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SarahBell

Dialysis On Nhs?

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http://epetitions.direct.gov.uk/petitions/72236

For dialysis to remain a prescribed service on the NHS in 2015

Responsible department: Department of Health

Kidney disease charities were "stunned" to have been told this week (20 Nov '14) dialysis will no longer be a prescribed service on the English NHS from next year.

Care for dialysis patients should not be the responsibility of CCGs (clinical commissioning groups). Dialysis is a specialist service that should be managed by renal experts.

We want dialysis to remain a prescribed service on the NHS


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This just sounds too bizarre to actually mean people will no longer get dialysis... ?

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11. NHS England has recommended to the Prescribed Services Advisory Group that the following services currently commissioned by NHS England should in future be commissioned by CCGs:

 renal dialysis (excluding encapsulating sclerosing peritonitis surgery)

 surgery for morbid obesity

This means that the CCGs will be responsible for commissioning dialysis, not the NHS [England], as it is at present.

Complete document here.

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This means that the CCGs will be responsible for commissioning dialysis, not the NHS [England], as it is at present.

Complete document here.

And what will that actually mean?

More managers to spend the same amount of money = worst services? Or better management of services with no cost increases?

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No. It's changing the way it is organised.

Most NHS services are organised and budgeted locally (by the CCGs). It's a local decision how many hip surgeons or gynaecologists are needed, and how many physiotherapy centres, etc. Are needed.

Some conditions are rare, and it may not be feasible to provide services locally on all areas. Prescribed services are services catering for rare diseases. These are organised and purchased on a national or regional level.

Historically, dialysis has been a specialist prescribed service. The idea is that it is now sufficiently common that it could be organised and planned locally.

As to what the motivations are, I don't know. It could well be a political scheme to move balance sheet lines around.

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This is an example of the wedge that CCGs provide to allow NHS privatisation. The local CCG can now choose their provider of dialysis services which may include private providers.

I am not against private or other non-NHS providers of services as often it may be the best in terms of both patient care and value for money. My concern is more about the unaccountability of CCGs.

CCGs are committees of local GPs. There is minimal accountability to the local population and there is poor scrutiny of what they are doing with public funds centrally. It is in such an environment that opportunities for corruption exist.

The PCTs that they replace were rightly derided as troughers paradises but at least they had organised boards which included a cross section of health professionals not just GPs and members of the public.

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