New Recommendations to Improve Care for Kidney Patients, UK

Main Category: Urology / Nephrology
Article Date: 03 Feb 2005 - 11:00 PDT

email to a friend   printer friendly   opinions  

Plans to ensure that healthcare professionals offer the best possible treatment to people with kidney problems were set out today by Health Minister Rosie Winterton. The National Service Framework (NSF) for Renal Services provides the NHS with recommendations on three main areas:

Chronic Kidney Disease (CKD) - helping primary care staff to spot the early signs of chronic kidney disease (CKD) because early intervention can often prevent the need for dialysis or transplant.

For example, by prescribing the right medication for high blood pressure, or by controlling glucose levels in people with diabetes and by modifying diet, the disease can be better managed.

Acute Renal Failure (ARF) - encouraging the NHS to use all opportunities to reduce the incidence of ARF and cut the number of deaths by reinforcing NICE guidelines on pre-operative testing, early identification of people at risk and prompt treatment when people need the specialist skills available at critical care units.

End of Life Care - extending good palliative care practice to people with established renal failure who are near the end of their lives. The NSF will ensure that people who do not wish to receive dialysis will be able to die with dignity in a place of their choice, and strengthen the role of staff such as district nurses to care for people in their own homes.

Visiting Somerset Gardens Family Health Care Centre in Haringey, Rosie Winterton said:

"This framework is designed to ensure that we are getting services right for kidney patients. It's estimated that there are up to 2.5 million people with chronic kidney disease, most of whom will not have any symptoms. We need to make sure, through improvements in primary care, that we identify them and ensure their condition is properly managed, in the right place at the right time and by the right people.

"It is essential that people at high risk of developing CKD are identified as soon as possible and closely monitored. It is also important that people with acute renal failure get the best treatment from the NHS. The NSF offers an opportunity to develop co-ordinated strategies to both prevent and treat this condition and, whenever clinically feasible, to avoid people from becoming reliant on dialysis.

"NHS organisations need to set their sights on delivering the programme of modernisation and improvement set out in both parts of the NSF over the next ten years. Work has already started and progress is being made. "We are already seeing the results of the extra investment that has been going into the NHS. Dialysis capacity is increasing fast and last year saw the highest number of kidney transplant operations for fourteen years. Both are clear signs that services are expanding and improving."

Professor Carol Black, President of the Royal College of Physicians said:

"It is right that the burden of chronic renal disease - which now affects 5% of the population - is recognised within a National Service Framework. As with other long term conditions, effective management is best achieved through seamless, unified primary and secondary care, supporting independence. This will enable affected people, with their families and carers, to live the fullest lives possible."

Mayur Lakhani, Chairman of the Royal College of GPs, said:

"We commend this new guidance. It is distressing to see patients suffer from preventable kidney disease in this day and age. GPs and primary health care teams are uniquely placed to detect kidney disease at an early stage and are adept at chronic disease management and in preventing complications by controlling cardiovascular risk factors."

Michael Hill, Co-Chair of the National Kidney Federation, said:

"The National Kidney Federation is pleased to welcome the publication of the second half of the Renal National Service Framework. Early detection and prevention of kidney failure is vital, as is the need to ensure that acute cases avoid, if possible, the progression to Chronic Kidney Disease. It is also good to see a quality requirement ensuring considerate and compassionate care for patients reaching the end of their lives. Prevention and early management, although costly, will achieve significant benefits for patients, delaying and in some cases avoiding chronic kidney disease, an immense saving in the long run and alleviating the pressure caused by the increasing incidence of kidney failure. We are encouraged to find this document placing these quality requirements into the clinical and public domain"

NOTES TO EDITORS

The NSF has been published in two parts. Part One of the NSF, published in January 2004, describes a framework for the care of people with Established Renal Failure (ERF), including renal replacement therapy by dialysis and renal transplantation, as well as the preparation necessary in the year before renal replacement therapy is instituted in those known to have progressive renal failure.

Part 2 of the NSF covers all remaining aspects of the patient pathway for those with kidney disease and those at risk of kidney disease. It sets four Quality Requirements covering prevention and earlymanagement of chronic kidney disease, acute renal failure and end of life care. It can deliver a major dividend in the prevention of ERF and also builds upon the NSF programme with strong links with the Coronary Heart Disease, Diabetes and Older People's NSFs and the Children's NSF, and is in keeping with the developing programme of work undertaken on Long Term Conditions. It also links with the Government's White Paper Choosing Health.

The National Service Framework for Renal Services, Part Two: Chronic Kidney Disease, Acute Renal Failure and End of Life Care is available on the Department of Health website at http://www.dh.gov.uk The National Service Framework for Renal Services Part One: Dialysis and Transplantation. Published January 2004 is also available on the website. For further enquiries, please contact Anna Brosnan or Katie Robinson at the Department of Health media centre on 020 7210 4984 / 5329.

For all other enquiries, please contact the Department of Health public enquiry line 020 7210 4850.
GNNREF: 110213
Issued by : DOH Press Office (UK)

• Additional
• References
• Citations