Quality and Value

Focus on: preparing for end stage renal disease

renal1.jpgThe aim of this project is to identify clinical pathways and processes that give renal patients easier, more efficient access to their chosen treatment option.

The following key question is at the heart of this:

‘What are the aspects of an effective and efficient clinical pathway from diagnosis of end stage renal failure, to assessment and addition to the transplant list?

Read the report

Focus on: Preparing for end stage renal failure

As part of the project we are examining the following issues:

  • planning a pre-emptive transplant – options,choice and education
  • planning the transplant assessment
  • preparing the patient and their relatives, carers and potential donor for dialysis and therapy options
  • how a multi-skilled renal team impacts on the pathway and ensures timely interventions
  • the organisation of processes and information throughout the patient journey
  • evidence of support and guidance for service development provided by trusts and commissioners.

Our methodology

Using the NHS Institute’s High Volume Care programme methodology, we have analysed the available hard and soft intelligence and are now working closely with NHS co-production partners to learn more about existing pathways and explore how these can be improved. As part of this, we have completed a series of in-depth visits to trusts providing renal services and workshops with trusts and individuals across the service. We have observed the care environment and carried out interviews with staff, patients and carers.

Products and milestones

We have hosted a co-production event where representatives of the trusts we visited and other key stakeholders came together to develop an optimised care pathway and generate ideas to support wider implementation of the pathway in the NHS.

The focus now is on prototyping and testing these products, which might include:

  • a peer support framework tool for specialist commissioners
  • a framework and guidance for setting up a patient befriender service
  • tools and guidance for streamlining clinics - aimed primarily at service providers, but also providing guidance for service commissioners.

The project’s products are anticipated to be launched between late 2008 and early 2009 following testing.

Get involved or find out more

email: renal@institute.nhs.uk *

Read the report

Focus on: Preparing for end stage renal failure


20708 High Volume Care Kidney Newsletter Issue 1.pdf High volume care kidney newsletter issue 1 (299.46 KB)


Listen to an interview with Dr Michelle Webb, focusing on the year leading up to end stage renal failure.

* Please note that the NHS Institute is an innovation and improvement organisation and is unable to give medical advice to patients or their carers


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