Vaughan Gething, Cabinet Secretary for Health and Social Services
The Betsi Cadwaladr University Health Board (BCUHB), supported by the Welsh Renal Clinical Network (WRCN) is engaged in a competitive tender process with service providers for chronic haemodialysis (dialysis) services. The subject has become a point of focus in recent plenary business so I wish to set out Welsh Government’s well established policy position to all Assembly Members. No decision has yet been made as dialogue is still ongoing.
BCUHB worked with WRCN to engage patient representatives, trade unions and staff representatives from the outset in review of dialysis services. This included face to face meetings with satellite renal units. Difficulties were encountered early on in ensuring that staff representatives could attend meetings. Engagement was later strengthened, including representation from UNISON and the Royal College of Nursing (RCN) on the BCUHB tender Programme Board and Evaluation Panel. This ensured that staff representatives were engaged in looking at the various options along with service users.
It is widely recognised that Wales leads the UK in terms of access to high quality and sustainable dialysis facilities. The inclusion of a specific and measurable standard in the 2007 Renal National Service Framework (now the Renal Delivery Plan) enabled bespoke modelling of population need, in collaboration with Welsh Government, and the planning of the appropriate sites and sizes of dialysis units across Wales. A consistent approach to the commissioning of these services since 2004 has facilitated the proportion of the Welsh population that live within a 30 minute drive time of a dialysis unit to improve from 75% to over 90%.
This success is as a result of the collaborative arrangements between NHS and independent service providers (ISPs) for the provision of NHS care. Wales has a long history of contracting with ISPs for renal services, the first contracts awarded over 20 years ago. These arrangements have never led to a requirement for NHS staff to transfer to an independent provider of renal dialysis services.
The current tendering process in north Wales is the responsibility of BCUHB, with the support of WRCN. It is similar to processes that have taken place over many years in mid and south Wales. Since the recent conclusion of the 2016 South East Wales expansion contract, patients now experience facilities offering the best available equipment, greatly improved nursing to patient ratios and new comfortable environments for treatment.
The expansion and improvement of NHS renal services in Wales has been a success for staff and patients and provided excellent value for money. Welsh Government’s long established policy position is we will not support the transfer of staff between the NHS and independent renal services providers.