%

23%

13%

7%7%

IAs available to transplant unit

Base: All in Transplants – Solid Organ Donation sector (88), fieldwork dates: 14th June – 2nd July 2010 Source: Ipsos MORI

Q52 To what extent, if at all, do you agree or disagree that the IAsavailable to your transplant unit, satisfy its organ donation activity?

Q53 What, if anything, are the potential barriers to sustaining the IAsavailable to your transplant unit?

Strongly agreeNo

opinion

Tend to agree

Neither/nor

Tend to disagree

Q52

Workload

Constraints in the NHS

Lack of funding

Staff turnover

Other

None of these

Don’t knowQ53


Focus for the HTA in the future

Unprompted, a varied range of suggestions emerged here.

Some are focused on costs, with one in ten stating ‘controlling or reducing licensing fees and

costs’ as a priority. Eight per cent mention ‘clarifying or simplifying the guidance / codes of

practice’, while seven per cent emphasise ‘avoiding overlap of regulations or considering

merging or working with other bodies’.

The sub analysis reveals no fundamental differences. Among the marginal variations worthy

of note are that IAs would particularly like to see raised public awareness of the value of

organ donation. The research sector appears particularly to want greater clarity on guidance

/ codes etc - but this is based on small numbers.

(NB The chart below is summarised. For the full answer wording and category listings,

please refer to the full computer tables).


10%

8%

7%

5%

5%

4%

4%

3%

3%

3%

3%

3%

Controlling/reducing/licence fees/costs


Focus for the HTA in the next two or three yearsQ Thinking about the next few years, what two or three things do you

think might be the most important for the HTA to focus on?

Clarify/simplify guidance/Codes of Practice

Avoid overlap of regulations between similar organisations

Better/more training days/conferences/events for IAs/DIs/PDs

Reduce/avoid over burdensome regulations/frequent inspections

Raise its profile/public awareness of the value of organ donation

Work closer with its stakeholders/those in the profession

Reduce paperwork/bureaucracy/reporting

Standardise regulations/inspections across the UK/between England/Scotland/sectors etc

Consent for tissue research/organ donation/ port mortem research

Ensuring compliance to HTA standardsRaise standards/improve practices/do more to support

stakeholders


Improving the HTA’s relationship with its stakeholders

When asked (unprompted) how the HTA could improve its relationship with stakeholders,

three in five say ‘nothing in particular’ comes to mind - and a further six per cent say they are

‘happy as it is / nothing to improve’.

The improvements which are occasionally mentioned include ‘improving communications /

having more updates’ (five per cent) and ‘appointing a primary contact for each area’ (three

per cent).

The HTA’s demeanour is also an issue for a handful of people - with requests that it be less

heavy-handed - but this specific view at this particular question comes exclusively from some

in the post mortem sector.

6%60%

15%2%2%2%2%3%5%6%

Improving relationship with the HTA

Don’t know

Q How, if at all, could the HTA improve its relationship with you?



Other

Happy as it is/its fine/nothing to improve/continue as it isImprove communication/keep me in the loop/more better

information /updatesAppoint a primary contact/dedicated officer for queries/key

person for each areaReduce/stop increasing fees/charge less/more value for

money

More/different teaching sessions/would like to attend training events

Be more supportive

Be less threatening/don’t involve the police/less heavy handed approach

About three quarters of stakeholders (choosing from a pre-coded answer list) believe that the

HTA should use the feedback from this evaluation to ‘give feedback via the e-newsletter or

website’ (74%). Two in five say it should be used to ‘inform HTA policy development’ (46%)

and that ‘results should be presented to key stakeholders’ (43%).


4%

1%

2%

1%

8%

21%

43%

46%

74%

Feedback from this evaluation

Don’t know

Feedback via e-newsletter and website

Q How do you think the HTA should use the feedback from this evaluation?


