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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 5.2 Partnerships NHS agencies should work in harmony to meet the standards laid out in this document. Success will depend upon a common approach to the development of services and quality. The RSCGs should oversee joint working at all levels between NHS and partner agencies. In particular, the priorities of the RSCGs must be linked to the priorities of Health Authorities, Primary Care Groups and Trusts (PCGs and PCTs), Hospital Trusts, and other partner agencies. This should be done through the existing NHS planning mechanisms: • Health Improvement Programmes (HimPs) are local strategies for improving health which combine a range of nationally and locally set targets. HimPs should refer to the Regional renal priorities, especially in areas with low prevalence of RRT, and demonstrate how local health priorities and development programmes will complement and enable them. Health Authorities should have specific targets aimed at providing health improvement in this area. • Where and if appropriate in the future, PCGs and PCTs should include in their annual plans and in their agreements with Trusts reference to activities and developments which will impact on renal standards. At the time of writing the PCG/Ts were not expected to do the contracting for RRT. However, PCG/Ts are likely to make a significant impact in improving local diabetes services (see Section 4.1.2). This will be of particular importance in areas with high proportions of ethnic minorities. • Host Trusts, in preparing renal business plans should demonstrate how they will contribute to the delivery of regional plans and targets. They should be able to demonstrate an understanding of their current baseline with regard to renal services and the key tasks which are required to meet the national service standards. • Hospital Trusts, PCGs and PCTs should develop shared care protocols to ensure seamless care for renal patients. • Local Authority Social Services Departments have the responsibility to assess the needs of patients and carers under the Care in the Community legislation and the professional accountability for social work services. The increase in the RRT population will significantly affect the demand for these services and will result in even greater need for Local Authorities to work closely with Provider Trusts.  |