In the UK, quality standards for chronic kidney disease (CKD) are set out in a National Service Framework and in pay-for-performance indicators. As CKD is largely asymptomatic in its early stages, it is therefore generally detected following routine renal function testing. In a paper published recently in Family Practice, Simon de Lusignan and colleagues examined which groups of patients were most likely to have renal function testing in primary care. The found that testing rates were highest in people with diabetes, and slightly higher in women than men. The results will help in the planning of the new NHS Health Check programme.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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