None of these

OtherImplement recommendations

Issue media releaseImprove their communications

Present results to key stakeholdersInform HTA policy development

In particular, Living Donor Co-Ordinators advocate e-newsletter and website feedback, and

those in the research sector especially see the evaluation’s potential to improve HTA’s

communications.


Appendices


Appendices

Appendix 1 - Profile of sample

PROFILE OF KEY SUB-GROUPS

Original sample

universe

Achieved sample (number of interviews in brackets)

Know at least a fair

amount about

the HTA

Favourable towards the HTA

Unfavourable towards the

HTA

Would speak

highly of the HTA

Base: 768 349 318 238 59 204 % % % % % %

Relationship with the HTA

DI 66 66 (230) 68 58 78 55

IA 16 18 (64) 18 24 10 26

AA 5 4 (14) 3 5 2 3

Living donor coor-dinator

12 11 (38) 10 13 10 15

Stem cell coor-dinator

2 1 (3) 1 * - -

Length of time in role

Less than 1 year N/A4 15 (51) 13 16 14 16

1-5 years N/A 79 (274) 81 78 76 75

6-10 years N/A 4 (14) 4 4 5 5

More than 10 years N/A 3 (10) 2 3 5 4

4 N/A means this information is not available.


Sector5 Post

mortem 25 25 (86) 25 18 39 18

Human appli-cation

21 13 (47) 13 13 12 13

Public display

2 3 (9) 2 2 2 *

Research 14 14 (49) 15 16 7 14

Anatomy 3 4 (13) 4 3 3 3

Trans-plants – solid organ donation

27 25 (88) 24 32 15 35

Trans-plants – bone marrow or stem cell donation

7 10 (34) 9 8 15 8

Other - 7 (23) 8 5 7 6

5 A comparison of the profile of the universe and of the sample reveals that they are very similar. The main difference is that in the sample 7% said other and 13% said human application whereas in the profile of the universe 21% said human application. Because the profile of the sample by job role and sector are both similar to the profile of the universe, the data were not weighted.


Appendix 2 - Topline results

HTA Online Survey - Professional Groups

Topline Results 6th September 2010

This data is based on 349 HTA stakeholders, representing a response rate of 46% (A total of 768 professional stakeholders - the total number of all professional stakeholders on the HTA database were emailed a link to the survey).

Fieldwork took place between 14th June and 2nd July 2010.

Where results do not sum to 100, this may be due to multiple responses, computer rounding or the exclusion of don’t knows/not stated.

Results are based on all respondents unless otherwise stated. Base sizes are in brackets.

An asterisk (*) represents a value of less than one half of one percent, but not zero.

A double asterisk (**) represents a very low base size - these findings should be treated as indicative only

Identification Questions Q1. Please specify your relationship with the HTA: Please select one option only

% Designated Individual (DI) 66 Independent Assessor (IA) 18 Accredited Assessor (AA) 4 Living donor coordinator 11 Stem cell coordinator 1 Other - Q2. How long have you been working in this role? Please select one option only

% Less than 1 year 15 Between 1 and 5 years 79 Between 6 and 10 years 4 More than 10 years 3


Q3. In which sector do you primarily work? Please select one option only

% Post mortem 25 Human application 13 Research 14 Public display 3 Anatomy 4 Transplants – solid organ donation 25 Transplants – bone marrow or

stem cell donation 10

Other 7 Q3b. Do you work in any other sectors? Tick as many as apply

% Research 10 Transplants – bone marrow or

stem cell donation5

Human application 4 Post mortem 3 Transplants – solid organ donation 3 Public display * Anatomy * Other 1 None of these/not stated 78 Q4. In which of the following geographical areas are you mainly based?

Please select one option only

% London 21 South East 14 North West 13 West Midlands 11 South West 10 Yorkshire & Humber 6 East of England 6 East Midlands 5 Wales 5 Scotland 4 North East 3 Northern Ireland 3


General Questions Familiarity and Favourability Q5. How well do you think you know what the HTA does?


