title: Regional differences in the provision of adult renal dialysis services in the UK.
abstract: BACKGROUND
  Provision of renal dialysis varies between UK regions.
  
  
  OBJECTIVE
  To analyse these differences in provision and investigate their causes.
  
  
  METHODS
  Questionnaire-based survey.
  
  
  METHODS
  A questionnaire was posted to all renal provider units and renal commissioning groups in the UK. Questions covered issues such as dialysis modalities and patient choice. Data were collected by telephone interview (or post in some cases) and analysed using SPSS.
  
  
  RESULTS
  All renal provider units in the UK responded. A full range of modalities was provided by the majority of units. Clear variations in the level and quality of dialysis provision were seen between the UK regions. These included variation in choice of dialysis modality, provision of high-cost drugs, vascular access waiting times, number of support staff and availability of spare dialysis slots.
  
  
  CONCLUSIONS
  The considerable variation between UK regions in the provision of adult renal dialysis services cannot be entirely explained by age or ethnic variation, and is in part due to limited bed space, dialysis machines and support staff, as well as changes in commissioning arrangements. To meet the requirements of the renal national service framework in most regions, changes to policy and funding will be required, such that the relatively new commissioning groups implement more appropriate funding structures in closer dialogue with their provider units.
authors.affiliation: Section of Public Health, University of Sheffield, Sheffield. l.blank@sheffield.ac.uk
authors.forename: L
authors.initials: L
authors.lastname: Blank
authors.forename: J
authors.initials: J
authors.lastname: Peters
authors.forename: A
authors.initials: A
authors.lastname: Lumsdon
authors.forename: D J
authors.initials: DJ
authors.lastname: O'donoghue
authors.forename: T G
authors.initials: TG
authors.lastname: Feest
authors.forename: J
authors.initials: J
authors.lastname: Scoble
authors.forename: J P
authors.initials: JP
authors.lastname: Wight
authors.forename: J
authors.initials: J
authors.lastname: Bradley
mesh_terms: D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000706:statistics & numerical data; D004921:Erythropoietin / Q000008:administration & dosage; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000379:methods / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014850:Waiting Lists
chemical_list: D011994:Recombinant Proteins; D004921:Erythropoietin