RT Journal Article SR Electronic T1 Will the unusual become usual? A new legal change that aims to increase discussions around organ and tissue donation in England JF Future Healthcare Journal JO Future Healthc J FD Royal College of Physicians SP e170 OP e173 DO 10.7861/fhj.2020-0098 VO 8 IS 1 A1 Heena Khiroya A1 Adnan Sharif A1 June Jones A1 Derek Willis YR 2021 UL http://www.rcpjournals.org/content/8/1/e170.abstract AB UK guidelines recommend that discussions about organ and tissue donation are conducted as part of end-of-life care. However, there are several barriers to discussing organ donation, and this is reflected in a critical shortage of donors. This article explores who should start the conversation about donation and how all healthcare practitioners can maximise their communication skills to have success in this area. It is particularly pertinent to be upskilled in this area in light of the recent legal change in England, where the system moved from an opt-in to a ‘soft’ opt-out one. Based on a similar legal change that took place in Wales and global data, it is unlikely that the legal change alone will prompt an increase in donation rates in England. This article proposes suggestions to increase awareness and conversations among healthcare professionals and patients with education, public health campaigns and interventions rooted in psychological theory.