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Greater Manchester
Chronic Kidney Disease (CKD) Discovery
Part of the Health Innovation Accelerator
Health Innovation Manchester (HInM) has worked in partnership with life sciences company, Boehringer Ingelheim, to undertake a project to understand the current pathway and patient journey for people with chronic kidney disease (CKD), from early-stage diagnosis through to treatment. The aim was to identify where there are opportunities to improve the experience and outcomes for patients with chronic kidney disease and their carers, focusing on prevention, earlier diagnosis and slowing disease progression.
HInM undertook an analysis of chronic kidney disease in Greater Manchester (GM), which found that the prevalence of CKD for GM is 3.9% (England avg. 4.2%), equating to 97,426 people. The estimated total cost of CKD care, treatment and provision in GM is estimated to be £78.1m. These figures highlighted the opportunity to review the existing provision and to make improvements so that patients receive the best possible care, delivered in the most efficient way.
Over a 9-month period, with the support of a service design agency called The Care Lab, the project engaged with over one hundred health and care professionals working in a variety of roles, from across different care settings.
Twenty-three patients and 8 carers were also able to contribute to the discussions. Working together the groups were able to map the CKD pathway, identify the main problems and develop potential solutions that could improve services to meet the specific needs of CKD patients across Greater Manchester better.
The project identified key gaps in the current pathway from before diagnosis to advanced disease. These gaps identified that the general population and high-risk ethnic communities are unaware of renal health and risk factors.
This poor renal knowledge, combined with inconsistent testing and coding tools and practices in primary care and a lack of guidelines to support early detection mean CKD is not being picked up early enough to prevent or slow disease progression. It is also difficult to coordinate care during transitions between acute and primary care services, which means that the continuity of care and patient support is being disrupted.
In addition, there is also a lack of psychosocial and emotional support for patients and carers to cope with a rollercoaster of challenging emotions along their CKD journey.
These findings were discussed with patients, carers and healthcare professionals to determine which areas for improvement should be the highest priority, this included:
- Raising awareness and increasing understanding of renal disease so people understand how to keep their kidneys healthy and are able to detect any issues early. This information could be delivered through activities in the community and by establishing a network of contacts with community organisations to support this work as they are often believed to be a trusted source of information.
- Introducing innovate screening and diagnostic services in primary care to enable CKD to be detected earlier.
- Introducing better procedures, tools and digital infrastructure to improve the coordination of care and support between primary care and renal specialists so that the teams are more integrated.
- Enabling empowering conversations to take place between patients and professionals by helping to create time and space to discuss their condition, treatment and potential lifestyle changes.
- Extending mental health support to help more patients and their carers deal with the challenges of living with a long-term condition.
- Encouraging ongoing patient participation in the management of their condition.
- The establishment of partnerships with community organisations to enable them to provide continual support and create the right conditions for a more sustainable, equitable, relevant and resilient care model.
This part of the project formally concluded in early 2024. The outputs were published and shared with key partners and stakeholders to inform further improvements to the pathway. HInM will also be looking for potential innovative solutions that can be used to support this work.
Hear more about the CKD pathway work from key leaders involved in the project
The Health Innovation Accelerator
The Health Innovation Accelerator encompasses two projects, the Advanced Diagnostics Accelerator and the DEVOTE programme, delivered through a partnership between Health Innovation Manchester, Manchester University NHS Foundation Trust (MFT), The University of Manchester, and industry partners.
This project is part-funded by the Greater Manchester Innovation Accelerator programme. Led by Innovate UK on behalf of UK Research and Innovation, the pilot Innovation Accelerators programme is investing £100m in 26 transformative R&D projects to accelerate the growth of three high-potential innovation clusters – Glasgow City Region, Greater Manchester and West Midlands. Supporting the Government’s levelling-up agenda, this is a new model of R&D decision making that empowers local leaders to harness innovation in support of regional economic growth and help attract private R&D investment and develop future technologies.
References
1 Kidney disease: A UK public health emergency The health economics of kidney disease to 2033 June 2023 https://www.kidneyresearchuk.org/wp-content/uploads/2023/06/Economics-of-Kidney-Disease-full-report_accessible.pdf
2 NICE Guideline NG203 https://www.nice.org.uk/guidance/ng203/
This webpage has been produced as part of a collaborative working partnership between Health Innovation Manchester and Boehringer Ingelheim Ltd.