Wednesday, 21 July 2010

Front door to needle time

I heard on the radio this morning that French air traffic control are on strike. Plus ça change. So despite the typical Manchester weather, are they trying to play cricket at Old Trafford? I know it must be holiday season. Have you ever missed a train or even a plane? If not I bet you have come close. Travelling is stressful!! About 10 years ago, Guy Hill of the North West Region Kidney Patient Association, described a journey – taxi not arriving, several phone calls – who is responsible then? Unexpected road works, increasing anxiety, why are all the lights red, oh and now we have to pick up someone else, and they are not even on the way to the airport. Powerfully Guy then revealed the truth – he had made up a small part of the story, everything else was true – the destination wasn’t the airport it was the dialysis unit!. The journey wasnt once a year it’s to and fro 6 times per week.

Transport, transport, transport continues to be the top 3 patients experience concerns for many receiving hospital and satellite based dialysis. Dr Richard Fluck (Consultant Renal Physician, Derby) has started applying the term “door to needle time” for haemodialysis plaugiarising the heart attack thrombolytic response time performance target. The phrase makes the point that it’s not getting to the unit that always the issue. In Derby the waiting room for dialysis is always empty – start times and transport procedures are staggered so there is no delay getting on the machine.

You may remember the National Kidney Care Audit’s patient transport survey, which took place in 2008. The NHS Information Centre have announced that they next survey will take place on 13 and 14 October 2010, and I hope that once again as many people receiving haemodialysis as possible will be able to take part.

Two thirds of all haemodialysis patients took part last time, and having the highest possible response rate really does give us a more accurate picture and makes the survey more useful. All responses will be treated anonymously, and will not affect patients’ treatment in any way.

All renal units will also be sent an organisational questionnaire about the patient transport services they provide.

This survey really does encourage improvements to services, and this survey will measure what changes patients have experienced since it was last carried out in 2008. I went down to Birmingham on the morning of the survey. I thought I had an early start from Manchester but the poor lady I met at 8am in the dialysis unit had been up before me, waiting for the ambulance 45 minutse before it arrived; she hadn’t been given a precise pick-up time. She lived about 20 minutes away from the unit!

To see your local results from the 2008 survey look at NHS Kidney Care. I’m delighted to see that action-planning has taken place across the country as a result of the earlier survey, and this focus on patient transport should continue. It’s such an important issue for patients, and improvements can make such a difference to their quality of life.

To read other organisation’s action plans, and for resources to help you improve services, visit The NHS Information Centre’s action-planning resource.

Clinical Lead Alistair Chesser from Barts and The London has written to all renal units and The NHS Information Centre will give units all the information and support they need to participate. I hope that all renal unit staff will be on board to help patients fill the questionnaires in. If you are a haemodialysis patient, I encourage you to look out for the survey in October, and to take part in this important national audit.

The NHS Information Centre have a useful e-bulletin for the National Kidney Care Audit. To subscribe, please e-mail

You can read more on the NHS Information Centre website.

Related blogs:
Travel chaos – improvements expected soon; Jan 2010
Patient transport survey results launched ; June 2009