Most people are 'in favour' of organ donation, but few of them sign up themselves. If individuals are not on the register, the likelihood that their organs will be used for transplant is greatly reduced. Using an inventive and brave approach to communications planning and powerful creative, this paper shows how Scottish people signed up faster than the rest of the UK. A rolling road-show took the campaign to regional towns, with media coverage and direct response activity 'hot-housing' areas of Scotland on a rolling basis. The campaign produced an ROI of £1.9m on a spend of £340k and has shown why future investment in communications will be crucial if the UK is to address the shortage of organs available for transplantation