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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 5.7 Finance To support the development of renal services there should be a clear financial support structure. This should include: • A clear responsibility of the RSCG is to ensure allocation of funding aimed at achieving equity of provision and eliminating 'blank spots'. • A uniform cost structure which allows RSCGs and commissioners to understand the costs of different services, modalities and methods of provision. This information should be freely available to providers of services and other local stakeholders. • A system of benchmarking which allows Trusts to compare and contrast their costs and financial indicators with their peers. • A clear process for targeting investment in services to implement the 7 National Service Standards for end stage renal failure. • Clear guidelines from the RSCG regarding the funding and responsibilities for prescribing expensive medications including erythropoietin and immunosuppressant drugs.  |