Renal
Background
Renal care is centred around patients with kidney disease. Chronic kidney disease is not curable and the number of people receiving dialysis or transplantation for established kidney failure in England is set to rise by 50% over the next decade. Patients with kidney disease often require frequent dialysis and significant lifestyle adjustments and if a suitable organ is available, a kidney transplant is often the best treatment. Because of this wide range of care needs there are many workforce related issues in delivering renal care.
The DH commissioned Skills for Health in 2008/09 to develop a programme of work for renal services. Building on previous work on long term conditions and making the connections with the latest policy developments, this work programme will deliver a set of integrated resources to support the delivery of the renal workforce objectives. These resources were showcased at the British Renal Society Annual Conference at Birmingham's International Conference Centre, further details about the conference can be found here
The National Service Framework for Renal Services (NSF), was launched in two parts, the first came out in January 2004 and part two in February 2005. The NSF aims to raise the quality of care provided for people with kidney disease, increase their choice, and minimise the impact of their disease. The documents are about improving care and ensuring the best services are the standard across the country. They give local NHS organisations clear standards and quality requirements to aspire to and achieve, as well as supporting them through sharing good practice and evidence about what care and treatments work best for patients.
The NSF sets five standards and identifies 30 markers of good practice which will help the NHS and its partners manage demand, increase fairness of access, and improve choice and quality in dialysis and kidney transplant services.
By 2014 the NHS will need to deliver these five standards:
Standard one: a patient centred service
All children, young people and adults with chronic kidney disease are to have access to information that enables them, together with their carers to make informed decisions and encourages partnership in decisionmaking, with an agreed care plan that supports them in managing their condition to achieve the best possible quality of life.
Standard two: preparation and choice
All children, young people and adults approaching established renal failure are to receive timely preparation for renal replacement therapy so the complications and progression of their disease are minimised, and their choice of clinically appropriate treatment options is maximised.
Standard three: elective dialysis access surgery
All children, young people and adults with established renal failure are to have timely and appropriate surgery for permanent vascular or peritoneal dialysis access, which is monitored and maintained to achieve its maximum longevity.
Standard four: dialysis
Renal services are to ensure the delivery of high quality clinically appropriate forms of dialysis which are designed around individual needs and preferences and are available to patients of all ages throughout their lives.
Standard five: transplantation
All children, young people and adults likely to benefit from a kidney transplant are to receive a high quality service which supports them in managing their transplant and enables them to achieve the best possible quality of life.
Workforce Planning
Renal services need to ensure there is enough staff with appropriate skills and experience who are well led, supported and deliver high quality care. The Department of Health's (DH) Long term Conditions Care Group Workforce Team has been established to take a national view on the health and social care workforce pressures and priorities for people with, or at risk of, conditions that require long term management. The renal work programme of the Care Group Workforce Team will be taken forward by the Renal Workforce Group, comprising key stakeholders and reporting to the Care Group Workforce Team.
The Renal Team: A Multi-Professional Renal Workforce Plan for Adults and Children with Renal Disease provides the baseline data that supports projections of workforce demand and supply. With information about disease prevalence, it allows the Care Group Workforce Team to understand the possible impact of new roles in health and social care teams in delivering the NSF.
Planning and developing the workforce to enable appropriate renal services to be delivered presents a new set of challenges, which include:
- Potential new or extended roles
- New models of care
- New types of team working across organisational boundaries and new settings
- New education and training needs
Workforce planning resources
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