The Renal National Service Framework: a step in the right direction

Part one of the National Service Framework (NSF) for Renal Services was published early in 2004. The document covers the treatment of patients with end stage renal failure with dialysis and transplantation. Five standards to be achieved by 2014 are proposed. These cover access to information, timely preparation for dialysis, quality planned access surgery, patient choice for dialysis modality, and improvements in the quantity and success of renal transplants. These standards are underpinned by five early actions to be achieved by 2006. These include improved information flow about current practice and outcomes, increases in haemodialysis capacity and adherence to National Institute for Clinical Excellence guidelines on immunosuppression. The Renal NSF is welcome as a significant boost to the profile of renal services in England. Implementation will be difficult and will require the sustained pressure of the 'Kidney Alliance' representing patients, clinicians and supporting organisations.