Cheshire and Merseyside Kidney Care Network Newsletter

Summer 2012 Issue Inside this issue: Welcome to the Cheshire and Merseyside Network News 2 Kidney Care Network Newsletter News from the Units 3 Welcome to the first issue of the newly re‐launched Cheshire and Merseyside Kidney North West Updates 6 Care Network Newsletter. This newsletter aims to communicate developments and Update from British Renal facilitate joint working across kidney services in Cheshire and Merseyside. This Society Conference 7 newsletter is circulated widely to all local kidney units, local and patient groups, colleagues in primary and secondary care as well as nationally to NHS Kidney Care National Updates 9 and the National Clinical Director for Kidney Care.

Forthcoming Events 11 We will update you on local and national news as well as highlighting examples of Network Details 12 best practice to show how we are all making a difference to improve the quality of life of kidney patients.

Did you know?

Are you a GP or Practice Nurse with an

interest in Chronic Kidney Disease? The official NICE

Guidance app is now available to download Cheshire and Merseyside Kidney Care Network has received a limited amount for users of Android of funding in order to provide GPs and Practice Nurses within the Network with and iPhone CPD accreditation via an online education tool, www.ckdonline.org. smartphones. This up‐to‐date, peer reviewed online tool will help you to improve the management of patients with CKD and maximise your QOF points. The content of the online tool will focus on providing detailed information on:

 Why this resource is needed: Looking at the NSF, eGFR, QOF

World Kidney Day was held  CKD – Why it has become an important issue: Epidemiology, th on Thursday 8 March 2012. NEOERICA, NHANES, increase in RRT population and the cost of RRT

 Causes of CKD: diabetes, hypertension, obstruction and infection World Kidney Day is  Medicines management: pharmacology and modes of action celebrated in over 100 countries worldwide on the Each section is presented in an easy to use and engaging manner, populated second Thursday in March throughout with illustrations and videos, underpinned with cross referenced every year. It raises glossary. The resource is free to use as a reference tool. awareness of the importance of healthy kidneys and the CPD accreditation usually carries a cost of £10 per person; however, we are positive effects of pleased to inform you that the Kidney Care Network can provide this free of transplantation. charge to each Practice in Cheshire & Merseyside. However, due to the limited

www.worldkidneyday.co.uk number of promotional codes we have been allocated, there is only one promotional code available for one individual per practice.

To obtain your code, please email [email protected]

Network News

Chronic Kidney Disease Algorithm The Network is pleased to launch the NICE Chronic Kidney Disease (CKD) Algorithm pocket card. This excellent resource was originally developed by the Cumbria and Lancashire Kidney Care Network. These cards provide handy reminders for the management of chronic kidney disease stages 1 ‐ 5. They have been circulated across the Network to colleagues working in primary care; if you have not received one, please contact [email protected]

CyberREN The Region‐wide Renal Information Technology System is now live across the whole of the Network. This system, which is the first regional IT system specifically for kidney services in the UK, provides seamless patient care, improves patient safety, ensures clinicians have access to all patient information and to fulfil national reporting requirements has enabled safe clinical care in line with clinical governance and good medical practice; access to data for audit purposes at Trust, Regional and National levels and addresses Renal Association and National Service Framework standards.

Implementing a Regional IT System: A Collaborative Approach Dr Alex Crowe (Clinical Network Lead), Jo Minogue‐Sharp (CyberREN Programme Lead) and Hannah Hague (Kidney Care Programme Lead), gave a presentation on the renal IT system CyberREN, at the recent iLinks Innovations Annual Conference and Exhibition. This session introduced the difficulties of managing patients with renal failure across a large geographical area and explained how renal services are managed through a Kidney Care Network. The presentation covered the procurement of CyberREN, the importance of collaborative working, the governance of the programme, lessons learnt and future plans for the programme. For further details on iLinks, click here.

