Wednesday, 1 April 2009

Care closer to home: IV Iron

The multi-professional CKD Forum and the Anaemia Nurse Specialist Association (ANSA) have pooled their considerable expertise and produced this clear, concise guidance to assist healthcare professionals, managers and commissioners to establish services for the administration of intravenous iron for people with the anaemia of CKD in primary care and community settings. CKD is now recognised as a public health and primary care condition as much as a secondary care hospital based disease; one of its major complications is anaemia and that is one of the aspects of the disease where we have excellent evidence based treatments.

People with advanced kidney disease should not have to travel long distances to receive IV iron as an outpatient or a day case in hospital setting. “A guide to the administration of intravenous iron for people with anaemia of chronic kidney disease (CKD) in a non acute hospital setting” sets out this intention, and highlights that, where appropriate, specialist services should be transferred to a community setting; administration of IV iron is an ideal example. The CKD Forum and ANSA are leading the way in developing partnerships with primary care so that services can be delivered safely and effectively closer to patients’ homes.

Many of the 1 in 10 people affected by kidney disease in England, are elderly and most have other associated conditions – particularly vascular disease. Historically people with kidney disease were referred to specialist services but it is increasingly clear that primary care has a major part to play in care planning with people affected by kidney disease and that services can easily be provided in alternative settings such as day hospitals, community hospitals, GP surgeries and of course patients’ own homes.

Project lead Karen Jenkins (Consultant Nurse, East Kent) with contributions from Lesley Bennett (Senior Anaemia & Renal Patient Support Nurse Manager, Oxford), Sharon Benton (Anaemia Nurse Specialist, Cornwall), Laura Corner (CKD Nurse Practitioner, Liverpool), Jane Higginson (Practice Nurse Manager, Oldham), Dr Ian Wilkinson (GP, Oldham) have produced guidance which provides us all with an opportunity to take a further step in providing fair, personalised, effective and safe care for our patients. Implementation will demonstrate that the NHS is a system of care, where primary and secondary care are partners and where quality is the organising principle.