Renal services

This Transform Clinical Reference Group (CRG) 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.

Scope

This clinical reference group 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.

Membership

  • Chair: Dr Smeeta Sinha, National Clinical Director for Renal Services
  • Lydia Ball, Lead Commissioner
  • Catherine Croucher, Public Health Lead
  • TBC, Clinical member
  • TBC, Clinical member
  • TBC, Clinical member
  • TBC, Clinical member
  • TBC, Clinical member
  • TBC, Clinical member
  • TBC, Clinical member
  • TBC, Pharmacy Lead
  • TBC, Pharmacy Lead

Affiliates

  • TBC
  • TBC
  • TBC

Guide to renal transplantation services

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

Products

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:

Policies

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:

Commissioned

Not routinely commissioned

Policy statements

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

Transport support for patients attending in-centre haemodialysis

In August 2021, NHS England and NHS Improvement published the outcome of a review into non-emergency patient transport services (NEPTS). This sets out a new national framework for a responsive, fair and sustainable service.

The updated eligibility criteria for the service includes a universal commitment of transport support for patients attending in-centre haemodialysis. This was developed following extensive engagement with key stakeholders, patient groups and commissioners.

The main principle of NEPTS is to travel independently with the support of family or friends if possible, or where appropriate receive financial reimbursement for travel costs. However, all patients registered with a GP in England who are receiving in-centre haemodialysis, should be offered transport support if required.

The local system should be flexible in providing transport support for all patients attending in-centre haemodialysis – whether or not they use NEPTS.  Similarly, transport requirements should be part of dialysis away from base planning with referral to the NHS Who Pays? guidance.

Haemodialysis patients must be fully informed and involved in decisions about the right transport offer for them. This should be flexible to allow for changing requirements.

Dialysis units will play a key role in these conversations. Patients, relatives, clinicians and dialysis units can also seek support through engagement with renal networks and patient groups.

Further details can be found here: Transport support for patients attending in-centre haemodialysis.

Get involved

If you are interested in the work of the internal medicine NPOC or its CRGs, you can register as a stakeholder.  For details on our latest consultations please visit NHS England » Consultations

Get in contact

For any questions or queries relating to the work of the internal medicine NPOC or any or its CRGs, please contact: england.npoc-internalmedicine@nhs.net