Telemedicine Remote Monitoring Project We are pleased to announce that funding has been secured from NHS North West, to undertake a pilot project at Royal Liverpool University Hospital. The project will enable patients who dialyse at home to link into the regional CyberREN system. Further updates on the project will be provided in future newsletters. For more information contact the CyberREN Programme Manager, [email protected]

End of Life Care Project Update The Kidney Care Network and the Palliative and End of Life Care Network are implementing the recommendations in the End of Life Care in Advanced Kidney Disease: A Joint project report between Cheshire and Merseyside Kidney Care Network and Merseyside and Cheshire Cancer Network, which was published in July 2010. In January 2012, the Kidney Care Network Board:

• Approved the framework of a Renal & Supportive & End of Life Strategy Group to monitor the work of the task/finish group, and produce quarterly progress reports to the Board and the Palliative and End of Life Care Clinical Network Group

• Approved the forming of a task/finish group which will maximise the potential of CyberREN by producing: o an end of life pathway o a register of patients on end of life pathway o template letters to communicate end of life issues with GPs as well as other primary and palliative care services o an advance care plan for each patient which is regularly reviewed and updated

Work is currently underway in this process, with engagement from primary and secondary care. If you would like to receive more information or get involved please contact Elaine Owen, End of Life Care Service Improvement Lead for Acute & Specialist Services, [email protected]

National Kidney Federation Thanks to generous funding from the British Kidney Patient Association, the National Kidney Federation (NKF) has appointed five additional Advocacy Officers, with effect from April 2012. Dennis Crane, who has been the North Region Advocacy Officer for NKF since the post was established in 2004, will now only have responsibility for the North West of England, and Linda Pickering will take over the North and Yorkshire & the Humber part of Dennis’ former region. This should enable him to spend more time dealing with issues in Cheshire & Merseyside, Cumbria & Lancashire and Greater Manchester, whilst retaining a lead role or involvement in some extra‐regional and national issues also. For further information on the NKF, please email [email protected]

Network Website launching soon We will be launching our brand new Kidney Care Network website in the summer. The website will be a comprehensive resource of information, advice and education about kidney disease for patients, carers and healthcare professionals. Please watch out for further details of the website launch.

News from the Units

Care Plans & Renal PatientView Colleagues at Royal Liverpool University Hospital and Arrowe Park Hospital have been working together to produce care plans for their patients. The care plan is supported by the regional CyberREN system and Renal PatientView, with the addition of a hand held record for the patients. Work is on‐going for completion of the electronic pathways. For more information contact either, Mandie Balshaw‐Greer, CKD Nurse Practitioner, Royal Liverpool Hospital ([email protected]) or Marie Bosworth, CKD Nurse Practitioner, Arrowe Park Hospital ([email protected])

The teams launched Renal PatientView on World Kidney Day “Whilst the hand held element of our care and are using a systematic approach to recruit patients. plan is still in process we believe that the Recruitment of the haemodialysis population across Wirral launch of Renal Patient View is the and Liverpool is progressing, and the aim is to recruit the initiation of our care planning process for peritoneal dialysis population in May. Early summer will our renal population”. begin the enormous task of recruiting the Chronic Kidney Mandie Balshaw‐Greer & Marie Bosworth Disease population. Project Leads

Timely Listing for Transplantation Projects: Aintree University Hospital A 6 month Timely Listing for Transplantation Project has been successfully completed at Aintree Hospital. Led by Dr Sharma, Consultant Nephrologist, and Melanie Griffin, Deputy Ward Manager, and funded by NHS Kidney Care, the aims of the project included:  Identifying barriers to timely listing  A clear transplant decision for all prevalent patients with eGFR < 20 (not yet on RRT)  Designing and implementing sustainable service developments to improve rates of listing and transplantation

Following completion of the project, the results are being shared nationally; a presentation was given at the British Transplant Society Conference and a poster presented at the recent Renal Association Conference. For further details, contact [email protected]

Royal Liverpool Hospital Following a successful bid to UK Transplant, the Liverpool Renal Transplant Unit will be undertaking a 6 month Timely Listing for Transplantation project in collaboration with Nephrology Units across Cheshire, Merseyside and North Wales. Further updates will be provided in future newsletters. For further information, please contact Maureen Wain, Directorate Manager for Transplantation ([email protected])

Acute Kidney Injury Workshop – 21 August 2012 Royal Liverpool University Hospital is holding an internal training workshop about implementing an electronic Acute Kidney Injury Pathway across the Trust. For further information about the pathway, please contact [email protected]

Using the Preferred Priorities for Care Document : One Unit’s Experience In 2011, the team at Countess of Chester Hospital were approached by Hospice Education in Chester to become a trial area to support the implementation of the Preferred Priorities for Care (PPC) document. 90% of staff from the Unit attended training about communication and how and why the document can be used. Jane Lush, Dialysis Unit Manager, said “The feedback from this training was excellent, we all felt ready to implement this. However, once back in the unit all of us became apprehensive about tackling this issue with the dialysis patients”. A letter was developed to be given to the patients alongside the PPC booklet. Jane has personally given these documents to 66 dialysis patients. She notes “Overall this document has been received relatively positively, despite my pre‐discussion reservations. To give the booklets out I allocated myself as much time as was required, I did not want the

