A06. Renal Services

Renal services deal with patients with kidney failure. 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 people 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 people are treated using the thin membrane that lines the abdominal cavity (the peritoneum) as a filter. This is called peritoneal dialysis. Approximately half of these patients are treated by having a kidney transplant.


This Clinical Reference Group (CRG) covers:

  • services for people with acute kidney injury
  • the preparation for and delivery of dialysis, whether in a centre or at home
  • people who undergo kidney transplantation.


  • Chair: Dr Sandip Mitra, Manchester University Hospitals Foundation Trust Professor of Nephrology and University of Manchester National Clinical Chair for Renal Services
  • Ian Wren, Lead Commissioner
  • Dr Nitin Kolhe, Clinical member
  • Dr Richard Baines, Clinical member
  • Dr Ravindra Rajakariar, Clinical member
  • Dr Phil Mason, Clinical member
  • Mr Adam Barlow, Clinical member
  • Peter Andrews, Clinical member
  • Andrea Devaney and Clare Morlidge, pharmacy leads
  • Catherine Croucher, Public Health England lead
  • Nick Palmer, Patient and Public Voice representative
  • Maddy Warren, Patient and Public Voice representative


Paul Cockwell (Renal Association)
Lisa Burnapp (NHSBT/BTS)
Sharlene Greenwood (British Renal Society)
Will McKane (Renal GIRFT)

Guide to renal transplantation services

NHS England has produced a summary of renal transplantation services and how they are commissioned.


A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 Hub Commissioning Teams to contract services on an annual basis.

Service Specifications

Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care. The specifications have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe both core and developmental service standards. Core standards are those that all funded providers should be able to demonstrate, with developmental standards being those which may require further changes in practice over time to provide excellence in the field.

The following service specifications fall within the scope of this CRG:


A commissioning policy is a document that defines access to a service for a particular group 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 ensure consistency in access to treatments nationwide.

The following policies fall within the scope of this CRG:


Not routinely commissioned:

Policy statements

Policy statements are brief documents that define the current commissioning position to support service contracting.