A project which identifies people with progressive chronic kidney disease (CKD) earlier and improves access to treatment and patient outcomes has received £400,000 funding for expansion nationwide. The project is being led by the medical research charity Kidney Research UK, with funding from the Health Foundation.
The programme called ASSIST-CKD (ASSIST-Chronic Kidney Disease) looks for early signs of progressive kidney damage in patients by combining data from routine blood tests carried out by GPs and hospitals, using dedicated software to create graphs of kidney function over time.
It aims to help to reduce the burden of kidney disease and, through the early identification of patients with deteriorating kidney function, reduce the rate of late referral for dialysis, an important ambition for renal services across the UK.
Nearly 2 million people in the UK have been diagnosed with moderate-severe CKD by their GP and it is estimated that a further one million people remain undiagnosed as people with CKD often have no symptoms. Early detection and treatment is critical and can help to delay or prevent the need for dialysis in some kidney patients.
Following the success of a smaller-scale project in the West Midlands, the ASSIST-CKD project has received Health Foundation funding for expansion across 12 to 15 locations nationwide, covering a population of between five and eight million people.
Dr Hugh Gallagher, Project Lead for ASSIST-CKD, said: 'The outcomes in patients referred late for renal replacement treatment are particularly poor, and through the ASSIST-CKD project, healthcare teams will be made aware of problems at an earlier stage. This will mean patients will access treatment in a more timely fashion, and they will also be given more information to help understand their condition.'
As part of the programme, kidney function graphs are assessed by a laboratory scientist or renal nurse to review the trends in patients’ tests results. This identifies people with failing kidney function, to allow earlier intervention and treatment, often before the problem becomes too severe. Patients’ GPs are then alerted with a prompt that further action may be needed, and advice on treatment options is provided. Resources are also provided to help improve patients’ understanding of CKD, encouraging them to become involved in their care. They include practical advice on self-management techniques and lifestyle changes which can help to slow down the progression of their kidney disease.
Since 2005, when the original community-wide CKD management system in the West Midlands first started, the number of patients starting dialysis per year at the Heart of England Foundation Trust (HEFT) has fallen by 16% compared to an increase of 8% in England as a whole. HEFT also have the lowest percentage of patients presenting late for dialysis in the UK.
74% of GPs in the HEFT project found the reports and eGFR graphs to be useful, and 41% have changed the management of their patients as a result.
Dr Gallagher continued: 'This work is supported by a number of important organisations within the kidney community and the NHS more widely. We hope to demonstrate that the programme can be effective in other areas outside of the West Midlands, which will create a powerful case for universal adoption of the service across the UK.'
Jane Jones, Assistant Director at the Health Foundation, comments: 'The ASSIST-CKD project is an example of real innovation in helping to deliver more timely interventions for patients at risk of developing serious, long-term health problems. The emphasis is on early diagnosis, and the impact we have seen so far has been very promising. We hope that this will continue to allow both patients and care teams to achieve better outcomes.'
Notes to editors
Kidney Research UK is the leading national charity dedicated to research that will lead to better treatments and cures for kidney disease.
The Health Foundation is an independent charity working to improve the quality of healthcare in the UK. We exist to support people working in healthcare practice and policy to make lasting improvements to health services. The Health Foundation carries out research and in-depth policy analysis, runs improvement programmes to put ideas into practice in the NHS, supports and develops leaders and shares evidence to encourage wider change.
A dedicated Patient Advisory Group has been set up to ensure that patients’ voices are strongly represented in the design, leadership and governance of the ASSIST-CKD project.
Key policymakers and stakeholders have been involved in the development of the project. The Advisory Board overseeing the project is led by the NHS England National Clinical Director for renal care.
A national renal Quality Improvement Development Group is aligned to this project and aims to support and spread quality improvement work within the kidney community.
The project will engage with specialist renal commissioners, clinical commissioning groups and laboratory scientists, all of whom are represented within the project team.
Mike Findlay, Senior Media Manager
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