8 Leadership and network-level planning

8 Leadership and network-level planning

8.1 Renal-service providers should:

  • establish a multiprofessional operational team that has plans for contingency staffing, agreed pathways to ensure safe provision of dialysis, senior team oversight and clear links with provider COVID‑19 planning

  • work in partnership with commissioning teams within the region

  • nominate an executive lead to support the service, assure planning, work within the regional network and review renal plans in line with national guidance on COVID‑19

  • discuss dialysis provision with contracted private provider partners to establish agreed working patterns during the COVID‑19 pandemic, adapting them as needed

  • develop regional networks to maintain links with other local or regional providers, and share limited resources and best practice.

8.2 Develop individualised plans for patients so that their dialysis schedule can be reduced safely if that becomes necessary. Local policies should address the use of fluid restriction and the prescription of potassium binders to allow the frequency of dialysis to be reduced. This will enable the ongoing operational delivery of dialysis in the unit or at home if there are constraints because of widespread COVID‑19.

8.3 Regional or national networks with commissioning support should prioritise:

  • overseeing appropriate provision across the network, including assessing capacity, the supply chain and transport issues

  • establishing a pathway to ensure patients on dialysis do not get admitted into a hospital without dialysis facilities and to enable rapid transfer if they do.