Introducing the Atlas of Variation in Healthcare for People with Kidney Disease

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The indicators in the Kidney Care Atlas have been chosen by the expert team assembled by NHS Kidney Care and Right Care because they are important reflections of the quality and value of care. Although we cannot provide the “right” answers – there is no magic percentage – this Atlas does pose the right questions for local networks in partnership with patients.

Exploring the questions the Kidney Care Atlas raises should prompt improvements in the local organisation of care delivery,  building on the best examples that currently exist, promote a shift to establishing shared decision-making systems between patients and healthcare professionals as the norm for preference-sensitive care, such as choice of modality of renal replacement therapy or whether to opt for conservative care, and strengthen the science of healthcare delivery to foster innovation and put effective care delivery on a solid scientific foundation.

Dr Donal O’Donoghue FRCP
National Clinical Director for Kidney Care
May 2012

About Kidney Care

NHS Kidney Care provides leadership and resources to enable health professionals and commissioners to provide high quality, patient-focused, affordable care for people with long term conditions, such as kidney disease.

From improved prevention and early diagnosis through to enhanced end of life care, NHS Kidney Care supports healthcare professionals to understand and implement new guidelines, standards and national priorities and to help patients and their carers make more informed choices and live life to the full.

NHS Kidney Care produces resources and tools that support the NHS to drive up quality, improve patient outcomes and become more efficient.

For more information, please visit

  About the Atlas

The Kidney Care Atlas is a landmark in the study of variation in kidney care in England. Data from the UKRR and QOF, as well as other datasets, have been used to illustrate how aspects of healthcare specific to kidney disease vary.

The indicators in the Kidney Care Atlas highlight only 18 of potentially numerous indicators relating to kidney care. They represent a sample of the variation in value and quality in renal services across England.

Identifying, mapping and attempting to address unwarranted variation should not be regarded as independent pursuits, but instead be perceived as intertwined with the quality improvement agenda for renal services. Simply meeting targets for investigation and treatment is not enough. Listening to patients and altering systems of care according to their experiences is intrinsically linked to improving the quality of care.

It is through the efforts of individual clinical teams working “on the shop-floor” that change must be implemented, value increased and quality improved so that unwarranted variation can be addressed.

The Kidney Care Atlas has been produced in collaboration with:

NHS Kidney Care and the UK Renal Registry