oThis isn’t a starter for 10. LES stands for a Locally Enhanced Service and DES stands for a Designated Enhanced Service. Alex is Alex Crowe (Consultant Renal Physician, Arrow Park, Wirral). Now Alex is a great guy and a super physician. You would know that Alex and his colleagues have been working hard to raise the profile of kidney disease and to support general practice by looking at the I detection rates for kidney disease that are revealed in the Quality and Outcome information – NHS Wirral has one of the best detection rates in the country.
Do you know your local PCT’s detection rates? The information is available practice by practice on the Information Centre website.
So, back to the question, would it be LES, DES or Alex? You might be thinking Alex and in certain circumstances you would be right but for the majority of people who do not have advanced kidney disease, management by primary care in the community is usually the most appropriate and best placed for care to be coordinated from. Primary care services can be truly integrated. General practice is a speciality in its own right and has the facilities, teams and structures to be able to deliver high quality kidney care for the majority of people with CKD.
NHS Wirral have implemented a locally enhanced service for chronic kidney disease which supports implementation of the NICE Guideline 73. If you want to read or copy them they are available here.
Wirral Guidelines for the primary care management of CKD stage 3
NHS Wirral Local Enhanced Service (LES)