The Strategy Unit

ILD159

Dialysis is a treatment to filter the blood when kidneys fail. Dialysis centres are struggling with demand and there is an expectation that demand will continue to grow due to changes in population size and health profiles. There are therefore concerns about the capacity of centres to meet future needs and it is a priority to try and address this. The different elements of the renal health system could be optimised to help meet future needs and improve patient outcomes. An early simulation model was developed in 2004 to predict future demand for kidney replacement therapy in England. An adapted version of the model was used in 2007 to inform plans for future kidney care services in the West Midlands. These models are now outdated and were created in a software which is no longer available. There are also suggested changes needed. For example, home haemodialysis, pre-emptive transplant and conservative care need to be added, and the factors that may influence chronic kidney disease (CKD) progression to requiring KRT need to be addressed. This project is an attempt to update and improve on the work of these models. Informed by data analysis, evidence and expert opinion including patient perspective, the updated interactive model will represent the current and future demand, and flow of patients through renal services. The model will show the number of people progressing into and through CKD, and patient flow through kidney replacement therapies and conservative care. It will simulate renal services including the impacts of variability in demand and process times. It will also simulate the population at risk of CKD and disease stage progression. This updated model will support planning of renal services and help ensure that they can meet future capacity. It will allow the Midlands Renal Network, and other systems, to model different future scenarios and test interventions. It will also help make choices about allocation of resources to secure the capacity required for renal services in the next 10-20 years, to meet the needs of patients and provide the best possible care. This model will also be supported via patient experience perspective. We will invite 6 patients for a half day workshop. We will explore how they understand and experience their renal pathway to input into designing improvement and changes to models of care. They will receive a participation information sheet in advance, and we will feedback to them once we have generated outputs. In addition, we plan to gather wider patient views via the Kidney Patient Involvement Network. Data from all adult patients in England on KRT from 2010 onwards will be included in the model. Children will be excluded as CKD is least common in this population.