In-Centre Haemodialysis
The In-Centre Haemodialysis (ICHD) Special Interest Group (SIG) brings together UKKA members involved in planning and delivering haemodialysis in hospital and satellite units. It provides a forum to understand variation between services, share practice and develop practical work to improve the safety and consistency of in-centre haemodialysis care.
The SIG’s current programme focuses on vascular access, service resources, serious intradialytic events, medicines optimisation and the commissioning of dialysis services.
SIG Co-Chairs
Medical Co-Chair
MPT Co-Chair
What the SIG does
The SIG’s responsibilities include:
- Identifying variation in in-centre haemodialysis care and service provision
- Collecting information about staffing, resources and service demand
- Supporting improvements in vascular access pathways
- Examining serious clinical events that occur during haemodialysis
- Sharing experience and practical resources between dialysis services
- Supporting services involved in commissioning and re-contracting dialysis provision
- Identifying priorities for education, service improvement and further study
Workstreams and projects
This workstream examines what happens when a patient’s arteriovenous fistula can no longer be used for dialysis.
An initial review involving 13 kidney units identified variation in how patients are assessed and referred for intervention. The next phase will examine these pathways in more detail, including delays in assessment and treatment, time spent in hospital and the need for temporary dialysis access.
The findings will help identify opportunities to improve services and reduce the impact of access problems on patients.
The SIG is mapping the staffing and resources available across adult haemodialysis services.
The survey is intended to provide a clearer national picture of how services are resourced and where variation exists. The group is also considering how the findings could be compared with service demand to support benchmarking, service planning and local business cases.
This workstream examines serious clinical events occurring during haemodialysis. Its initial focus is suspected dialysis-related hypersensitivity reactions, which can present in different ways and may be difficult to recognise consistently.
The group is developing clearer diagnostic criteria and a practical approach to assessment. This could support more consistent identification, investigation and reporting across dialysis units and inform future multicentre work.
The SIG is reviewing the scope and priorities of its medicines optimisation work. Further information will be added once the programme has been agreed.
This workstream aims to support NHS teams commissioning or re-contracting haemodialysis services involving independent providers.
Commissioning these services can be complex and is undertaken relatively infrequently, making it difficult for teams to find recent experience and suitable documents. Proposed work includes:
- Sharing service specifications, key performance indicators and procurement experience
- Developing practical guidance and a potential national specification template
- Creating a structured collection of commissioning resources
- Connecting teams with colleagues who have relevant commissioning experience
The SIG is seeking additional contributors to help take this work forward.