We wish to define the needs of patients within an objective framework and ensure that we are clear what skills are then needed to care for the patients. So, we have identified four key elements to the work.

1. Organisation of patient care: We wish to find a way of assessing patients' dependency through more-objective methodology than the current, largely subjective, professional assessment. However, it is crucial that this system reflects the skills and experience developed within renal nursing. So, this system will be flexible and consider the patient's journey through different modalities of treatment.

2. Competency development: We need to be clear about the skills needed to care for renal patients. With the proposed changes in Agenda for Change, it is our chance to think more widely and creatively than the current grading system allows. The group intends to recommend a framework of competencies, which can be refined to reflect local needs.

These competencies will incorporate the proposals published within the Fitness for Practice document, which suggests the way forward for nurse training and development.

3. Education: We are defining the education needs of renal nurses and care assistants at all levels to ensure that they are equipped with the appropriate skills to care for renal patients. This includes assessment and accreditation of Continuing Professional Development alongside the more formalised education programmes.

This area is being closely linked to the competency development framework.

4. Recruitment and Retention: There are many areas of good practice in the recruitment and retention of renal carers and the Steering Group is pulling together these for wider circulation. We have met representatives of the Human Resources Directorate at the Department to Health to ensure that Renal Nursing is given a higher profile in national recruitment campaigns.

We have also conducted a survey of current vacancies to understand the scope of the problem and this has highlighted a number of areas with significant problems, most notably the inner cities.

What happens next?

		We aim to produce a preliminary report for the end of June 2000 in draft form for comment within the group.
		We are currently seeking funding for the validation of a dependency-scoring tool that can be adapted for use in all Renal Units.
		When the draft documentation is complete we will present it to the Department of Health for comment and circulate it widely for feedback from renal units in the UK.
		We plan to follow this with a consensus conference to launch the finished document formally.

Do you want to know more?

Email: gillsav@hotmail.com

I would be delighted to hear from you

Gill Savage is Chair of the Renal Services Framework Development Steering Group and Professional Head of Nursing, Specialised Services, North Staffordshire Hospital, Princes Road Stoke- on Trent. Tel: 01782 554521.