% Very well 36 A fair amount 55 Just a little 8 Not very well * Heard of HTA, but know nothing

about it-

Don’t know * Q6. How favourable or unfavourable is your overall opinion of the HTA?


% Very favourable 26 Mainly favourable 42 Neither favourable nor

unfavourable14

Mainly unfavourable 10 Very unfavourable 7 No opinion 1 Don’t know - Q7. Which of these comes closest to describing how you would speak about the

HTA? Would you… Please select one option only

Public Sector Norm

% % Speak highly of HTA, without

being asked14 14

Speak highly of HTA, if asked 45 31 Be neutral about HTA, if asked 28 32 Be critical of HTA, if asked 10 16 Be critical of HTA, without being

asked3 5

No opinion 1 2 Don’t know *


Q8. And in your opinion, has the overall performance of the HTA improved,

worsened or stayed about the same over the last 3 years? Is that a lot or slightly… Please select one option only

% Improved a lot 13 Improved slightly 36 Stayed about the same 26 Worsened slightly 6 Worsened a lot 2 No opinion 6 Don’t know 11 Q9. In your experience, please indicate the extent to which you agree or disagree with each

of the following descriptions about the HTA. Please select as many as apply.

Strong

ly agree

Tend to

agree

Neither agree

nor disagree

Tend to

disagree

Strongly

disagree

Don’t know/

No opinion % % % % % % Accessible 39 43 11 4 2 2 Accountable 25 33 20 7 4 11 Authoritative 35 43 15 3 1 3 Consistent 27 39 18 7 3 6 Effective 28 41 15 6 4 5 Efficient 29 35 20 6 5 5 Engaging 22 39 21 6 5 7 Flexible 13 32 24 15 7 8 Focused 31 45 13 3 2 6 Informative 39 44 10 4 2 * Modern 25 36 24 2 2 10 Professional 46 40 9 2 3 1 Proportionate 17 30 23 9 7 14 Reliable 36 38 17 2 2 6 Responsive 39 40 11 4 2 4 Supportive 36 36 14 7 5 3 Targeted in its actions 24 47 16 4 2 7 Transparent 20 42 21 6 3 7


Q10. How important, if at all, do you think each of the following activities are for the HTA?

Please select one option only for each.

Very importan

t

Fairly importan

t

Not very

important

Not at all important

No opinion

% % % % % Improving public confidence 70 23 5 1 1 Improving professional confidence 51 33 10 4 2 Providing licences 60 30 4 2 4 Producing codes of practice 69 24 4 1 1 Overseeing the consent requirements of

the Human Tissue Act74 20 4 1 1

Inspecting organisations to ensure good standards and appropriate procedures

60 31 5 1 4

Giving advice and guidance on interpreting relevant legislation

75 20 3 1 1

Ensuring the safety of human tissue and cells used for patient treatment

77 13 3 2 5

Ensuring dignity and respect for the deceased

68 21 5 2 3

Ensuring medical schools and surgeons have access to bodies for education and

training

38 31 12 5 14


33 34 17 6 11

Regulation to ensure that living donors are not coerced and understand the

risks of organ or bone marrow donation

70 17 4 3 6

Providing an effective website 40 47 8 3 1 Providing training events and workshops 38 49 9 3 1 Working with other organisations to

ensure joined up regulation, advice and guidance

54 33 5 4 4


44 32 13 7 4

Reducing the burden on your sector 35 30 19 10 6 Supporting business and innovation 13 28 34 14 11 Working with Government and Europe

to implement legislation51 36 7 3 3


Q11. How effective if at all do you feel the HTA is in relation to each of these activities?

