Advice from NICE aims to improve commissioning of services to help early identification and management of chronic kidney disease in adults
NICE has today (31 March 2011) published the latest in its series of good practice commissioning guides to support commissioners in designing services to improve outcomes for patients and to help the NHS make better use of its resources. The NICE commissioning guide on early identification and management of chronic kidney disease in adults draws on the NICE clinical guideline on the early identification and management of chronic kidney disease in adults in primary and secondary care and the recent NICE quality standard on chronic kidney disease in adults.
Chronic kidney disease (CKD) is a common condition but it is frequently unrecognised and often exists together with other conditions (for example, cardiovascular disease and diabetes). When advanced, CKD carries a higher risk of mortality. There is evidence that treatment can prevent or delay the progression of CKD, reduce or prevent the development of complications and reduce the risk of cardiovascular disease. Early detection is considered to be cost effective in both financial and human terms. However, because of a lack of symptoms people with CKD are often not diagnosed, or diagnosed late when CKD is at an advanced stage.
Illustrated with examples from the NHS, the NICE commissioning guide identifies the potential benefits of effectively commissioning an integrated service for the early identification and management of chronic kidney disease in adults, including:
- raising awareness of the risk factors associated with CKD and identifying people through appropriate testing
- preventing or delaying the progression of CKD through early and effective treatment
- reducing costs associated with treating established renal failure
The commissioning guide contains:
- A benchmark which estimates that a large proportion of adults with CKD or people with risk factors (7.6%) do not currently have their estimate of glomerular filtration rate (eGFR) measured at least annually
- A commissioning and benchmarking tool which commissioners can use to determine local service levels needed for early identification and management of chronic kidney disease in adults.
Dr Paul Stevens, Consultant Nephrologist and Associate Medical Director at East Kent Hospitals University NHS Foundation Trust, Chair of the Topic Expert Group for the NICE quality standard on chronic kidney disease in adults and member of the Guideline Development Group for the NICE chronic kidney disease clinical guideline, said: "The importance of prevention and early diagnosis of CKD cannot be underestimated. Earlier identification and, where possible, prevention of complications associated with CKD and prevention of disease progression are clearly needed. The purpose of this guide is to ensure that high quality services are commissioned, not just to improve outcomes for people with CKD, but also to enable commissioners to release resources or generate savings through service redesign and by identifying treatments and interventions that do not add value".
While the commissioning guide draws on existing NICE recommendations, it does not constitute formal NICE guidance and is intended as a tool to help the NHS improve patient care through effective commissioning of services.
Notes to Editors
About the commissioning guide
1. The NICE guide on early identification and management of chronic kidney disease in adults is available on the NICE website at www.nice.org.uk/guidance/CMG37
2. The guide is the one of two commissioning guides published by NICE in March 2011, the other being:
- Weight management before, during and after pregnancy
3. Details of all the NICE commissioning guides published to date can be found on the NICE website at http://www.nice.org.uk/usingguidance/commissioningguides/bytopic.jsp
4. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health.
5. NICE produces guidance in three areas of health:
- public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
- health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
- clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS
6. NICE produces standards for patient care:
- quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
- Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients
7. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.
This page was last updated: 30 March 2011