Harrogate-Self-Care-Unit-01

A History of Haemodialysis Care in Yorkshire

Haemodialysis treatment, initially only for patients with reversible acute kidney injury, was pioneered in three sites in the United Kingdom in the 1950s, one of which was in Yorkshire at the Leeds General Infirmary. The treatment then became available for people with kidney failure which was not going to recover, initially cited at the big hospitals in Leeds, Sheffield and Hull. Subsequently kidney units were established in the hospitals in Bradford and York and more recently Doncaster. As well as the six main unit renal dialysis centres in these cities, there are 20 satellite dialysis units which were opened to serve local communities and reduce the need for patients to travel long distances for treatment. These units serve from Skipton in the West to Scarborough in the North East, Grimsby in the East and Chesterfield the most southerly. The geographical area covered is West Yorkshire, North Yorkshire, the East Riding of Yorkshire, South Yorkshire, along with North Lincolnshire, and patients travel from the adjoining regions particularly Darbyshire and Bassetlaw. 

In the 1960s when there were only main dialysis centres in the big three cities, a very large proportion of patients were trained for and supervised their haemodialysis treatment at home. However the absolute number of patients receiving treatment were relatively small. Over the last two decades the numbers of people treated by chronic haemodialysis has increased enormously and at the moment there are approximately 1900 people treated in the dialysis units in the region. Coincident with this big expansion of numbers there was an increase in the frailty of patients receiving dialysis. These two factors, along with the growth of home peritoneal dialysis, influenced the very big decline in the proportion and absolute numbers of patients haemodialysing at home. The need to provide treatment that was as efficient as it could be also led to a reliance on care delivered by highly trained nurses concentrated into units to which the patients travelled.

In 2009 the Yorkshire and Humber Renal Network was formed, amalgamating the network that covered West and North Yorkshire and the East Riding of Yorkshire with one that covered South Yorkshire. The network fostered a spirit of shared learning, comparative audit and concerted planning, which allowed us to reexamine models of haemodialysis care.

This website explains the philosophy, achievements and difficulties relating to our drive to share the delivery of care in the haemodialysis setting between the healthcare professionals and the patients. We have been inspired to do this by the example of colleagues in other parts of the United Kingdom and other countries, but in particular from the data from several healthcare environments which demonstrate an improved outcome for the patient where such a philosophy is embraced.