Please select one option only for each

Very effective

Fairly effectiv

e Not very effective

Not at all effective

Don’t know

% % % % % Improving public confidence 19 45 9 4 23 Improving professional confidence 22 44 14 9 11 Providing licences 54 31 1 1 12 Producing codes of practice 54 37 3 2 4 Overseeing the consent requirements of

the Human Tissue Act49 38 5 2 7

Inspecting organisations to ensure good standards and appropriate procedures

34 39 5 3 18

Giving advice and guidance on interpreting relevant legislation

40 43 8 3 6

Ensuring the safety of human tissue and cells used for patient treatment

36 28 2 3 31

Ensuring dignity and respect for the deceased

31 34 7 4 25

Ensuring medical schools and surgeons have access to bodies for education and

training

9 22 7 5 57


8 22 11 6 52

Regulation to ensure that living donors are not coerced and understand the

risks of organ or bone marrow donation

38 30 4 2 26

Providing an effective website 34 55 5 3 3 Providing training events and workshops 23 52 11 4 10 Working with other organisations to

ensure joined up regulation, advice and guidance

13 36 12 7 31


9 25 14 11 41

Reducing the burden on your sector 7 24 26 20 23 Supporting business and innovation 5 15 13 7 61 Working with Government and Europe

to implement legislation21 37 4 1 36


Regulation Q12. To what extent, if at all, do you have confidence in the HTA as a regulator of

the removal, storage, use and disposal of human tissue? Please select one option only

% A great deal 41 A fair amount 45 Not very much 7 Not at all 2 No opinion 3 Don’t know 2 Q13. Has your confidence in the HTA as a regulator of the removal, storage, use and

disposal of human tissue increased, decreased or stayed the same over the last three years? Would you say it has… Please select one option only

% Increased a lot 9 Increased a little 30 Stayed about the same 43 Decreased a little 5 Decreased a lot 4 Don’t know 9 Communications Q14. Which, if any, of the following forms of communications with or from the HTA

have you had in the past 12 months? Please select as many as apply

% Email 93 HTA website 87 Received e-newsletter or bulletin 71 Telephone call 55 Conferences or events 46 Letter 35 Face-to-face meetings 26 Contributed to consultation 26 Training 22 Press release 12 Inspection 6 Other 1 Had no contact - Don’t know -


Q15. How useful, if at all, do you personally find the following forms of communication with the HTA? Please select one option only for each Base: all who mentioned each of the communications at Q14

Very useful

Fairly useful

Not very

useful

Not at all

useful

Don’t know/

No opinion Base

% % % % % Face-to-face meetings 71 26 - - 3 89 Training 58 34 6 - 1 77 Conferences or events 47 41 8 1 3 162 Telephone call 73 24 2 1 1 192 Contributed to consultation 20 56 11 4 9 91 Email 54 41 4 1 1 324 Received e-newsletter or bulletin 34 56 8 * 2 249 Letter 38 47 8 1 5 123 Press release 24 55 14 2 5 42** HTA website 47 47 5 - 1 302 Inspection 77 18 5 - - 22 Other 74 22 4 - - 27** Q16. To what extent, if at all, do you agree or disagree with the following statements about

the HTA website. Please select one option only for each

Strongly agree

Tend to

agree

Neither agree

nor dis-agree

Tend to disagree

Strongly disagree

Don’t know

% % % % % % A The homepage gives a clear

overview of what can be found on the site

17 58 15 7 1 3

B The design and layout is user friendly

14 51 18 12 2 3

C The search function returns relevant results

9 48 19 7 1 16

Q17. Do you use any of the following social media for professional purposes?

