Below is a letter written by patients and families involved in heart and lung transplantation to highlight concerns about outcomes and access to services in the UK. These services save lives, yet recent data show variation in outcomes and capacity across centres. It also shows our outcomes fall significantly behind centres around Europe and the world. Patients and families deserve confidence that the system is working as well as it can.

We recognise the dedication of clinical teams delivering highly complex care, often under significant pressure. The challenges facing transplant teams and services are not about individuals, but about the wider system, including funding, capacity, variation in practice and long-term outcomes.

We believe there is an opportunity to take a closer, system-wide look at how services are working today, and how they can be improved to ensure the best possible outcomes for patients now and in the future

To support the open letter, which will be sent to the Right Hon. Wes Streeting MP, please sign the petition below. 

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Dear Secretary of State,

People in the UK are dying because heart and lung transplantation is falling behind what patients need and what comparable countries now deliver. Some die waiting for an organ that never comes. Others receive a transplant, only to experience poorer outcomes and shorter lives than patients elsewhere. Behind each of these failures are patients and families living with prolonged uncertainty, repeated hospital admissions, and all in the knowledge that time is running out.

For patients, a heart or lung transplant is not a marginal intervention. It is the difference between breathlessness and breathing, survival and death. For families, it offers the chance to plan a future again; to work, to care for children, and to live without the constant fear of deterioration. When that chance is delayed or lost, the consequences are lifelong or life ending. 

Transplantation is built on an extraordinary act of generosity. Donor families agree, often in moments of acute grief, to give others a chance at life. Patients who receive a donor organ carry a profound sense of responsibility to honour that gift. It is therefore deeply troubling that, in the UK, those gifts too often result in poorer survival and quality of life than an equivalent patient would experience in other developed nations. This isn’t due to failures by donors or clinicians, but because the system around cardiothoracic transplantation does not give it the focus, resources, support or enable the sustained national leadership it requires.

We are writing as heart and lung transplant patient advocates following the BBC Radio 4 documentary File on 4, broadcast on 24 March 2026. The programme brought into the public domain what patients and clinicians have long known: that UK heart and lung transplant services now lag behind comparable countries in access, transplant rates and outcomes.

Last year the UK undertook 200 heart and 144 lung transplants for a population of 69.5million compared to Sweden who undertook 59 heart and 77 lung transplants for a population of 10.6million. Sweden like the UK has free healthcare at the point of delivery and a similar percentage of gross domestic product spend on healthcare and almost identical deceased donation rates per million population. Sweden delivers double the number of heart and treble the number of lung transplants per million population. 

In terms of outcomes, Australia historically publishes their 5-year outcomes from transplant. The latest comparable periods show the UK’s 5-year heart transplant survival at 72.1% compared to Australia at 85.4%. Following lung transplantation, it is 56.2% for the UK compared to 73.5% for Australia. 

The UK was once a world leader in heart and lung transplantation, recognised internationally for its early establishment and growth, innovation and pioneering work. Today, however, the UK undertakes fewer heart and lung transplants than it did at the start of the 21st Century, while comparable countries have significantly increased their activity. Long-term outcomes in the UK have stagnated while others have improved and continue to advance. Our system has allowed cardiothoracic transplantation to fall down the list of priorities, in contrast to higher-profile specialties with clearer narratives and simpler solutions. For many patients, this has tragic consequences.

On current trajectories, heart and lung transplantation will fall well short of the ambitions set out in Organ Donation and Transplantation 2030: Meeting the Need, which committed the UK to becoming a world-leading system with outcomes among the best internationally. Without urgent ministerial intervention, this shortfall is no longer a risk; it is a certainty.

We recognise and value the recent work undertaken by the Department of Health and Social Care to improve transplantation services. Patients welcomed the Organ Utilisation Group and subsequent implementation work. Many of us are also involved in the NHS England Heart and Lung Transplant Transformation Programme. While important, these initiatives alone cannot deliver the scale and pace of change required.

To reach outcomes comparable with peer nations, the scale of change required is stark. The UK would need to double the number of heart transplants, treble the number of lung transplants, and reduce five-year mortality for both organs by almost 50 percent.

Day in, day out, as patients we see transplant teams doing everything they can within a system that does not adequately support them. Heart and lung transplant patients require lifelong, specialist, multidisciplinary care.  We see teams struggling to secure theatre time, ICU beds, diagnostic tests, interoperable records and sufficient specialist staff. For those deteriorating while waiting for a transplant, these system constraints shape everyday decisions - whether to keep working, whether to relocate their care to another centre, whether to hope for a future or prepare for the end. These are the human consequences of a system that is not yet delivering what cardiothoracic transplantation requires.

We therefore ask to meet with you to discuss how heart and lung transplantation can be restored to a position of international leadership. We believe this requires a ministerially sponsored review to reset national focus, identify the changes needed and ensure sustained oversight of improvement. Patients, and donor families have already given everything they can. Without renewed national focus and ministerial leadership, avoidable and premature deaths will continue.

Yours sincerely,

Zanib Nasim,
Patient & Public Voice Representative, Transplant Oversight Group, NHSE

Trevor Collins,
Patient Partner Heart Transplant, NHSBT

Lucy Ryan,

Patient Partner Heart Transplant, NHSBT

Sandra Evans,
Patient Partner Lung Transplant, NHSBT

Carly Edge,
Patient Partner Lung Transplant, NHSBT

Jessica Jones,
Patient Representative, Organ Utilisation Group and Implementation Steering Group for Organ Utilisation, DHSC                  

Rosie FitzGerald,
Patient & Public Voice Representative, Heart and Lung Transplant Transformation Programme, NHSE

Robbie Burns,
Patient & Public Voice Representative, Heart and Lung Transplant Transformation Programme, NHSE & Cardiothoracic Transplant Patient Group Chair, NHSBT (2022-2025)

Andrea Mistry,
Patient & Public Voice Representative, Heart and Lung Transplant Transformation Programme, NHSE