Many of the patients felt that this was patients to feel rushed as I anticipated lots of questions; in just what they needed to introduce end total it has taken me approximately 7 hours to speak with of life care to their next of kin and the 66 patients.” convey their priorities for this time in their life. Jane Lush, Dialysis Unit Manager “Many of the patients felt that this was just what they needed to introduce end of life care to their next of kin and convey their priorities for this time in their life, some of the patients knew that their relatives and next of kin were unaware of their wishes for end of life, some of the patients stated that they have told their Overall, despite my initial hesitation regarding this relatives but worry that when the time comes they would subject and length of time it has taken to actually carry out these wishes, some like the idea of making distribute this information, I feel that this pause has ensured that this process was a positive one a record of this. When talking through this, some of the for the patient and the staff. patients informed me that they thought they had living wills; Jane Lush, Dialysis Unit Manager when I explained further the PPC, we ascertained they were financial wills but some had not been reviewed for 10 years, so this served as a good reminder for them to review this information also”.

For further information, contact Jane Lush, Dialysis Unit Manager, [email protected]

Practice Development Units Update

Arrowe Park Hospital

“Wirral Renal Service is currently in the process of being re‐accredited as a Practice Development Unit (PDU) with Leeds University. We decided to continue with the process after the initial two years because we felt our service had benefitted greatly from the process. It was agreed that it was necessary to continue to maintain the high standards we have achieved and to have influence, guidance and direction from key people in our steering group to shape excellence in our renal service. Being a PDU has definitely made an impact in improving communication, patient involvement and collaboration from all members of the team from the bottom up. As the PDU has matured our steering group has evolved in its membership so we could take our evidence and good practice to shape practice regionally and nationally.

We have a number of subgroups working on different projects from shared care, improving inpatient nutrition, end‐of life care, solution focus training (with Dominic Bray, Renal Psychologist), renal pharmacology, education tools and a library drop in service to name a few. In the initial two years we worked on developing a website, a patient newsletter, patient/relative support group, a renal blog, renal biopsy pathway and improved psychological support which are all still evolving and running effectively. These groups have allowed us to work with other professionals in the healthcare service that we did not utilise or access before the PDU process. It has been invaluable to learn from each other and work together to improve the patient experience.

We could not have done all this work without the commitment of the staff and the patients. Our patients help with fundraising and are very involved in the decision making process. We have found that renal services are the perfect environment for being a Practice Development Unit due to our strong relationships with our patients and the general culture of innovation and practice development. We hope to be successful in November when Leeds University come to accredit us again!” Marie Bosworth, Practice Development Nurse, [email protected]

Countess of Chester Hospital

The team at Countess of Chester Hospital have been working with the University of Chester since April 2011 on the Practice Development Research Partnership. They have focused on 3 projects in their first year: Did you know?  Implementation of evidence based practice ‐ buttonhole needling  What are the barriers for nursing staff in the implementation of The team at Arrowe Park Hospital recently evidence based practice and what are their educational had an article published in the British requirements to overcome these barriers Journal of Renal Medicine:  What are the patients’ views of the service

An abstract on the patient project was presented at the Nurse Education Value of a clinical library service to Today Conference in Baltimore in June 2012. improved practice: one renal unit’s experience Once these projects are complete, and from the information gained, further themes will be identified and 3 further projects, which will be led by other members of the renal team within the Department, will be undertaken.

Reports on all these projects will be available in due course.

Please contact [email protected] for further information. Jane Lush, Dialysis Unit Manager

Congratulations and Best Wishes Congratulations to the Transplant Team at Royal Liverpool University Hospital who have carried out 101 transplants in just one year – helping to transform the lives of patients across the region. Read the full story.

Congratulations to two of the Nephrology Teams at Royal Liverpool and Broadgreen University Hospital who have been shortlisted for internal achievement awards; the End of Life Team for Team of the Year and the North Cheshire Outreach Team for the Divisional Directors Award.

Ben Wilson, haemodialysis nurse from Arrowe Park Hospital, is undertaking the London to Paris Bike ride to raise money for Kidney Research. Good Luck Ben!

North West Updates

The Cheshire and Merseyside Kidney Care Network is collaborating with the Cumbria and Lancashire and Greater Manchester Kidney Care Networks on 3 North West Projects. Each group is led by one of the Kidney Care Network Managers from each of the North West Networks.

