Tuesday, 23 December 2008

Renal NSF update December 2008

The Renal NSF update for December 2008 is available here

Thursday, 18 December 2008

bedtime reading: NHS Choices guide to kidney disease

A new guide to kidney failure is available on NHS Choices . The increasingly popular NHS website, now with 4.5m visitors a month, is developing information and advice across a range of specific long term conditions, the latest being kidney disease.

Written in plain English and covering prevention, symptoms, diagnosis, treatment and living with kidney disease, the Guide also enables health professionals, carers and those living with the condition to search for local services such as local support groups.

Friday, 12 December 2008

Christmas message

The year began with Gordon Brown informing Parliament that kidney disease is a major vascular risk factor - the first Prime Minister in history to use the “k” word in the Palace of Westminster. As the year draws to a close we are putting the final touches to a new NHS organisation – NHS Kidney Care, an improvement team for the kidney community. Between those time points lots has happened:

  • In February the Organs for Transplants report was funded.

  • New vascular checks for all above the age of 40 has been inveiled.

  • 25% more people have been identified with early kidney disease.

  • The NICE guideline on CKD was launched.

  • The Dialysis Manifesto has been produced by the All Party Parliamentary Kidney Group.

  • New kidney units have been opened.

  • The National Kidney Federation has moved to new offices.

  • More people are receiving home haemodialysis now than at any time for several decades.

  • We have continued to see growth in live and non heart beating donor transplant.

2008 has been a good year, lets make 2009 a great year for kidney care.

Thursday, 11 December 2008

Measuring for quality improvement

“I am called eccentric for saying this in public; that hospitals, if they wish to be sure of improvement, must find out what their results are, must analyse their results, to find out their strong and weak points, must compare their results with those of other hospitals and must care for what cases they can care for well, and avoid attempting to care for cases which they are not qualified to care for well … must welcome publicity not only for their successes, but for their errors. Such opinions will not be eccentric in a few years hence” (Codman, a surgeon from Boston, 1917).

Ninety one years later, Lord Darzi, another surgeon said “we can only be sure to improve what we can actually measure” in High Quality Care for All.

A set of clinical indicators have now been assembled from routine data that the NHS already collects (and sometimes, but rarely is used!). In kidney care we are fortunate to have “form” as Sir Bruce Keogh (Medical Director of the NHS) says – a “track record” or “previous”. That is in the form of the Renal Registry that collects key information on dialysis and transplantation.

The fact that the Renal dataset, covering the whole kidney care pathway has now been approved and mandated from May 2009 will also help with data completeness and quality.

The clinical indicators have been developed in partnership between the Department of Health and the Royal Colleges, comments are being sought by the Information Centre.

Clinical indicators are of course only part of quality. The Institute of Medicines’ influential report “Crossing the Quality Chasm” (2001) identified 6 aims for improvement, each of which could be considered aspects of quality: safety, effectiveness, patient centredness, timeliness, efficiency and equity.

Clinical indicators are the start point, patient experience, safety and patient reported outcomes must also be gathered if we are to achieve Lord Darzi’s vision of “High Quality Care for All”, and high quality care for all is the reason why 1.3 million people in the UK get up in the morning.

ODTF recommendations: progress report November 2008

Further to the Organ Donation Task Force's report with 14 recommendations last year read the letter and update from Chris Rudge (Transplant Tsar).

Home haemodialysis - going further, the next stage


This is a really good video clip so if your Trust policy doesn’t allow UTube fire it home and look there.

Wednesday, 10 December 2008

Q & A: national renal dataset

Read Q & A

Related blogs:
Implementation of the national renal dataset
Bedtime reading: National renal dataset change notice published

bedtime reading: Renal dataset change notice published

The DSCN for the National Renal Dataset has been published - the reference number is 27/2008.

This is the legal notice requiring the service to provide the 693 data items mandated in the first phase of the national renal dataset. The notice and the requirement comes into effect on 31 May 2009.

Related blogs:
Implementation of national renal dataset
Q & A: national renal dataset

Tuesday, 9 December 2008

bedtime reading: core principles of transition

Transition from childrens to adult services is a ticky time. I have recently blogged about the risk and signposted the excellent e-learning available so I was pleased to be sent a copy of 'Think Transition': Developing the essential link between paediatric and adult care’ (November 2008) from the Royal College of Physicians of Edinburgh.

The document identifies the requirement to actively manage and coordinate the porcess. The care coordinator key worker model - I think that is a youth worker to you and me, and the importance of not limiting this role to health is key message. Most issues in transition are generic but this document has a good section on chronic kidney disease as well.

Two in three patients take part in patient transport survey

All the responses are now in from the National Patient Survey that took place on 15 and 16 October 2008 and I’m really pleased to hear that two thirds of all haemodialysis patients in England, Wales and Northern Ireland took part. The survey is part of the new National Kidney Care Audit, which is being run by The NHS Information Centre (IC). The audit will also look at aspects of vascular access, which will be collected from renal units themselves.

I’m glad that patients have really responded to the survey, because I think it will be an important tool for delivering better patient transport services. There was an over 90 per cent response rate in 67 of the 252 units that took part, which is great.

Separate surveys were also sent to renal unit managers and commissioners of renal services, of whom 81 per cent and 89 per cent responded respectively – an impressive figure that reinforces the commitment that people have to improving services.

The NHS IC are now analysing the survey data, and they are planning to release an interim set of results to renal units in January 2009. The full results will be published in April.

Once the interim results are published, I want to see people turning their attention to action planning because I don’t think any units will be providing the service people receiving haemodialysis need . All renal units should be thinking about how they can use the results of the audit to improve services – who is doing that in your Kidney unit? This could involve setting up action planning groups and working with patients, to learn from what works best in other areas, and see whether it can be applied locally. I know The NHS IC are developing an online resource to give practical support for action planning, and I will let you know here when this is available.

In the meantime, I am really pleased to see the progress that the National Kidney Care Audit is making, and look forward to seeing the results.