Renal Association

Renal Association Clinical Affairs Board

Wednesday 21st November 2007, 4.00 pm Library Annexe, The Novartis Foundation, London

MINUTES

1. Present Kevin Harris Donal O’Donohue Charlie Tomson Robert Mactier Lawrence Golbderg Martin Raftery Jonathan Kwan David Wheeler

2. Minutes of previous meting: agree that an accurate record

3. Matters arising

a. Interaction with Critical care network to be discussed further with the executive b. High risk Transplantation: the document had taken a long while to create. Action to check status with doctors Winearls and Scoble

4. UK Renal Registry

A wide-ranging discussion took place about the current issues facing the Registry and the tabled papers. The following were agreed at actions. a. MR to contact Colchester, to explore the specific issues, they have in making returns to RR b. All CDs to be reminded of the importance of including IT and returns to RR in commercial HD contracts c. CT to produce a simple guide to the required RR fields on co-morbidities. To be circulated to all CDs d. Data managers and clinical directors, to be provided with performance data on their units completeness of returns e. the President will be notified of unit who were significant outliers f. New data items to come to CAB for approval g. MR to seek the views of the clinical service committee on the ongoing needs of renal IT, unless to be fed into JF and D O’D and RIXG for ongoing discussions around the proposed electronic clinical records system. h. RR to co-operate with “NHS choices” helping them to include sensible markers of performance on this site i. RR to consider establishing a social site or electronic communication for renal data base managers 5. Guidelines Committee

It was noted that DW was stepping down as clinical guidelines committee chair to be replaced by RM. DW’s contribution to the work of the guidelines committee was formerly recorded. The board welcomed RM to his first meeting as chair of the clinical services committee

The following were noted. a. Final version of complications module had been posted b. draft version of transplant module had been posted c. AKI guidelines were being reformatted to appropriate style

CAB discussed the process for writing a subsequent approval of the guidelines. It was agreed that the process previously outlined by CW should be followed. There needed to be discussion between the guidelines committee and RR about the proposed audit standards and in particular how the RR could assist with these.

The following were proposed as new guidelines: a. medical management of the transplant patient – Alan Jardine and Richard Baker b. infection-control – Richard Fluck

The need for the harmonisation, where appropriate of future guidelines with international guidelines was supported RM’s proposal to split the future guidelines into component parts to produce a style more consistent with international guidelines was supported It was recommended that the UK KDIGO representative should liaise closely with the RA guidelines committee chair.

6. National issues

a. Darzi: SHA led. RA members to be encouraged to get involved with the process. MR to encourage through clinical services committee b. Liverpool care pathway. A potentially useful document. Some clarification is required in order to allow RA to fully endorse. KH to write a professor Ellershaw with suggestions and encouraging engagement with the RA for the next draft. c. HD capacity. An ongoing but variable problem across the UK. Has been raised at the NHS management board. Ongoing discussions about appropriate modelling at acceptance of an and need for year on year growth for the foreseeable future. d. I need to define the interactions between primary and secondary care, and how this will be supported by IT. Working group established.

7. Clinical services committee

The board welcomed MR to his first meeting as chair of the clinical services committee a. BAUS-RA joint initiative to harmonise guidelines for the management of patients with haematuria b. DUK-RA: the questionnaire had been proposed to look at the diabetic patient crash landing. Ongoing work required c. PD survey: work from the working party to be brought to next CAB d. NICE and HHD. Ongoing work. Proposed topic for next CD Forum

8. Date of the next meeting 19th March Norvartis Foundation, London Time to be confirmed