Enabling self-management and shared haemodialysis care in hospital based dialysis

This project focused on the demanding and time-consuming routine of kidney dialysis. Most dialysis patients spend many hours every week in hospital; there is evidence that it leaves people feeling helpless and dependent on hospital staff.

The project aimed to embed shared haemodialysis care across six main renal units and 20 satellite haemodialysis units. Shared haemodialysis care is when patients at dialysis units are supported to undertake tasks involved in their own treatment to the extent that they wish.

Key findings

• Patients reported greater control of their illness and increased confidence.
• Staff reported increased job satisfaction and greater respect for patients.
• There was more dialogue between patients and nurses.
• Some patients felt frustrated by slow rate of progress, with differing levels of engagement from staff.
• Staff were able to spend more time with more dependent patients.

Challenges

• Embedding shared haemodialysis care into all 26 units at the same time proved to be overly ambitious for the two-year timescale.
• The team found it more challenging to deliver the project in units where they did not have managerial control over the dialysis service, in units that had low staffing levels, or where there were significant competing pressures.
• Changes to commissioning arrangements, NHS Kidney Care and Clinical Networks created a period of uncertainty and anxiety throughout the project.

Who was involved?

The project was led by Dr Martin Wilkie, Consultant Nephrologist at Sheffield Teaching Hospitals NHS Foundation Trust, alongside York and Leeds Hospital Trusts.

Project partners were the Yorkshire and the Humber Renal Network, the School of Health and Related Research, the Leeds Institute of Health Sciences, and eight kidney patient and carer groups.