The Department of Health launched its vision for World Class Commissioning at a major event on the 3 December 2007 in London.
By summer of next year Primary Care Trusts will be expected to be putting together plans setting out how they will achieve both the vision and meet the competencies; plans will be assessed against more specific criteria to be launched next year.
Monday, 24 December 2007
Tuesday, 18 December 2007
A Christmas message for the kidney care community
Seasons greetings to everyone reading this message. I hope you are looking forward to the festive season and that you get a break and rest over the holiday period. It’s a time to reflect and recharge for the year ahead.
I am sure we will all have many opportunities to improve kidney care in 2008 and you will have my support to help make your services world class for local people with kidney disease.
I have listened a lot in the last 12 months – I appreciate staff are under a lot of pressure, for many patients I understand that the experience is the outcome and I realise that we have a long way to go before we can put hand on heart and say our kidney care service is truly world class. I have no doubt we can get there – that’s why I took this job.
It’s been a roller coaster of a year for me. Standing down at President of the Renal Association to take on the National Clinical Director role was a very difficult decision. The support and advice I received from colleagues, my family, patients and carers had been marvellous. I am going to enjoy the break and will be back working for better kidney care and blogging with renewed enthusiasm on 2 January.
Best wishes to all.
I am sure we will all have many opportunities to improve kidney care in 2008 and you will have my support to help make your services world class for local people with kidney disease.
I have listened a lot in the last 12 months – I appreciate staff are under a lot of pressure, for many patients I understand that the experience is the outcome and I realise that we have a long way to go before we can put hand on heart and say our kidney care service is truly world class. I have no doubt we can get there – that’s why I took this job.
It’s been a roller coaster of a year for me. Standing down at President of the Renal Association to take on the National Clinical Director role was a very difficult decision. The support and advice I received from colleagues, my family, patients and carers had been marvellous. I am going to enjoy the break and will be back working for better kidney care and blogging with renewed enthusiasm on 2 January.
Best wishes to all.
Review and update of the specialised renal services definition
Following the Carter Review of commissioning arrangements for specialised services May 2006 it was agreed that the specialist services definitions set would be updated. We are currently using the second edition produced in 2002 which covers 35 definitions including renal services. So an update to bring the definitions in line with the Renal NSF (the KDOQI nomenclature and the “eGFR” era) makes eminent sense.
The purpose of updating the definition is to produce a set of classifications (ICD and OPCS codes plus text where codes are lacking/insufficient) to enable providers and commissioners to identify and cost specialist service activity. It is important to recognise that the definitions are not service specifications or descriptions of best/evidence based practice or service models. Normally, specialist services are those services where the catchment planning population is greater than 1 million. In other words, these services would not be provided in every district general hospital.
The Renal NSF recommends that preparation for replacement therapy, dialysis and transplant services are best commissioned through a “network” approach in order to ensure equity of access and cohesive planning responsive to the needs of the whole community. The natural population for such effective planning remains in excess of 1 million and may more typically be covered by a Strategic Health Authority (SHA). The Specialist Commissioning Groups (SCGs) are co-terminus with the SHAs and the need to plan for increased dialysis capacity was flagged to the SCGs in the recently published Operating Framework.
Clearly the pathway for patients with CKD involves elements of care which are best delivered at local level and there needs to be clear lines of accountability to ensure that early kidney disease management is provided in line with the principles laid out in Part 2 of the Renal NSF. Acute kidney injury and the “conservative management pathway” also need to be clearly defined for the same reasons.
The unanimous view of the Renal Association and of the National Kidney Federation is that renal services should remain included within the specialist services national definition set. Clearly the update of the specialised commissioning definition links with the current PbR project and with the coding initiatives including the renal SNOMED exercise and the review of the HRGs. They are all important pieces of the jigsaw that, when in place, will enable us to translate between clinical activity and financial returns.
We will be working to update the specialised definition for renal services over the next couple of months. I have asked Kevin Harris (Clinical Vice President of the Renal Association) and Bob Dunn (Patient Advocacy Officer of the National Kidney Federation) to help with this task. I would also welcome the views and comments of individuals – if you would like to contribute please contact me.
The purpose of updating the definition is to produce a set of classifications (ICD and OPCS codes plus text where codes are lacking/insufficient) to enable providers and commissioners to identify and cost specialist service activity. It is important to recognise that the definitions are not service specifications or descriptions of best/evidence based practice or service models. Normally, specialist services are those services where the catchment planning population is greater than 1 million. In other words, these services would not be provided in every district general hospital.
The Renal NSF recommends that preparation for replacement therapy, dialysis and transplant services are best commissioned through a “network” approach in order to ensure equity of access and cohesive planning responsive to the needs of the whole community. The natural population for such effective planning remains in excess of 1 million and may more typically be covered by a Strategic Health Authority (SHA). The Specialist Commissioning Groups (SCGs) are co-terminus with the SHAs and the need to plan for increased dialysis capacity was flagged to the SCGs in the recently published Operating Framework.
Clearly the pathway for patients with CKD involves elements of care which are best delivered at local level and there needs to be clear lines of accountability to ensure that early kidney disease management is provided in line with the principles laid out in Part 2 of the Renal NSF. Acute kidney injury and the “conservative management pathway” also need to be clearly defined for the same reasons.
The unanimous view of the Renal Association and of the National Kidney Federation is that renal services should remain included within the specialist services national definition set. Clearly the update of the specialised commissioning definition links with the current PbR project and with the coding initiatives including the renal SNOMED exercise and the review of the HRGs. They are all important pieces of the jigsaw that, when in place, will enable us to translate between clinical activity and financial returns.
We will be working to update the specialised definition for renal services over the next couple of months. I have asked Kevin Harris (Clinical Vice President of the Renal Association) and Bob Dunn (Patient Advocacy Officer of the National Kidney Federation) to help with this task. I would also welcome the views and comments of individuals – if you would like to contribute please contact me.
Monday, 17 December 2007
Dialysis capacity planning gets a mention in the operating Framework
The Operating Framework sets out the specific business and financial arrangements for the NHS in 2008/09. Coming at the beginning of the next 3 year planning cycle following the recent comprehensive spending review it identifies priorities and ambitions in detail. Many of its key aims are central to delivering world class kidney care including:
- Reducing healthcare associated infections
- Keeping people well
- Delivering the 18 week standard
- Reducing health inequalities
- Improving patient experience
- Improving staff satisfaction and engagement
- Co-ordinating end of life care.
Specialised services commissioning is highlighted as one of the key enabling strategies.
The 10 Specialised Commissioning Groups (SCGs) were created as a result of the Carter Review and are charged with driving up the quality of specialised services.
“In commissioning for world class health services, SCGs should pay particular attention to areas where significant increase in demand is likely to lead to pressure on services. For example, demand for renal replacement therapy (dialysis and transplantation) is projected to rise by around 5% per year until at least 2030. SCGs will wish to consider options for expanding the provision of satellite dialysis centres and offering more people the option of home dialysis, as well as expanding acute dialysis units”.
The Operating Framework sets out the vision that will shape our future. It's short and readable.
Subscribe to:
Posts (Atom)