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Health Innovation East Midlands as part of its evaluation fund has supported the evaluation of the Leicester, Leicestershire and RUtland (LLR) Chronic Kidney Disease Integrated Care Delivery Programme (LUCID).
LUCID aims to integrate the management of chronic kidney disease (CKD) by bringing specialist capability into primary care. The program aims to improve patient-centred outcomes through early detection of CKD, early intervention and patient management optimisation, as well as maximising productivity and value for money across the healthcare system.
LUCID has been developed as part of a Joint Working initiative between The John Walls Renal Unit, UHL and AstraZeneca UK.
Bridging the gap between primary and secondary care means patients receive more equitable care, and improved patient experience and outcomes. The pilot has demonstrated a potential saving of £830 per clinic (once set up has been achieved) by treating patients in primary care (community clinics) instead of within hospitals. Treating more patients in the community potentially also means a positive impact on NHS Net Zero targets as fewer trips are needed to the hospital, resulting in a reduction of CO2 emissions.
In the UK 3.25 million people are living with CKD stages 3-5 and a further 3.9 million people are estimated to have stage 2 CKD. Local estimates suggest In LLR there is a disproportionate number of people who suffer from CKD.
As a result, the programme takes on board recommendations from the 2021 Getting It Right First Time (GIRFT) Kidney Services Review which set out many key priorities to improve kidney services in England.
CKD is a long term condition where gradual loss of kidney function over time causes the kidneys to become less effective at filtering waste products from our blood. Results are characterised by stages 1-5 taking into account age, size and gender to calculate how many millimetres of waste the kidneys can filter out in a minute (eGFR).
Michael Ellis, Senior Innovation Lead at Health Innovation East Midlands said: “We conducted an independent evaluation of the project to assess the impact and benefits. The programme has identified the removal of barriers to accessing care for CKD can have a profound impact. The evaluation has shown that better integration between primary and secondary care for this condition positively impacts patient outcomes. It also addresses health inequalities in LLR. Trialled in 54 clinics across nine primary care networks (PCNs) it focuses on three main elements which include specialised LUCID clinics, case finding and risk stratification and clinical sessions and educational resources. It is also possible that this pilot can provide a blueprint for the management of other conditions.”
Dr Rupert Major, Associate Professor at University of Leicester and Honorary Consultant Nephrologist at University Hospital of Leicester NHS Trust who co-developed LUCID, said: "Kidney disease is a public health emergency and LUCID, a collaboration between University Hospitals of Leicester and Leicester, Leicestershire and Rutland Integrated Care System, has shown its clinical impact to deliver more integrated care for people living with kidney disease.
“Earlier detection and intervention for kidney disease is crucial to reduce the risk of both the need for dialysis or a kidney transplant and also heart attacks and strokes, which are more common if you have kidney disease. Both have profound impacts on quality and quantity of life so we’re delighted this independent report has shown the benefit of the LUCID approach and look forward to sharing it across the region and nationally.”
The evaluation report funded by Health Innovation East Midlands and produced by healthcare analytics firm, Edge Health, says that LUCID has:
Not only is the pilot scheme set to be expanded more widely across the region but it could be extended to the care of patients with other long-term conditions.
Professor Michael Steiner, Deputy Chief Medical Officer for NHS Leicester, Leicestershire and Rutland Integrated Care Board (ICB), said: "Importantly, the programme offers improvement in the quality of care that can be delivered to patients in their own communities through innovative collaboration between primary care and specialist teams.”
Dr Ed Piper, Medical and Scientific Affairs Director for AstraZeneca UK, said: “I’m excited about the incredible potential of expanding this project to other regions. The impact we have already seen during this pilot could translate to even more patients benefitting from improved care and outcomes. This is a notable example of how partnerships between the NHS and industry can result in improved patient experience."
Dr Aisling McMahon, Executive director of research at Kidney Research UK, believes it is “imperative” new ways to improve earlier detection and prevention are found to “avoid the considerable burden of dialysis.”
Fiona Loud, Policy Director of Kidney Care UK, called the LUCID programme “novel and exciting”.
She added: “It shows that by making simple changes we can help to identify people at risk, ensure they receive the right tests and are offered interventions to help delay decline in kidney health.”
LUCID was shortlisted in two categories at the prestigious national Health Service Journal Awards (HSJ) which recognises outstanding contributions to healthcare. The categories were: Integrated Care Initiative of the Year and Medicines, Pharmacy and Prescribing Initiative of the Year.
For more information or to request a copy of the report contact This email address is being protected from spambots. You need JavaScript enabled to view it.