Will this provide opportunities for PROs in these treatment areas?
Yes, because there will be an increase in provision. The NSF says patients should be able to decide the type of dialysis they receive. This focus on treatment is new, which should mean more patients will receive better care. Treatment rates in England are low compared with the rest of Europe, and this is seen as a welcome step by the Government to address that.
What else should PROs be looking out for?
The Department of Health’s renal NSF external reference group, which came up with this first set of guidelines, is working on the second part of the framework, which deals with issues around prevention and end-of-life care and should be out in early 2005.
Sounds very positive. Any downsides?
Not with the thrust of the NSF. But the Association of Renal Industries, which represents stakeholders including pharma companies, admits the sector has a job to do to present itself as a credible source of help in the face of some scepticism from clinical partners. It also says there is a PR battle to prevent dialysis products and drugs being seen as mere commodities by the NHS, with all the implications for downward pressure on price that suggests. Twenty-five per cent of patients are treated by the private sector for the NHS. By 2006 the Government wants to expand home- and centre-based haemodialysis.
What’s the scale of the problem?
In England there are about 30,000 patients with established renal failure, half of whom have had a kidney transplant. The rest are on dialysis. Afro-Caribbeans and South Asians are three to five times more likely than the rest of the population to develop renal failure.