Background NHS Blood and Transplant (NHSBT) requires approximately 5000 corneas (NHSBT. Organ and tissue donation and transplantation: activity report 2022/23) per year to meet the demand for sight restoring transplants. Donations fell during the pandemic (NHSBT. Organ and tissue donation and transplantation: activity report 2022/23) and have not returned to pre-pandemic levels. 50% of hospice inpatients (Long-Sutehall, Madi-Segwagwe, Hurlow, et al. Cell Tissue Bank. 2023;24(2):341–349) are estimated to be eligible for corneal donation but less than 3% are identified. Many patients (Williams, Muir. Clin Ophthalmol. 2018;12:1049–1059) are unaware they can donate, as are the staff looking after them. A lack of knowledge and confidence (Long-Sutehall, Zatorska, Myall, et al. BMC Palliat Care. 2023;22–173; White, Long-Sutehall. BMJ Support Palliat Care. 2023;13:A42) in discussing eye donation have been suggested as barriers to starting these discussions.

Aim To increase the number of corneal donations by training the hospice team, screening all admissions to the hospice Inpatient Unit (IPU) for their donor eligibility and including the option of donation routinely in end-of-life discussions.

Method From June 2022 the IPU team regularly discussed corneal donation at IPU handovers and multidisciplinary team (MDT) meetings and attended inhouse education. From 26/8/2023 to 31/3/2024, the hospice joined an NHSBT study into corneal donation in hospice inpatients. This involved online staff educational modules and completion of an anonymous online eligibility checklist for each patient. A retrospective notes search of all admissions from 1/7/22 to 31/3/24 was undertaken to assess, whether discussions took place, the outcomes of these discussions and the number of subsequent eye donations.

Results During the initial period there were 119/239 (50%) eligible admissions. Discussions were had with 41(34%) eligible patients or their families. 21 (18%) consented to donation and 19 (19%) eligible patients who died donated. During the NHSBT study 46/87 admissions (53%) were eligible. Discussions were had with 30 (65%) of those eligible and 13 (33%) of eligible patients who died donated.

Conclusion Education of a hospice inpatient team and normalising corneal donation as part of end-of-life discussions improves awareness amongst staff and patients, increases eye donations and brings joy to the family members of those who donate.