Please select as many as apply

% LinkedIn 11 Facebook 7 YouTube 6 Blogs 3 Twitter 2 Email 2 Other 3 None/ Don’t use any 71


Q18. How well informed, if at all, do you feel HTA keeps you about….. Please select

one option only for each

Very well informed

Fairly well informed

Not very well

informed

Not at all well

informed

Don’t know/

No opinion % % % % % A Its work generally? 22 62 10 2 4 Public Sector Norm 8 51 29 9 3 B Why it takes specific decisions? 19 50 21 5 6 C Forthcoming changes to regulation /

legislation36 50 9 2 4

* Norm wording is: ‘How well informed do you feel about what is happening within XYZ?’ Q19. As you may know the HTA provides codes of practice. Thinking about the most

relevant code/s to your area, would you say you… Please select one option only

% Read all or nearly all of them 45 Read most of them 30 Read a few pages 4 Just glance at them 1 Refer to them when you have a

specific query19

See them but never read them 1 Have never seen them 1 Don’t know/can’t remember - Q20. How useful, if at all, do you find the HTA’s codes of practice?

Please select one option only Base: All those who have read the codes of practice (345)

% Very useful 50 Fairly useful 43 Not very useful 4 Not at all useful 1 No opinion 1 Don’t know 1 Q21. And overall, how would you rate your communications with the HTA?

Would you say they are… Please select one option only

% Very good 41 Fairly good 44 Neither good nor poor 12 Fairly poor 1 Very poor 2 No opinion 1 Don’t know -


Q22. How, if at all, could the communications you receive from the HTA be improved? (Unprompted, open ended)

% Information specific to me/ my

sector/ each sector6

Quicker response time to e-mailed/ written/ queries

4

Nothing/ satisfied/ happy with communication

4

Able to contact a specific person/ telephone contact

2

Better search facilities on the website/ more user friendly

2

Less/ detailed information/ shorter communications

2

Other 7 Nothing in particular 68 Don’t know 8 Sector-Specific Questions Post mortem sector Q23. How easy, if at all, is it to know what you have to do to comply with the HTA’s

standards in the post mortem sector? Please select one option only Base: All in the Post mortem sector (86)

% Very easy 7 Fairly easy 49 Neither easy nor difficult 17 Fairly difficult 16 Very difficult 9 No opinion - Don’t know 1 Q24. As you may know, the HTA provides summary of compliance reports for the

post mortem sector. Thinking about the most recent summary of compliance report, would you say you… Please select one option only Base: All in the Post mortem sector (86)

% Read all or nearly all of it 40 Read most of it 37 Read a few pages 9 Just glanced at it 6 Saw it but never read it 1 Did not see it 5 Don’t know/can’t remember 2


Q25. How useful, if at all, did you find it? Please select one option only Base: All in the Post mortem sector and who read the most recent summary of compliance report (79)

% Very useful 33 Fairly useful 53 Not very useful 10 Not at all useful 1 No opinion 3 Don’t know - Q26. How, if at all, can summary of compliance reports be improved?

Please select as many as apply Base: All in the Post mortem sector (86)

% Include more case study examples 42 Decrease length 21 Include more data 12 Decrease frequency 9 Include more diagrams 7 Appearance (more use of colour,

graphics etc) 7

Increase frequency 6 Layout (better mix of text and

charts) 6

Increase length - Other 5 Nothing in particular 30 Don’t know 9 Q27. The HTA would like to increase the amount of feedback it receives following

inspections. How, if at all, would you prefer to provide feedback to the HTA following a site-visit inspection? Please select as many as apply Base: All in the Post mortem sector (86)

% Email 66 Telephone call 23 Via the HTA website 22 Letter 17 Surveys 3 Other 3 Prefer not to feed back 5 Don’t know 3 In December, the HTA issued a regulatory alert to Designated Individuals in the post mortem sector on compliance reporting and the retention of tissue and organs following post-mortem examination. The alert gave DIs advance notice of HTA General Directions issued on 30 April 2010 requiring them to audit relevant material from the deceased and submit results to the HTA.


