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An opt out system will make a great difference to the NHS especially due to the shortage of organs at present as more organs will became available, thus enabling a higher frequency of effective transplants to be carried out.
An opt out system will also be more effective as many people may wish to be an organ donor but never sign up or feel it will take too long. This way one is automatically signed up and does not need to do anything. The opt out system being brought in in Wales, I believe will be highly effective.
Most people who are not organ donators would most likely not have a problem with donation, but rather haven't filled out the proper paperwork. Once you die, you no longer need your organs, so give them to someone who does. If, for religious reasons you do not want to donate, go ahead and opt out, however we shouldn't assume that people don't want to help people.
Creating the donor system from an opt-in to an opt-out is essentially losing a freedom. You should decide if you want to be an organ donor. You should not have to go to some government agency in order to not be an organ donor. Donating your organs is a personal decision.