Unless you have been holidaying on Mars for the past 2 months, you will be aware that Andrew Lansley, the Secretary of State for Health set out his plans for reforming the NHS in the White Paper “Equity and Excellence: liberating the NHS” in the early weeks of July. The White Paper is supported by a series of consultation documents which are now underway.
It is clear that the quality and efficiency work to make productivity savings of £15-20 billion must continue with renewed focus and pace. We still do not yet have a good representation of all kind of ideas and projects the kidney community has been working on available on NHS Evidence. Patrick Harnett and colleagues from Southend have described an innovative scheme to improve transport and reduce costs and a few other projects are under review. I would encourage all members of the kidney care community to consider show-casing what you do well on NHS Evidence and will be happy to speak with anyone considering a submission.
Much of the commentary on the White Paper is focussed on the changes to Commissioning but there are equally big changes ahead for providers. There is a huge opportunity for clinicians to influence the shape of future services. The next 3 years will be challenging. Renal consultants and the multiprofessional team will play a crucial part by offering clinical leadership within your renal units and across the range of organisations that make up your local health and social care system. Never has it been more important that the renal clinicians engage with general practice colleagues and that primary care and hospitals work together.
It is vital that as many members of the kidney community as possible engage and participate in the consultation and bring your experience and knowledge to bear on the formation of the Outcomes Framework.
The White Paper sets out plans for reform through 4 key themes, all relevant to people with kidney disease.
- Give patients more information and choice about their care guided by a simple mantra; “there will be no decisions about me without me”. Shared decision making about renal replacement therapy and conservative kidney care fits perfectly.
- Improved health outcomes to among the best in the world. From targets to outcomes – we have been arguing this for a decade. Our NICE standards for kidney disease are due to be published shortly.
- Hand back power to patients and the NHS professionals who treat them. Empowering doctors to deliver results and put them in charge of the services that best meet the needs of local people. GP clusters will change the whole commissioning environment. We have an opportunity to address commissioning across the whole pathway but there is a risk that renal services will be marginalised or seen as completely separate from the main focus of the NHS.
- Remove unnecessary beaurocracy, cut waste and make the NHS efficient. To which we could add green! Providing the right care is a responsibility we all have.
The White Paper lays out the what but you are part of the how. The landscape is changing, it reminds me of 10-12 years ago when the groundwork for our NSF was laid. Don’t wait until it’s all settled down, shape your future – comment nationally and get engaged locally.