Q28. How clear, if at all were the communications you received from the HTA about the General Directions? Please select one option only Base: All in the Post mortem sector (86)

% Very clear 20 Fairly clear 64 Not very clear 10 Not at all clear 2 Don’t know 3 Human application sector Q29. How easy, if at all, is it to know what you have to do to comply with the HTA’s

standards in the human application sector? Please select one option only Base: All in the Human application sector (47**)

% Very easy 6 Fairly easy 49 Neither easy nor difficult 21 Fairly difficult 17 Very difficult 6 No opinion - Don’t know - Q30. As you may know, the HTA provides summary of compliance reports for the

human application sector. Thinking about the most recent summary of compliance report, would you say you… Please select one option only Base: All in the Human application sector (47**)

% Read all or nearly all of it 21 Read most of it 40 Read a few pages 21 Just glanced at it 6 Saw it but never read it - Did not see it 11 Don’t know/can’t remember -


Q31. How useful, if at all, did you find it? Please select one option only

Base: All in the Human application sector and who read the most recent summary of compliance report (42**)

% Very useful 29 Fairly useful 57 Not very useful 10 Not at all useful - No opinion 5 Don’t know - Q32. How, if at all, can summary of compliance reports be improved?

Please select as many as apply Base: All in the Human application sector (47**)

% Decrease length 38 Include more case study examples 36 Layout (better mix of text and

charts)17

Include more diagrams 11 Appearance (more use of colour,

graphics etc)11

Include more data 9 Increase frequency 4 Decrease frequency 4 Increase length - Other 4 Nothing in particular 19 Don’t know 15 Q33. The HTA would like to increase the amount of feedback it receives following

inspections. How, if at all, would you prefer to provide feedback to the HTA following a site-visit inspection? Please select as many as apply. Base: All in the Human application sector (47**)

% Email 72 Telephone call 34 Via the HTA website 23 Letter 19 Surveys 2 Other 6 Prefer not to feed back - Don’t know - In March the HTA wrote to more than 150 organisations following concerns that umbilical cord blood collection may be taking place unlawfully. This followed a number of incidents where unlawful cord blood collection by parents or untrained staff could have compromised safety and quality standards.


Q34. How clear, if at all were the communications you received from the HTA about regulation of cord blood collection? Please select one option only Base: All in the Human application sector (47**)

% Very clear 17 Fairly clear 34 Not very clear 4 Not at all clear 2 Don’t know 43 Anatomy sector Q35. How easy, if at all, is it to know what you have to do to comply with the HTA’s

standards in the anatomy sector? Please select one option only Base: All in the Anatomy sector (13**)

N Very easy 4 Fairly easy 6 Neither easy nor difficult 2 Fairly difficult 1 Very difficult - No opinion - Don’t know - Q36. As you may know, the HTA provides summary of compliance reports for the

anatomy sector. Thinking about the most recent summary of compliance report, would you say you… Please select one option only Base: All in the Anatomy sector (13**)

N Read all or nearly all of it 5 Read most of it 6 Read a few pages - Just glanced at it 2 Saw it but never read it - Did not see it - Don’t know/can’t remember -


Q37. How useful, if at all, did you find it? Please select one option only

Base: All in the Anatomy sector and who read the most recent summary of compliance report (13**)

N Very useful 5 Fairly useful 6 Not very useful 1 Not at all useful - No opinion 1 Don’t know - Q38. How, if at all, can they be improved? Please select as many as apply

Base: All in the Anatomy sector (13**)

N Include more case study examples 7 Include more data 2 Layout (better mix of text and

charts)2

Increase frequency 1 Increase length - Decrease length - Decrease frequency - Include more diagrams - Appearance (more use of colour,

graphics etc)-

Other 1 Nothing in particular 5 Don’t know 1 Q39. The HTA would like to increase the amount of feedback it receives following

inspections. How, if at all, would you prefer to provide feedback to the HTA following a site-visit inspection? Please select as many as apply Base: All in the Anatomy sector (13**)

N Email 11 Via the HTA website 4 Telephone call 2 Letter 2 Face to face visits 1 Other - Prefer not to feed back - Don’t know -


