News from Wales

Contact Professor John Williams, Lead Renal Clinician for Wales: williamsjd4@cf.ac.uk

2009 Update

Renal Policy Statement and National Service Framework

The Welsh Assembly Government published in April 2007, a National Service Framework and Policy Statement 'Designed to Tackle Renal Disease in Wales'. Improving the quality of the care of those people with or at risk from renal disease is the cornerstone of that policy statement and National Service Framework (NSF) which defines evidence based standards for the planning, organisation and delivery of care for those with or at risk from renal disease.

The Welsh Assembly Government's aim is to ensure that renal services are planned, organised and delivered around the needs of the children, young people and adults with or at risk of developing renal disease and their families.

In 2008 the Welsh Assembly Government issued a three year Strategic Framework for the period 2008-11 that sets out the key interventions required of the NHS in Wales in implementing NSF standards.

NHS Wales and the Renal Network Structure

The Welsh Assembly Government has announced the establishment of 7 unified health organisations covering the span of community, primary and secondary services in Wales. The new Local Health Boards (LHBs) will come into effect fully from 1st October 2009. The statutory planning and commissioning responsibility will rest with the new LHBs in the new NHS structure with a new Joint Committee being established to undertake the planning of specialised and tertiary services on behalf of all seven LHBs The Minister for Health and Social Services has also agreed the establishment of a single Welsh Renal Managed Clinical Network. In this new structure there will be a single Network Board which is multi-purpose and replaces the current Renal Advisory Group and current two Renal Network Boards. It is assumed in this model, that planning the development and delivery of an integrated renal service on an all Wales basis will be undertaken by the National Renal Managed Clinical Network on behalf of, and with the agreement with the new Joint Committee. The Structure within the National Renal Managed Clinical Network Board will include two Regional Network Teams which will promote the link between the Network Board and the renal service locally.

This is a vehicle through which specialised renal services can be planned and developed on an all Wales basis in an efficient, economical and integrated manner and will provide a single decision-making framework with clear remit, responsibility and accountability. National prioritisation and implementation will generate economies of scale and increased synergy between the network and its stakeholders.

The Welsh Assembly Government are currently undertaking a resource mapping exercise with the LHBs to establish a centralised and ring fenced renal budget which will be managed by the Joint Committee through the single Welsh Renal Managed Clinical Network.

Dialysis Capacity Planning

Since its establishment in 2006, the All Wales Renal Advisory Group has commissioned a 6 monthly audit to assess and provide recommendations on the haemodialysis capacity throughout Wales. This audit has provided expert advice to aid the planning and commissioning of haemodialysis capacity across Wales, addressing issues such as travel times and projected growth in prevalence.

Based on the audit, in 2008 a Strategic Investment Plan was agreed for the expansion of dialysis capacity in Wales. On the basis of this plan the Assembly Government announced additional investment in dialysis services which will fund new subsidiary dialysis units and the replacement of a number of existing units, as well as investing in patient transport and home therapy. This all-Wales programme is being managed by the Renal Network and has incorporated extensive local engagement to ensure the implementation meets the needs and expectations of all stakeholders.

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