Evaluation of local kidney health priorities

Greater ManchesterRenal and Urogenital
Start Date: 1 Mar 2015 End Date: 1 Dec 2015

Project summary

The researchers have submitted a report to the Greater Manchester Academic Health Science Network (GM AHSN) detailing the findings from their consultation exercise to understand kidney health priorities for local clinical commissioning group (CCG) leads and GPs. We undertook this work to help the GM AHSN; understand CCG and GP priorities around kidney health and other cardiovascular related conditions; identify the support needed to implement these priorities; and inform the development of improvement interventions in these CCGs.

The team completed 45 semi-structured interviews with all 13 CCGs in Greater Manchester and Eastern Cheshire between March and June 2015. The interviews explored three key areas:

1)      Kidney health priorities – specific aims for improving kidney care

2)      Broader priorities – other key areas for implementation

3)      The way forward – existing support for implementing priorities and what additional support is required.

Main findings

  • The majority did not view kidney health specifically as a top priority area, but instead placed it within a broader agenda of long-term condition (LTC) care
  • Awareness of acute kidney injury is still low in primary care, but does appear to be gaining prominence
  • A low level of confidence in chronic kidney disease management still persists in primary care, which will be further adversely affected by recent quality and outcomes framework (QOF) changes
  • No single intervention (kidney-based or otherwise) is likely to be implemented with equal enthusiasm by all CCGs and/or practices
  • Incentivisation was the key driver for practices.

Data suggests that improvement interventions may receive increased engagement if they are:

  • Aligned with QOF or other financial incentives
  • Supported with provision of resources (e.g. staff funding/IT tools/education)
  • Framed within a broader LTC agenda (rather than disease-specific)
  • Driven by local clinical champions
  • Supported by data that proves their quick impact
  • Seen as relevant for local populations
  • Linked to existing strategic plans adopted by CCGs.
Dr Tom Blakeman