Public display sector Q40. How easy, if at all, is it to know what you have to do to comply with the HTA’s

standards in the public display sector? Please select one option only Base: All in the Public display sector (9**)

N Very easy 1 Fairly easy 2 Neither easy nor difficult 4 Fairly difficult 2 Very difficult - No opinion - Don’t know - Q41. As you may know, the HTA provides summary of compliance reports for the

public display sector. Thinking about the most recent summary of compliance report, would you say you… Please select one option only Base: All in the Public display sector (9**)

N Read all or nearly all of it 2 Read most of it 1 Read a few pages 4 Just glanced at it - Saw it but never read it - Did not see it 1 Don’t know/can’t remember 1 Q42. How useful, if at all, did you find it? Please select one option only

Base: All in the Public display sector and who read the most recent summary of compliance report (7**)

N Very useful 1 Fairly useful 4 Not very useful 2 Not at all useful - No opinion - Don’t know -


Q43. How, if at all, can they be improved? Please select as many as apply.

Base: All in the Public display sector (9**)

N Include more case study examples 6 Decrease length 2 Layout (better mix of text and

charts) 1

Increase length - Increase frequency - Decrease frequency - Include more data - Include more diagrams - Appearance (more use of colour,

graphics etc) -

Other 1 Nothing in particular 1 Don’t know - Q44. The HTA would like to increase the amount of feedback it receives following

inspections. How, if at all, would you prefer to provide feedback to the HTA following a site-visit inspection? Please select as many as apply Base: All in the Public display sector (9**)

N Email 5 Via the HTA website 4 Telephone call 2 Letter - Other - Prefer not to feed back 1 Don’t know - Research sector Q45. How easy, if at all, is it to know what you have to do to comply with the HTA’s

standards in the research sector? Please select one option only Base: All in the Research sector (49**)

% Very easy 10 Fairly easy 55 Neither easy nor difficult 24 Fairly difficult 10 Very difficult - No opinion - Don’t know -


Q46. As you may know, the HTA provides summary of compliance reports for the research sector. Thinking about the most recent summary of compliance report, would you say you… Please select one option only Base: All in the Research sector (49**)

% Read all or nearly all of it 27 Read most of it 29 Read a few pages 20 Just glanced at it 12 Saw it but never read it 2 Did not see it 6 Don’t know/can’t remember 4 Q47. How useful, if at all, did you find it? Please select one option only

Base: All in the Research sector and who read the most recent summary of compliance report (43**)

% Very useful 23 Fairly useful 60 Not very useful 12 Not at all useful - No opinion 2 Don’t know 2 Q48. How, if at all, can they be improved? Please select as many as apply

Base: All in the Research sector (49**)

% Include more case study examples 35 Decrease length 20 Layout (better mix of text and

charts) 20

Include more data 12 Include more diagrams 8 Decrease frequency 6 Increase frequency 4 Increase length 2 Appearance (more use of colour,

graphics etc) -

Other 2 Nothing in particular 29 Don’t know 16


Q49. The HTA would like to increase the amount of feedback it receives following

inspections. How, if at all, would you prefer to provide feedback to the HTA following a site-visit inspection? Please select as many as apply Base: All in the Research sector (49**)

% Email 73 Telephone call 29 Letter 22 Via the HTA website 14 Other 2 Prefer not to feed back 6 Don’t know 4 Q50. As you may know, last year the HTA conducted an evaluation of the research

sector. As far as you know, how do you think the HTA has used the findings of this evaluation? Please select as many as apply Base: All in the Research sector (49**)

% To improve the HTA’s advice and

guidance for the research sector61

To ensure researchers understand the requirements of the HTA’s

regulation

53

To contribute to other organisation’s advice and

guidance for the research sector

33

To streamline its regulatory approach with other organisations

27

Other - Nothing in particular 6 Don’t know 18


Transplants – solid organ donation sector Q51. How easy, if at all, is it to know what you have to do to comply with the HTA’s

regulation of solid organ donation? Please select one option only Base: All in the Transplants – solid organ donation sector (88)

