What did we do?
We supported GP practices to improve their identification and care for people with early stage chronic kidney disease (CKD).
Why was it important?
It is estimated that CKD affects around 6% of the UK adult population. The burden of CKD is severe, with patients having a greatly increased risk of suffering a stroke, heart attack, renal failure or death. It was identified that the number of people in Greater Manchester diagnosed with CKD was significantly lower than the estimated disease prevalence, meaning that people with CKD may not have been getting the best care and treatment.
How did we do it?
We worked with patients and healthcare staff to design the project, which had two main aims:
- To halve the gap between recorded and estimated prevalence on practice registers
- For 75% of CKD patients to be tested for proteinuria (the presence of abnormal quantities of protein in the urine, which may indicate damage to the kidneys) and managed to NICE recommended blood pressure targets.
Who did we work with?
NHS Ashton, Leigh and Wigan Primary Care Trust (now NHS Wigan Borough Clinical Commissioning Group),
NHS Salford PCT (now CCG),
NHS Stockport PCT (now CCG)
NHS Bolton PCT (now CCG).
- Evaluation Reports
NHS Ashton, Leigh and Wigan - Full evaluation report (this covers all three phases of facilitated CKD implementation work between 2009-2013 in 27 Wigan borough practices).
NHS Ashton, Leigh and Wigan, NHS Salford, NHS Stockport and NHS Bolton - Full evaluation report (evaluates CKD work in the 19 practices that formed phase one of the project in 2009-10)
Humphreys J, Harvey G, Coleiro M, Butler B, Barclay A, Gwozdziewicz M, O'Donoghue D & Hegarty J., (2012). A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester. BMJ Quality & Safety. Vol 21(8)
Blickem C, Blakeman T, Kennedy A, Bower P, Reeves D, Gardner C, Lee V, Chew-Graham C, Richardson G, Brooks H, Dawson S, Mossabir R, Jariwala P, Swallow A, Kontopantelis E, Gaffney H, Small N, Spackman E & Rogers A,. (2013) The clinical and cost-effectiveness of the BRinging Information and Guided Help Together (BRIGHT) intervention for the self-management support of people with stage 3 chronic kidney disease in primary care: study protocol for a randomized controlled trial. BMC Trials
Harvey, J Oliver K, Humphreys J, Rothwell K, Hegarty J., (2015). Improving the identification and management of chronic kidney disease in primary care: lessons from a staged improvement collaborative. International Journal of Quality in Health Care. Vol.27(1)
Yin-Tsang J, Blakeman T, Hegarty J, Humphreys J & Harvey G., (2016). Understanding the implementation of interventions to improve the management of chronic kidney disease in primary care: a rapid realist review. Implementation Science Vol.11(47)
For more information please contact Lorraine Burey (Project Manager).