Transport for Haemodialysis Patients There has been an increase in engagement recently with the three Kidney Care Networks and the renal units across the North West, the lead (and local) transport commissioners and with the North West Ambulance Service (NWAS) to further develop relationships and to collaboratively improve patient experience. Through this partnership working, we have been able to:  Align local NWAS Operation Managers with each main renal unit and satellite unit. The Operations Managers

and Renal Unit managers meet on a weekly basis to discuss any transport incidents that have occurred with a view to resolving them and avoid a repeat occurrence.  Launch a dedicated transport telephone line for renal unit staff and renal patients on 17 May.  Develop a communication pathway specifically for each renal unit in the North West to report on the day incidents. The pathway highlights the route for escalation should the matter not be resolved. Details include names, telephone numbers and email addresses of each NWAS staff member throughout the pathway.  Develop a new reporting template for any transport related issues that have occurred, which each of the units in the North West complete. The information is gathered on a monthly basis and is analysed. A summary report is produced at Network level (3 zones) and shared with NWAS, the local Kidney Care Network and the lead transport commissioners.  Review the eligibility criteria for transport for haemodialysis patients. Each of the zonal Kidney Care Networks are addressing this locally, with a view to agreeing who should be responsible for implementing it at Trust level.

 Re‐launch the transport tripartite meetings across the North West, and these will include renal transport as a

standing agenda item. Key renal staff have been identified and invited to be involved in these meetings. In addition, work is about to commence to develop a patient transport information leaflet that can be used across the North West. For further details on transport, please contact Cheshire and Merseyside Kidney Care Network Manager: [email protected]

North West Kidney Care Networks Transplant Group The objectives of the group include:  Agree referral criteria for kidney/pancreas transplantation  Agree a unified pathway for transplantation, to include patient experience, development of protocols and repatriation of patients  Advise and make recommendations to the Kidney Network Boards on issues relating to kidney transplant  Co‐ordinate a network approach to the monitoring of standards and service improvement The group are currently finalising guidelines for listing patients for renal transplantation in relation to renal function. These will be circulated in due course. For further information about this group, please contact Greater Manchester Kidney Care Network Manager: [email protected]

North West Home Therapies Quality Group The aim of the group is to work on the key priorities identified in the Kidney Care Network Strategic Frameworks and to ensure all patients across the North West, who require renal replacement therapy, receive equitable access to a home based therapy if they choose it and are clinically suitable for it. The group has undertaken a scoping exercise and an action plan has been formed. Areas of work include:  Development of a self‐care framework

 To feed into the national Clinical Reference Group

 Review of patient information for all home therapies to ensure consistency

 Development of a Carers Strategy  Data Collection If you would like a copy of the scoping document or any further information, please contact the Cumbria and Lancashire Kidney Care Network Manager: [email protected]

British Renal Society Annual Conference

The British Renal Society (BRS) Annual Conference, titled 'Balancing Quality, Safety and Value ‐ an Olympic Challenge', was held in Manchester in early May. The conference is the main multidisciplinary conference in the kidney community calendar.

Many congratulations to Alexandra Schenker and Hilary Morgan, Renal Dietitians from Royal Liverpool and Broadgreen University Hospital, who were awarded ‘Best Poster in Group’ for their poster Is old school dietetics causing delays?

A further 3 posters were accepted at BRS from staff in our local units. A huge well done to the authors. The abstracts can be accessed below:

Why do some haemodialysis patients achieve good phosphate control without the use of phosphate binders? Lloyd V, Banerjee A, Shah Y

Countess of Chester Hospital

Supermarket tours – An interactive teaching tool

for haemodialysis patients

Morgan, H, Schenker, A, Ryan, N

Royal Liverpool and Broadgreen University

Hospital

Salt Awareness – An innovative method of

educating the multi‐disciplinary team

Warburton, J, Morgan, H

Royal Liverpool and Broadgreen University

Hospital

The Anaemia Nurse Specialist Association (ANSA) and British Renal Society CKD Forum have launched an updated version of “A guide to community administration of Intravenous iron for people with anaemia of CKD”

For further details go to ANSA website

British Renal Society Annual Conference

British Kidney Patient Association collaborates with the British Renal Society The British Renal Society (BRS) and the British Kidney Patient Association (BKPA) are collaborating to increase the number of grants available to support patient‐centred research. With a commitment of up to £100,000 each year for the next three years, the BKPA is working with the BRS to support their annual Grants Awards. These Awards, now in their 10th year, are given to a wide range of health professionals working with kidney patients, including dieticians, nurses, psychologists, counsellors, and social workers, as well as clinical scientists and nephrologists. The submission deadline for the 12th Round of Grants is Monday 15th October 2012. Apply via the BRS website.

