Diagnosis and management of CKD in primary care

The national Chronic Kidney Disease (CKD) audit aims to improve the diagnosis and management of CKD in primary care using regular audit reports and electronic patient management systems. It is funded by the Health Care and Improvement Partnership (HQIP) as part of the National Audit and Clinical Outcomes Programme and the contract for this three-year audit has been awarded to BMJ Informatica.

The pilot phase, which commenced in August 2014, will end in December. Over 400 practices, (all of whom are existing BMJ Informatica clients) have been invited to take part and selected to provide a representative sample across England and Wales. The audit will provide data for practices, CCGs and LHBs in Wales, and nationally. Patient Management and QI is supported by a tool which is being road tested in the pilot phase. The audit tool will be rolled out nationally in the spring and summer of 2015 when the software package will be available for all practices free of charge.

Practices will have access to information on whether:

  • their patients at risk for CKD have been tested,
  • all those with evidence of kidney disease have appropriate read codes and are on practice registers,
  • patients with CKD have had core elements of care - as per NICE quality standards, for example blood pressure control.

Features of the patient management tool include a pop-up box if the patient record indicates the possibility of CKD without actually being coded as such, allowing correct coding to take part during a consultation.

The Chair of the Project Board is Dr Kathryn Griffith, the Royal College General Practitioners (RCGP) Clinical Champion for CKD, and is responsible for strong primary care input into the project. The National Clinical Director for Renal Disease in England, Dr Richard Fluck is a member of the Project Board and supporting the project, working with the Strategic Clinical Networks to increase local uptake.

In Wales each LHB has a nominated contact who has been asked to liaise with the twenty four selected pilot practices to encourage participation and gain feedback. LHB have also been asked to facilitate inclusion of this subject in Cluster Plans. NHS Wales is represented on the Project Board by Dr Paul Myres (GP and Chair, Primary Care Quality Forum; Clinical Lead, PCQIS & Professional Lead, Primary Medical Care Advisory Team (PHW)), and Nick Wilson (Deputy Renal Network Manager) contactable at Nick.Wilson@wales.nhs.uk

With the removal of CKD as a clinical domain in QOF in Wales, the Welsh Renal Clinical Network (WRCN) is encouraging Renal Clinicians to support the project. Service improvement in Primary Care can delay disease progression, and avoid some of the pressure on dialysis and transplant services. The audit will provide data to enable planning of services. NWIS have agreed to support the analysis of Welsh data more regularly than the audit's current plans.

If you require further information, and would like to express an interest, click here to visit the BMJ site.

For further details on the work Dr Kathryn Griffith is doing as the RCGP Clinical Champion for CKD, please visit here.




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