Modernisation Initiative
Kidney Services
Location: Guy’s and St Thomas’ NHS Foundation Trust, Lambeth Primary Care Trust , Southwark Primary Care Trust, King's College Hospital NHS Foundation Trust and NHS London
Award: £15,000,000
Start date: 01/11/2003
Project intentions: A major initiative to modernise health services in three key areas in Lambeth and Southwark, making improvements to kidney disease, sexual health and stroke services.
The kidney disease project aimed to address the whole patient pathway from diagnosis through to treatment – both dialysis and transplant options - as well as improving palliative care. Highlights of the programme outcomes are:
- The project set out to raise awareness of the benefit of having regular blood pressure (BP) checks. Three different campaigns were launched to target Caribbean, West African and white middle-aged men. Local DJs championed the campaign; leaflets were dropped into places of worship and barber shops, and a BP bus attended the south London festivals. The evaluation showed that over 45,000 people may have taken action to get their BP checked as a result of the campaign.
- A number of approaches were piloted to help GPs identify patients with high blood pressure and better manage their symptoms. A ‘Reduce the pressure’ toolkit has had a tangible impact on the numbers of patients identified as ‘hypertensive’ and improved management of these patients in the two boroughs.
- Awareness of the range of dialysis options has been improved through the production of the ‘Your Kidneys’, your choice’ and ‘Living Life to the full on dialysis’ resources. Self care has been promoted and facilitated both within hospital and at satellite dialysis units. The numbers of people dialysing at home has also increased as patients have become more empowered.
- The project has also raised awareness of the benefits of living donor transplantation and has introduced a blood cleansing system which enables people with an incompatible blood group to donate their kidney.
- The overall experience of kidney disease patients has been improved through enhancements to the hospital environment (including artwork selected by patients), the introduction of menu choices for inpatients and improved transport and communications. A special book of recipes has also been produced for people with kidney disease.
Reduce the pressure toolkit
This tool kit is a resource to assist general practitioners and practice staff to review and improve their management of patients with hypertension within their practice. It provides a step by step guide on what actions to take when addressing the practice’s organisational systems and clinical practice with a list of follow up actions.
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Download: Reduce the pressure toolkit |
‘Your kidneys, your choice’ booklet and dvd
A guide to living with chronic kidney disease (booklet and DVD)
This booklet and DVD explains to the patient about:
- Living with kidney disease;
- How the kidneys work and what they normally do;
- How kidney disease may make you feel;
- Possible treatment choices – transplant, dialysis and conservative management;
- What patients can do to keep themselves as healthy as possible;
- What support King’s College Hospital and Guy’s and St Thomas’ Hospital can offer to patients with chronic kidney disease
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Download: 'Your kidneys, your choice’ booklet |
Watch the dvd by clicking on any of the links below:
The DVD gives additional information about chronic kidney disease and features patients telling their own stories.
The DVD is meant for information purposes only and does not replace the detailed discussions you have with your consultant and other healthcare professionals. The detail in this DVD was correct when it was filmed in 2007.
Haemodialysis self-care guide (patients)
This booklet has been developed as a self-care education/training guide to help patients learn how to participate in their haemodialysis.
care.
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Download: Self-care dialysis |
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Download: Self-Care Measurement Form |
Haemodialysis self-care guide (staff)
A guide to self-care haemodialysis for new staff, to help teach willing and able patients, or carers, to do some or all of their own dialysis treatment.
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Download: Self-care dialysis |
Self-care dialysis poster
This poster describes the aim of the project to facilitate self care amongst kidney dialysis patients at the two participating NHS Foundation Trusts. It describes the aims, approach, results and lessons learnt. It won the Permanente Journal poster award for original research in Service Quality for its personal connection with patients at the IHI conference in Orlando in 2007.
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Download: Self-care dialysis |
Home Haemodialysis
A leaflet describing the benefits, criteria, training and frequently asked questions on home haemodialysis.
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Download: Home Haemodialysis |
Living Life to the Full on Dialysis dvd
Watch the dvd by clicking on any of the links below:
The dvd provides information on self-care kidney dialysis for those who are interested in self-care or know someone who is thinking about self-care as an option. It gives a brief introduction to the different self-care dialysis options, features patients and their experiences and answers some of the most frequently asked questions from patients considering self-care
The dvd is meant for information purposes only and does not replace the detailed discussions you have with your consultant and other healthcare professionals. The detail in this DVD was correct when it was filmed in 2007.
