Management of Acute Kidney Injury (AKI) in Primary Care with Manchester Health and Care Commissioning (MHCC)

Greater ManchesterRenal and Urogenital
Start Date: 1 Apr 2017 End Date: 31 Dec 2018

Project summary

CLAHRC GM is working in collaboration with medical practices across the Manchester Health and Care Commissioning and AKI Leads at Manchester University Hospital NHS Foundation Trust to identify processes of care and management of patients with Acute Kidney Injury (AKI) between secondary and primary care. Using a quality improvement approach of testing and sharing learning, they aim to explore:

  1. Processes to improve communication of AKI between secondary and primary care
  2. Processes to improve diagnosis and coding of AKI 
  3. Timely care and surveillance (e.g. serum creatinine checks; medication reviews and information given to patients as per national guidelines).

Facilitating the collaboration between secondary and primary care is at the core of this project, by creating strong relationships between the teams and sharing important information to inform improvement at the interface between hospital and general practice care going forward.

Why is it important?

AKI is a major marker of patient safety and illness severity. Illness complicated by AKI is associated with poor health outcomes in terms of high rates of rehospitalization, development or progression of Chronic Kidney Disease (CKD), and mortality. NHS England has introduced a Level 3 Patient Safety Directive to improve the recognition and response to AKI. 

As a clinical syndrome, AKI offers a lens to learn and improve care delivery and patient safety for people with a range of conditions, particularly those taking multiple medicines and living with complex health and social care needs (i.e. multi-morbidity).

Next steps

With a small number of general practices, in collaboration with the AKI team at Manchester University Hospitals NHS Foundation Trust, CLAHRC GM will explore the processes of care for patients who have had illness complicated by AKI, or have received a warning stage test alert, and identify barriers and systems to improve care. Each practice will conduct casenote reviews on patients, and the key lessons learned will be identified with the practice teams. This work will also feed into a project being undertaken in partnership with the Royal College of GPs (RCGP). 


Manchester Health and Care Commissioning 

Manchester University NHS Foundation Trust


Susan Howard