There is no national registry of chronic kidney disease (CKD). Over 99.9 per cent. of people with CKD will be under the care of general practitioners and not be seen by secondary or tertiary hospital services.
At general practice level, the maintenance of a practice register of patients with CKD became a part of the quality and outcomes framework in April 2006, which in due course should mean that a very rich dataset will be available for every community in the country.
Part 2 of the “National Service Framework for Renal Services” sets out the Department’s strategy for early identification and management of chronic kidney disease, and for slowing down its progression. This has been reinforced by the introduction of a set of indicators relating to chronic kidney disease in the quality and outcomes framework, which rewards general practitioners for developing services in this area.
Part 1 “Dialysis and Transplantation—The National Service Framework for Renal Services: Dialysis and Transplantation”, which is available in the Library, sets out the Department’s vision for the sufficiency and quality of dialysis services in the national health service. Standard 4 of the National Service Framework aims to improve the outcomes for people on dialysis and maximise their rehabilitation, quality of life and survival.
Choice is acknowledged as being of paramount importance in the “National Service Framework for Renal Services”, and that choice includes home dialysis. The National Institute for Health and Clinical Excellence has recommended that patients should be offered the choice of home haemodialysis, where clinically indicated, as a cost- effective alternative to haemodialysis in a hospital or satellite unit. The Department is currently hosting a seminar to promote the availability of home dialysis in the national health service.