Key data
| Regulation | Resolution of 23 March 2026, of the Instituto Nacional de Gestión Sanitaria, publishing the Framework Agreement with the Servicio Andaluz de Salud and the Organización Nacional de Trasplantes, O.A., on healthcare, teaching and research, and donation and transplantation of organs, tissues and cells |
|---|---|
| BOE Publication | 30 March 2026 |
| Entry into force | 23 March 2026 |
| Signing bodies | INGESA, Servicio Andaluz de Salud (SAS) and Organización Nacional de Trasplantes (ONT) |
| Territories covered | Ceuta and Melilla (managed by INGESA) |
| Those affected | Healthcare professionals, patients on the transplant waiting list and public health managers |
| Category | Social Security |
| BOE Reference | BOE-A-2026-7289 |
Healthcare professionals and public health managers in Ceuta and Melilla have had, since 23 March 2026, a new regulatory framework governing how transplants, healthcare and training are coordinated in their territories. The Resolution of 23 March 2026 of INGESA (BOE-A-2026-7289) publishes the framework agreement signed with the Servicio Andaluz de Salud and the Organización Nacional de Trasplantes.
This agreement is not a minor procedural change: it establishes institutional commitments affecting the coordination of human resources, infrastructure and shared clinical protocols between three top-level public bodies. For the healthcare teams involved, it means reviewing how referrals, training and access to transplants are managed in territories with specific characteristics.
What does this regulation establish?
The framework agreement structures the collaboration between INGESA, SAS and ONT into three distinct areas:
| Area of collaboration | Main content |
|---|---|
| Healthcare | Coordination of human resources, infrastructure and shared clinical protocols. Patient mobility, referrals and access to highly complex procedures. |
| Teaching and research activity | Framework for the continuing education of healthcare professionals involved in transplants and donation. Collaborative research between the three bodies. |
| Donation and transplantation of organs, tissues and cells | Coordinated management of the transplant network in INGESA territories (Ceuta and Melilla) with the support of the Andalusian health system. |
The agreement allows Ceuta and Melilla, territories with a smaller critical mass of population and their own hospital resources, to rely on the Servicio Andaluz de Salud network to guarantee their patients' access to highly complex transplant procedures. The ONT acts as the coordinating body at national level.
Economic and operational impact
The agreement does not set specific financial amounts in the published information. Its impact is primarily operational and organisational, with indirect consequences for resource management:
- Human resources coordination: Healthcare teams in Ceuta and Melilla will need to align with SAS and ONT protocols, which may involve additional training and a review of internal procedures.
- Shared infrastructure: The agreement enables the shared use of healthcare infrastructure between INGESA and SAS, optimising the transplant network without duplicating resources in small territories.
- Patient referrals and mobility: The mechanisms for referring patients from Ceuta and Melilla to Andalusian centres for highly complex procedures are formalised, affecting existing administrative and clinical circuits.
- Continuing education: Healthcare professionals involved in transplants may be affected by new training requirements or programmes arising from the agreement with the ONT.
Who is affected?
- Healthcare professionals in Ceuta and Melilla involved in organ, tissue and cell donation and transplantation processes.
- Transplant coordination teams from INGESA, the Servicio Andaluz de Salud and the Organización Nacional de Trasplantes.
- Patients on the transplant waiting list in the territories managed by INGESA (Ceuta and Melilla).
- Public health managers responsible for planning and coordinating healthcare resources across the three signing bodies.
- Teaching and research teams linked to INGESA and SAS healthcare centres participating in transplant-related training programmes.
Practical example
A patient residing in Ceuta who needs an organ transplant and whose procedure requires infrastructure or specialisation not available at INGESA centres in that territory can be referred to a hospital within the Servicio Andaluz de Salud. The agreement formalises and regulates this referral circuit, establishing the institutional framework under which collaboration between INGESA and SAS takes place.
For the INGESA transplant coordination team in Ceuta, this means reviewing current referral protocols and ensuring they comply with the new framework agreed with SAS and ONT. If the professional also participates in training or research activities, they should verify whether the programmes they are involved in are integrated into the new agreement or require updating.
What should healthcare organizations do now?
- Review patient referral protocols to SAS centres for highly complex procedures, verifying that they comply with the framework established in the agreement.
- Identify the healthcare professionals affected by changes in action protocols related to organ, tissue and cell donation and transplantation.
- Update continuing education programmes for staff involved in transplants, aligning them with the criteria agreed between INGESA, SAS and ONT.
- Coordinate with human resources management teams to anticipate potential mobility or collaboration needs arising from the agreement.
- Consult the full text of the agreement published in the BOE (BOE-A-2026-7289) to identify specific obligations applicable to each area of activity.
Frequently asked questions
Who is affected by the INGESA-SAS-ONT agreement published in the BOE in March 2026?
It directly affects healthcare professionals involved in transplants, patients on the transplant waiting list in the territories managed by INGESA (Ceuta and Melilla), and public health managers from the three signing institutions: INGESA, Servicio Andaluz de Salud and Organización Nacional de Trasplantes.
What territories does this transplant and healthcare agreement cover?
The agreement primarily covers the territories managed by INGESA, namely Ceuta and Melilla, which will rely on the Andalusian health system (SAS) to optimise the transplant network and access to highly complex procedures.
What areas does the INGESA-SAS-ONT framework agreement regulate?
The agreement regulates three key areas: healthcare, teaching and research activity, and the management of organ, tissue and cell donation and transplantation. It includes coordination of human resources, infrastructure and shared clinical protocols.
When does the 2026 INGESA-SAS-ONT agreement come into force?
The agreement entered into force on 23 March 2026, the date of its signing. It was published in the BOE on 30 March 2026 by means of a Resolution of the Instituto Nacional de Gestión Sanitaria.
What should healthcare professionals affected by this agreement do?
Healthcare professionals involved in transplants in Ceuta and Melilla should review the new action protocols and continuing education requirements arising from the agreement, as well as any potential changes to patient referral procedures and access to highly complex procedures through the SAS.
Official source
View the full regulation at the official sourceDisclaimer: This article is for informational purposes only and does not constitute legal advice. For specific decisions, please consult a qualified professional. Source: https://www.boe.es/diario_boe/txt.php?id=BOE-A-2026-7289