Scope and service
Each year, in England, approximately 5,500 people start treatment for kidney failure and there are currently around 43,000 people receiving treatment for kidney failure. Around 4 in 10 are treated by circulating their blood through a machine which cleans it of toxins (haemodialysis). This can be done either in hospital or at home. About 1 in 10 are treated using the thin membrane that lines the abdominal cavity (the peritoneum) as a filter. This is called peritoneal dialysis.
The services encompassed by this Clinical Reference Group (CRG) include:
- Acute kidney injury
- The preparation for and delivery of dialysis, whether in a centre or at home
Chair and membership
A voluntary Chair is appointed for a three-year term. Please see the Clinical Guide for CRGs for further information. Clinical members are drawn from the 12 Senate areas in England and are voluntary appointments. Up to four patient and carer members and up to four professional/training organisations are eligible to join the CRG membership. The accountable commissioner holds the managerial accountability for the work of the CRG; collaborating commissioners hold an interest in the work of the CRG.
|National Clinical Director Co Chair||Richard Fluck|
|N1||North East||Stephen Kardasz|
|N2||Greater Manchester||John Anderton|
|N3||Cheshire and Mersey||Hameed Anijeet|
|N4||Yorkshire and The Humber||William McKane|
|M1||West Midlands||Hugh Rayner|
|M2||East Midlands||Graham Warwick|
|M3||East of England||Roger Greenwood|
|L1||London Nw||Wendy Brown|
|L2||London NE||Neil Ashman|
|L3||London S||Daniel Jones|
|S1||South West||Chris Dudley|
|S4||South East Coast||Richard Kingston|
The CRG is currently in the process of recruitment to the membership places below; as appointments are confirmed this webpage will be updated.
Patient and Carer Member
|The Renal Association||Simon Davies Charlie Tomson|
|Professional Organisation||Simon Davies|
|Accountable Commissioner||Nesta Hawker||Manchester|
|Public Health Lead|
A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 specialised services Area Teams to contract services on an annual basis.
The service specifications are important in clearly defining what NHS England expects to be in place for providers to offer evidence-based, safe and effective services. They have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards. Core standards are those that any reasonable provider of safe and effective services should be able to demonstrate, with developmental standards being those that really stretch services over time to provide excellence in the field. The following service specifications have been prepared by the CRG:
- Centre Haemodialysis ICHD
- Haemodialysis to treat established renal failure in the home
- Peritoneal Dialysis to treat Established Renal Failure
- Acute Kidney Injury (Adult)
- Renal Assessment (Adult)
- Haemodialysis delivering only Dialysis Away from Base (DAFB)
A policy statement is a brief document that defines the current commissioning position to support service contracting. They are interim documents for use whilst a full commissioning policy is being developed or until a formal NICE Technology Appraisal Guideline has been published.
- A06/PS/a: Clinical Commissioning Policy Statement: Eculizumab in the prevention of recurrence of C3
glomerulopathy post kidney transplant
A commissioning policy is a document that defines access to a particular service for a cohort of patients. A NICE Technology Appraisal Guideline on the same topic will replace, or be incorporated into a commissioning policy, as appropriate. These are important documents that are developed to define national consistency.
Quality measures aim to find the most appropriate and deliverable measures that can be used nationally to help organisations improve the quality of care in their services. These are prioritised to form a ‘dashboard’.
Spending on the NHS will increase each year between 2011 and 2015. However, demand for health services is rising, and what is expected of the NHS changes as society changes. This means that the NHS will need to make up to £20 billion worth of efficiency savings by 2015, so that there are more funds available for treating patients and to allow the NHS to respond to changing demands and new technologies.
Productivity is one of the work streams to deliver those efficiency savings. Productivity is about the redesign and streamlining of healthcare services by examining the way the NHS commissions, manages, works and delivers healthcare services to reduce inefficiencies and maximise efficiencies; ensuring value for money; and reducing unnecessary poor design in its processes and delivery of care that are not cost effective, and have little impact on improved outcomes or improved quality of care for patients.
CRGs have a key role in providing advice about potential opportunities to improve productivity and efficiency, for example by removing any inefficiencies in care pathways or by identifying opportunities where a national procurement of drugs or devices might reduce costs.
Other important publications that relate to this CRG include:
Documents will be published online shortly