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Commissioning of Dialysis Services

NHS England Commissioning intentions were published on 3rd October

 

Please view the Commissioning Intentions document here

As NKF had anticipated there is a plan to cease Commissioning Dialysis as a "Specialised Service" and instead devolve commissioning responsibility to Clinical Commissioning Group consortia ( CCG's)

In the past NKF has always resisted such a move, however NKF has been promised full consultation in the coming months and we approach these potential changes with a cautious but open mind.

It would be helpful to the NKF if all those with an interest in Dialysis, read the Intentions document carefully, then fed their views back to Timothy F Statham OBE (NKF CEO)  at tim.statham@btinternet.com so that NKF can make submissions that reflect the widest perspective - either good or bad.

Please do not leave this to others - it is your service and such major changes matter.

Please keep checking back to the NKF website for the latest news.

If you wish to read the letter that the All Party Parliamentary Kidney Group sent to the Secretary of State for Health ahead of this announcement then please see  below:-

 

   

To

Jeremy Hunt MP

Secretary of State for Health 

 

Re: Dialysis as a Specialised Service

 

The All Party Parliamentary Kidney Group has received a representation from the National Kidney Federation that expresses concern that a proposal exists to move the responsibility for commissioning the specialised service, renal dialysis, to clinical commissioning groups as part of an NHS England review.

 

The concern has arisen following a report by Sarah Calkin in the Health Service Journal (HSJ) on the 29th May 2014.

 

It would be helpful if you could clarify whether or not such a review of Dialysis Services is underway.

 

Renal Patients have seen this proposal to “de-classify” dialysis as a specialised service on at least two previous occasions and have opposed such a move each time, they cite the following as just some of the reasons why such a move would be damaging:

 

  • The renal patient journey is not one way. Dialysis and Transplantation are inextricably linked, with patients moving backward and forward between the two therapies all their renal life. Transplantation remains a Specialised Service and it has to make sense for Dialysis to remain where it is.

 

  • There have been experiments in providing Dialysis in Primary Care some years ago in Ashfurlong but this was not well received or considered a success at the time.

 

  • GP’s are renowned in renal patient circles as knowing virtually nothing about Dialysis or the many and varied complications surrounding this treatment – renal patients stay well clear of GP’s and only consult with the specialist clinicians. The complexities of renal disease are myriad and GP’s themselves always refer upwards on any renal matter. There is a major lack of expertise in primary care

 

  • Could some smaller CCG’s possible run Hemodialysis Units in financial and staffing terms, and have they ever expressed any wish to do so?

 

  • What happens to all the issues surrounding Dialysis, for instance the specialist surgeons needed for “Fistulae” surgery, Home Dialysis training, transplant workup?

 

  • Dialysis Away from base is an essential requirement for any renal patient trying to live their lives – how will this ever be possible is dialysis is spread this thinly within CCG’s?

 

  • How will CCG’s provide the transport service (already a mess) to and from Dialysis?

 

  • Patients are looking for a high quality service that is transparent and has patient ownership, this proposal is the very opposite and patients fear their life saving treatment will be moved to GP’s who are not sufficiently qualified and who normally refer decisions to Nephrologists.

 

As you will appreciate these are matters of some great importance to those whose lives are blighted by Kidney disease. We would welcome your response to the issues and questions raised and hope you can assist in making the clinical journey, one that is highly stressful at best, into one that places the patients need to the forefront.

 

Yours Sincerely,

 

Joint Chairman, Madeleine Moon MP 

Joint Chairman, Glyn Davies MP 

Joint Vice Chairman, Duncan Hames MP 

Joint Vice Chairman, Lord Davies of Coity