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5 Structures Necessary and Organisation of Services 5.1 Regional Framework 5.2 Partnerships 5.3 Responsibilities of Primary, Secondary and Tertiary Care 5.4 Local Management 5.5 Information Technology and Audit 5.6 Human Resources 5.6.1 NHS Workforce Planning Reforms 5.6.2 Future Staffing Requirements 5.7 Finance 5.8 Organisation of Services 5.8.1 Managed Clinical Networks and Shared Resources 5.8.2 Infrastructure of Renal Centres 5.8.3 The Private Finance Initiative (PFI) and Private Provision of Renal Services 5.1 Regional Framework Renal services require a consistent, long-term approach across wide geographical areas. The NHS has recognised this and incorporated Renal services into the remit of Regional Specialised Commissioning Groups (RSCGs). These RSCGs need to ensure that an effective planning system is put in place: • First, the RSCGs should put in place systems that are capable of supporting major service developments. Within these systems, responsibility for establishing and implementing Regional plans for Renal services should be clearly identified. • There needs to be a thorough baseline assessment of need throughout the Regions which can be matched against current provision. This will then produce a gap analysis which can be used to prioritise development programmes and investment. • Based upon this analysis, there should be a 3-5 year implementation plan with clear objectives, milestones and responsibilities. This plan should aim to target areas of greatest need and to develop an equitable pattern of service across the NHS. There should be a commitment to review the plan annually to ensure that commissioning dialysis reflects changes in acceptance and transplant rates. • Linked to this should be an investment plan that explicitly links development priorities with resources. This should include: • Analysis of building and equipment needs with a clear mechanism for allocating capital, • Targeted revenue allocations to address gaps in provision, • Mechanisms for ensuring appropriate allocation of Consultants, Nursing and Paramedical posts within renal services. • The RSCG should put in place systems for monitoring progress on implementation of plans, and measuring the performance of commissioners and providers of renal services.  |