UK Renal Palliative and Supportive Care Network

The Conference saw the launch of this network, whose purpose is to:

 Share learning from the NHS Kidney Care test sites and other initiatives to develop renal palliative and supportive care  Share resources between renal units  Develop common approaches to data collection and audit  Gain approval from national bodies to help promote and sustain this work  Promote international renal palliative care links

NHS Kidney Care launched new publications at the Conference, including:

Reference costs for kidney Home haemodialysis transplantation – Review of data quality survey 2011 – feedback

and action plan for improvement Reports on an online survey of all renal

units across England that NHS Kidney The report is aimed at Clinicians, Care carried out to better understand managers and commissioners within the provision of home haemodialysis transplant units. It summarises NHS (HHD) and associated costs. Responses Kidney Care’s work to review the from the survey have been used to help quality of reference cost information inform the HHD tariff for 2012/13. related to kidney transplants in 2010/11, and to identify specific areas for improvement and recommends actions to enable organisations to further improve the quality of their activity and cost information related to kidney transplantation.

Copies of all the publications are available to order from the NHS Kidney Care website.

National Updates

Encouraging patients to use Renal PatientView Renal PatientView (RPV) is a secure, easy to use, internet‐based system through which kidney patients can view their latest test results online and obtain other information about their kidney disease. Data in RPV is updated by participating renal units on a daily basis and patients are able to enter their own self‐ measured blood pressure, weight and glucose readings, if they wish. In addition, RPV features a forum for kidney patients to network and provide each other with peer support and links to further useful information and resources. The system currently has more than 17,000 registered users.

Renal PatientView is available in all of our Units across Cheshire and Merseyside. To date, local units have reported that they have been successful in recruiting patients to use the system and they continue to work hard to increase the uptake of RPV.

In February this year, NHS Kidney Care launched the final Renal Patient View Evaluation Report, which presented the findings of a comprehensive evaluation carried out around the usage of RPV. The evaluation showed that patients and health professionals believe that using RPV makes patients feel more in control of their medical care, and gives them a better understanding of their kidney disease. Professionals observed that patients who use RPV are more informed about their kidney disease, and are much more involved in decisions about their treatment. Download the final report (here) and supporting resources, including a “How‐to” guide (here).

Getting it right: End of life care in advanced kidney disease A new report by NHS Kidney Care urges those caring for people with long term conditions to implement systems for identifying and recording the wishes of patients nearing the end of life. ‘Getting it right: End of life care in advanced kidney disease’ is based on the experiences of three project groups that have been working with NHS Kidney Care to implement the 2009 framework for end of life care in advanced kidney disease. The report describes their approaches, the challenges they have overcome and the knowledge and experience that can be shared with others seeking to improve end of life care for patients. The report, along with other end of life care resources, is available to download from the NHS Kidney Care website.

UK Renal Registry Ron Cullen, Director of UK Renal Registry, recently gave an update to representatives from the North West Kidney Care Networks and the North West Specialised Commissioning Team on some on‐going changes within the Renal Registry. In future, data in the data portal will be updated and validated on a more regular basis; it is planned that 2011 data will be validated by November 2012. A Renal Registry Data Manager has been appointed to each Unit; details can be found at UK Renal Registry

Green Nephrology ‐ Dialysis Heat Exchangers Update The Green Nephrology Programme successfully bid for funding for the Heat Exchangers project from 10:10 in 2011. The objective is to save energy and carbon in kidney care by encouraging retrofitting of heat exchangers to dialysis machines in use nationwide ‐ following the example of the Kent renal service. As a result, a number of units are now developing the business case for investing in retrofitting their machines. Click here to read the full story.

Improving inpatient hydration and reduce the incidence of AKI

NHS Kidney Care has launched a new campaign in hospitals and nursing homes to encourage healthcare staff to better monitor and manage inpatients’ fluid status, in a bid to help reduce the incidence of Acute Kidney Injury (AKI).

The Hydration Matters campaign aims to remind all healthcare staff that monitoring fluid status and ensuring correct hydration should be an essential core component of care for all patients.

