It was 2013, 10 years since the National Service Frameworks for kidney services had been published, and the environment was changing. We believed it was time for the kidney community to evaluate what we wanted to see our community focus on in the future. I therefore instigated a piece of work to create simple and clear ambitions that patients and professionals could use as a guide to what could be expected from their kidney service.
The principle was one of co-production and not to tell anyone what or how to do something, but to point to the outcomes we jointly desired. The board of what was then the Kidney Alliance, representing most of the national patient and professional kidney charities, contributed to and supported the work. Together we created a set of 16 ambitions for excellent kidney care, from early identification through to conservative care. Dr Hugh Gallagher (kidney doctor at Epsom and St Helier hospital) had kindly agreed to co-author the report and we launched it in parliament with the support of Baroness Masham and Jane Ellison, the Health Minister at the time.
Over the following years, we continued to meet as a Kidney Health Partnership Board, acting as a catalyst and touchpoint for work that resulted from the Kidney Health Delivering Excellence (KHDE) ambitions. The Board has retained national support and also that of the patient members who made a major contribution to its work and direction.
Summary of the Kidney Health: Delivering Excellence ambitions
1. Awareness & Identification – reduce cardiovascular risk
2. Prevent or delay disease progression
3. Inform self-management
4. Deliver person-centred care
5. Prevent and treat acute kidney injury
6. Preparation & choice
7, 8 & 9. Improve outcomes from transplantation, equity, increase numbers & live well with a transplant
10 & 11. Deliver better dialysis consistently & support patients to live well
12. Improve the care of children and young people
13. Access to & awareness of the multi-professional team
14. Treat and support people with rare diseases
15. Research – produce a national strategy
16. Conservative care – choice & multi-professional support
Four years on and I am delighted that we are today launching the review of the impact of the report. To quote from the review “We have heard consistently that the messages of KHDE are as relevant now as in 2013”.
Key Findings from the Kidney Health review
1. The KHDE report had a significant and broad impact with policymakers, resulting in important projects:
Transforming participation in Chronic Kidney Disease
The National Renal Research Strategy
The Kidney Quality Improvement Partnership (KQUiP)
The Think Kidneys Acute Kidney Injury programme
The pan-London review of kidney care services across the city
2. Cross community support for the kidney health work
85% thought drawing up ambitions in this way was important
Majority thought the report had had an influence on national policy in kidney care
Strong opinion that the KHDE report had overall been an important force for change
3. More work is needed in certain areas
4. Good, sustained and continuing visibility with policymakers.
However KHDE has not been so visible at ground level with patients or staff. As it inspired some significant and beneficial projects we hope local Kidney Patient Associations, national patient charities and professional bodies will feel encouraged to increase its visibility throughout our community.
The new Quality Improvement ambition
We are optimistic that our ambitions will continue to develop and become an intrinsic part of everyone’s expectations. The Kidney Quality Improvement Partnership (a collaboration to support improvement across our community) provides a focus for this. We have therefore updated the Kidney Heath ambitions to draw attention to its relevance to all of us and have developed a new quality improvement ambition. Ambition 17, for 2017, is:
“The kidney community promotes, encourages and supports continuous quality improvement and sharing of best practice by all healthcare workers to deliver better, safer, less variable and more efficient care.”
We can all be encouraged by the advances we have made together. Significant and further progress is needed and can be made within the kidney community by patient and professional bodies continuing to take active ownership of the ambitions, including the new one for Quality Improvement.
Fiona Loud, co-author Kidney Health: Delivering Excellence, co-chair Kidney Health Partnership Board