The Chronic Kidney Disease Health Integration Team (CKD HIT) is a team of clinical staff and patients, working together to improve patient outcomes and care pathways for patients with kidney disease.
The Health Survey for England found that 6-7 per cent of the population has kidney function of less than 60 per cent. This rises to over 30 per cent of the population over 75. The percentage with advanced disease is much lower.
In 2010, 1,250 individuals in the Bristol region had levels of kidney function low enough to necessitate renal replacement therapy, including haemodialysis (37 per cent), peritoneal dialysis (5 per cent) or kidney transplantation (58 per cent). CKD accounts for up to 2 per cent of NHS spending and is forecast to grow as the population ages and becomes more overweight. A third of dialysis patients experience heightened depression and psychological distress, with quality of life that is markedly lower than that experienced by patients with other chronic diseases and cancer.
With the introduction of routine reporting of kidney function in 2006, CKD awareness has increased dramatically. NICE has produced guidelines on CKD management in primary care and referral to secondary care services and these have been credited with better prevention in primary care and more timely referral to secondary care. As kidney function declines, the optimum level of kidney function at which to start dialysis or receive a transplant is still unclear. For some elderly patients dialysis may not prolong life by many months and some patients, although they want to live as long as possible, are not willing to do so at any cost. Nor is kidney transplantation right for everyone, but it is important that access to the waiting list does not depend on socio-economic status, ethnic group or where you live. Patients must be provided with the facts they need, at the appropriate time, in an understandable format, to make the decision that is right for them.
The Richard Bright Renal Unit at Southmead Hospital provides CKD, dialysis and acute kidney injury (AKI) services for a population of approximately 1.5 million and kidney transplantation services for approximately 2.5 million. In practice this means patients travelling from as far afield as Bridgewater, Warminster and Chippenham for dialysis education and dietary advice, while patients within the first few weeks of kidney transplantation can be travelling to Southmead three times a week from Bournemouth, Dorchester and Gloucester. Not only is this environmentally unsustainable, but it is recognised that proximity to specialist care increases the likelihood of receiving such care.
The CKD HIT aims to improve outcomes for patients with kidney disease in the Bristol area through:
The leading experts in kidney disease in Bristol are involved in the team. The HIT director is Dr Fergus Caskey, Consultant Nephrologist at North Bristol NHS Trust and Medical Director of the UK Renal Registry. The team includes doctors, nurses, a patient and carer.
Find out more about who's involved in the Chronic Kidney Disease HIT.
Patient and public involvement is being sought to capture a range of views across the patient demographic and Bristol area.
Other ways patients and the public are involved include:
Key projects for the team include:
To find out more, please contact:
Chronic Kidney Disease HIT at the HIT conference
The Chronic Kidney Disease HIT presented this poster (PDF) at the 2018 Bristol Health Partners Health Integration Team conference.
View the 2015 video here