% Very easy 43 Fairly easy 49 Neither easy nor difficult 5 Fairly difficult - Very difficult 1 No opinion 1 Don’t know - Q52. To what extent, if at all, do you agree or disagree that the IAs available to your

transplant unit, satisfy its organ donation activity? Please select one option only Base: All in the Transplants – solid organ donation sector (88)

% Strongly agree 42 Tend to agree 30 Neither agree nor disagree 3 Tend to disagree 2 Strongly disagree - No opinion 22 Don’t know - Q53. What, if anything, are the potential barriers to sustaining the IAs available to

your transplant unit? Please select as many as apply Base: All in the Transplants – solid organ donation sector (88)

% Workload 51 Constraints in the NHS 27 Lack of funding 23 Staff turnover 7 Other 7 None of these 13 Don’t know 17


Transplants – bone marrow and stem cell donation sector Q54. How easy, if at all, is it to know what you have to do to comply with the HTA’s

regulation of bone marrow and stem cell donation? Please select one option only Base: All in the Transplants – bone marrow and stem cell donation sector (34**)

% Very easy 18 Fairly easy 50 Neither easy nor difficult 9 Fairly difficult 12 Very difficult 9 No opinion - Don’t know - Concluding Comments Q55. Thinking about the next few years, what two or three things do you think

might be the most important for the HTA to focus on? (Unprompted, open ended)

% Controlling/ reducing license fees/

costs10

Clarify/ simplify guidance/ codes of practice

8

Avoid overlap of regulations between similar organisations/

consider merging/ linking/ working with other bodies/ streamlining

regulations

7

Better/ more training days/ conferences/ events for IAs/ DIs/

PDs

5

Reduce/ avoid over burdensome regulations/ frequent inspections

5

Raise its profile/ public awareness of the value of organ donation (and

associated issues)

4

Work closer with its stakeholders/ those in the profession (ie

RCPath)

4

Consent for tissue research/ organ donation/ post mortem research

3

Ensuring compliance to HTA standards

3

Raise standards/ improve practices/ do more to support

stakeholders

3

Reduce paperwork/ bureaucracy/ reporting

3

Standardize regulations/ inspections across the UK/

3


between England/ Scotland/ sectors etc

Better inspectors/ trained/ experienced HTA staff

2

Disband/ unnecessary quango/ bureaucracy

2

Facilitate research/ encourage innovation

2

Make the website more user friendly

2

Organ donations/ tissue samples 2 Other 24* Nothing in particular 26 Don’t know 16

• Only responses of 2% and over are displayed. For the full list of responses of please refer to the tables provided under a separate cover.


Q56. How, if at all, could the HTA improve its relationship with you?

(Unprompted, open ended)

% Happy as it is/ its fine/ nothing to

improve/ continue as it is6

Improved communication/ keep me in the loop/ more/ better

information/ updates

5

Appoint a primary contact/ dedicated officer for queries/ key

person for each area

3

Be less threatening/ don’t involve the police/ less heavy handed

approach

2

Be more supportive 2 More/ different teaching sessions/

would like to attend training events2

Reduce/ stop increasing fees/ charge less/ more value for money

2

Other 15* Nothing in particular 60 Don’t know 6 * Only responses of 2% and over are displayed. For the full list of responses of please refer to the tables provided under a separate cover. Q57. How do you think the HTA should use the feedback from this evaluation?

Please select as many as apply

% Feedback via e-newsletter and

website 74

Inform HTA policy development 46 Present results to key

stakeholders 43

Improve their communications 21 Issue media release 8 Other 2 None of these 1 Don’t know 4

Documents

HTA Online Survey – Professional Groups - Ipsos · HTA Online Survey – Professional Groups Report Prepared for The Human Tissue Authority October 2010