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Download: FAQs |
Making the Gift of Life dvd
Kidney transplantation from living donors is now an established and successful technique for the treatment of kidney disease. Donating a kidney is a major decision and it is important that you have all the information you need. We hope that this dvd will give you some insight into being a kidney donor and help you to make the decision that is right for you. The dvd features patients discussing their experiences of giving and receiving a living donor transplant.
The dvd is meant for information purposes only and does not replace the detailed discussions you have with your consultant and other healthcare professionals. The detail in this dvd was correct when it was filmed in 2007.
Watch the dvd by clicking on any of the links below:
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Living kidney donation: Introduction |
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James and Shelagh Duncan (mother and son) |
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Hansa and Jayesh Magudia (mother and son) |
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Tim and Sue Byrne (husband and wife) |
Peer support (posters)
Peer support aims to provide practical, emotional and social support for people with kidney disease and their families. It provides an opportunity to talk to an experienced kidney patient. People who become peer supporters are all patients at the hospital who have chronic kidney disease. They are all unpaid volunteers. They have all completed formal training and undergone criminal records checks. These posters highlight some of the experiences of those who have given and received peer support.
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Download: Jane Bevan |
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Download: George Brown |
Peer support report: 'Exploring kidney patients' experiences of receiving individual peer support'
Peer support schemes of various types are commonly offered to patients as an adjunct to health and social care services provided by professionals. For patients with chronic illness, peer support interventions have recently become associated with more directive attempts to increase self management and improve healthcare outcomes. There is little qualitative research on patients' experiences of one-to-one peer support. This report explores kidney patients' experiences of receiving individual peer support.
See the Health Expectations Journal for a copy of the report.
Peer support report: 'No White Coat Between Us'
Peer support has been recognised as a ‘fundamental service component’ of high quality pre-dialysis care. This report describes how peer support services for kidney patients were developed in two renal units in South London, which now have over 30 active peer supporters who have provided peer support for more than 75 patients.
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Download: 'No White Coat Between Us' |
British Renal Society Conference 2006 presentation on Renal End of Life Care.
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Download: Improving the care of patients dying in the renal setting |
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Download: Renal palliative service development |
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Download: Scratching the surface |
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Download: Renal palliative service development |
15 Minutes of Learning
A teaching tool for nurses covering the basics of kidney function and haemodialysis.
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Download: 15 Minutes of Learning |
High blood pressure in Lambeth and Southwark - a community perspective (MORI poll)
In June 2005, the Modernisation Initiative commissioned MORI to conduct a baseline survey of people's knowledge and understanding of HBP in Lambeth and Southwark. The survey also explored the effectiveness of various strategies for raising awareness and examined ways of promoting healthy lifestyle choices in the local community.
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Download: High blood pressure in Lambeth and Southwark - a community perspective |
General learning from the Modernisation Initiative
Quick guide: Gambro AK Machine
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Download: Gambro AK Machine |
Improving services by involving patients, carers and staff: A step by step guide to organising Whole System Service Improvement
This guide is based on learning from the Kidney Disease Modernisation Initiative,
which organised 13 large group events across the kidney units at Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust. These events focused on specific parts of the service, including pre-treatment education, dialysis, transplant, inpatient and end of life care.
This guide includes:
- why hold whole system events?
- how to organise an event - in advance, on the day, follow up
- lessons learned
- event checklist
- templates for patient letters etc.
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Download the guide |
Events In the last few months of the Modernisation Initiative (for kidney disease, stroke and sexual health services), David Jones, Director of Grant Making met with MI Director Fran Woodard to find out what she felt has been the main challenges faced and general learning from the initiative.
Their discussion was recorded and transcribed to provide other clinicians, managers, policy makers and academics involved in health service change with some insights into a range of issues including working across cross organisational boundaries, the importance of effective reporting mechanisms and achieving sustainability.
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Download the conversation here |
Modernisation Initiative website
Broad information on the aims and achievements of the three streams of the Modernisation Initiative is available on the Charity's website, or you can see a more detailed synopsis of achievements on the project website (which will remain live until December 2008).
End of Life Care
Building on the success of the last three years, the Charity’s Trustees have earmarked a further £15 million to tackle three more areas of health service modernisation via the same approach. The first area to be identified will tackle issues around End of Life Care - involving the acute and primary care sector, as well as representatives of the care home sector and relevant charities. A further two areas will be identified for transformation by 2012 at a cost of £10 million. More here