Resources to support healthcare professionals are available from NHS Kidney Care, along with details for downloading and ordering posters and a screen saver.

British National Transplant Week : 9th – 15th July 2012 The theme for this year’s National Transplant Week is to join the NHS Organ Donor Register and pass on the message that you’ve done so to family and friends. Passing on the message is crucial. Families are much more likely to give permission for donation if they know – in fact, over 90% of families will agree to donation if a loved one is registered AND has discussed their wishes. This drops to around 40% if donation wishes aren’t known. Visit the National Transplant Week website for further information and materials to download.

Atlas of Variation in Healthcare for People with Kidney Disease

A new report has been published which provides data highlighting variations in the care received by people with kidney disease across England. The Atlas of Variation in Healthcare for People with Kidney Disease is available to download from the Right Care website

The objective of the atlas is to build awareness and stimulate action to address unwarranted variation. While there are no ‘right answers’, it does highlight variations, enabling providers and commissioners to explore where they may be able to improve the quality of care they provide to kidney patients and identifying areas of good practice so that others can learn from what works well.

Motivational Interviewing Training Sessions NHS Kidney Care are hosting fully funded Motivational Interviewing training sessions which are available to healthcare professionals. The day is run by Jan Proctor‐King and is very informative and interactive, whilst being presented in an informal manner. Click here for details of session dates and locations. Please be aware, that places are limited for each session, so do book early to avoid disappointment.

Latest National Kidney and NHS News

Renal Tsar’s Blog

Forthcoming Events, Conferences & E‐Seminars

North West Region Kidney Patients’ Association Annual General Meeting – 1st July 2012 The Hough End Centre, Manchester For further details contact Margaret Bennett, Secretary, on 0161 448 1895

E‐seminar – Atlas of Variation in Healthcare for People with Kidney Disease : 4th July 2012 Click here for more details.

Renal Registry Annual Informatics Meeting : 4th July 2012 The Studio, Birmingham To book a place go to the Renal Registry website

Supportive Care for the Renal Patient 2012 : 4th – 5th July 2012 Hammersmith Hospital, London For more information: Download the flyer and Book online

REMEC : 11th July 2012 “Renal rehabilitation symposium : Improving the quality of life for dialysis patients” The Centre, Birchwood Park, Warrington For further details contact [email protected]

E‐seminar ‐ SAGE & THYME: providing a structured approach for dealing with distress : 18th July 2012 Click here for further details

Green Nephrology Summit 2012 : 26th September 2012 Birmingham For further details click here

European Dialysis & Transplant Nurses Association / European Renal Care Association : 1st October 2012 Burleigh Court, Loughborough Download the flyer For further information, please contact [email protected]

Home Dialysis Annual Conference : 4th‐5th October 2012 The Lowry, Manchester Download the flyer, programme and registration form For further details contact [email protected]

Network Details

The Cheshire and Merseyside Kidney Care Network was established in 2008; it was formerly known as the Renal Strategy Group. The Network links together the clinicians, managers, patients (and their carers) and other professionals from organisations that plan and provide care for people with kidney

disease across Cheshire and Merseyside. Our aim is to work Cheshire and Merseyside Clinical Networks together to deliver equitable, high quality and effective kidney Suite 4 care for our patients. Wood Court Riverside Park From April 2011, all of the Clinical Networks in Cheshire and Southwood Road Bromborough Merseyside (Cancer, Cardiac, Stroke, Kidney Care, Neurosciences, Wirral Critical Care, Neonatal Care and End of Life Care) have been CH62 3QX brought together under the same management structure to improve efficiency, make better use of resources and most Tel: 0151 201 4150 Fax: 0151 201 4151 importantly work together on cross cutting areas across the whole of the patient pathway. For more information, please contact the Network Director, [email protected]

Useful Contacts

Dr Janet Atherton – Chair Dr Alex Crowe ‐ Clinical Lead [email protected] [email protected]

Hannah Hague – Programme Lead Dennis Crane – North West Region Advocacy Officer [email protected] National Kidney Federation [email protected] Jo Minogue‐Sharp – CyberREN Programme Manager [email protected]

Useful Website Addresses

Wirral and Chester Kidney Services Mersey Renal Units

Feedback and More Information

If you would like any of the documents mentioned in this newsletter or require further information, please contact [email protected]

Comments and suggestions for future editions would be gratefully received. If you would like to share any examples of good practice or have any items for inclusion in the next edition please contact [email protected] by 14th September 2012.