Improving kidney care

St George’s is well established as a leading centre for kidney transplantation and treatment of kidney failure. It is the kidney transplantation centre for patients from St Helier and for the rest of South West London, Surrey and Sussex. That’s why it makes sense to combine this expertise with renal inpatient services from St Helier in a new kidney unit which will become a centre of excellence. 

No. The renal unit will see £80m additional investment into this important service to improve care for kidney patients.

All feedback will be analysed and shared with renal clinicians and the local NHS. Feedback will help highlight new issues, areas of most concern and how the service could be best shaped to provide the optimal experience for patients, their families and carers. 

Are you able to share details of the number of people affected by the change and where they reside?

Full details on the number of patients affected can be found in the Equalities Impact Assessment on our Important Documents page. Table 14 in particular shows the number of affected patients from each London borough and county and the impact on travel times.

This change would impact on less than 5% of contact with renal patients, for inpatient (overnight) care and a small This change would impact on less than 5% of contact with kidney patients, for inpatient (overnight) care and a small number of outpatient appointments. Inpatient examples include patients needing: renal and vascular access surgery, transplants and stabilisation, and treatment following an acute kidney injury. Outpatient examples include patients needing additional support in early stages of dialysis care and additional advice. 

Around 95% of patient contact with the service will remain the same as now. This means no change to locations for existing dialysis services and renal clinics closer to where patients live in local hospitals, units or at home. The new unit would receive around £80m of investment and would increase capacity for this level of care, including extra beds.  

Around 95% of the contact kidney patients will have with kidney services will continue to take place where it does now. Kidney patients will only need to visit the new unit for inpatient care and some specialist outpatient support. This will mean longer journeys for some patients, but they will be treated in a brand-new unit with all the expertise and resources they need 24/7. There is a lot of evidence around the benefits of specialist units and hospitals – for example to treat major trauma, rare cancers and strokes – even if it means slightly longer journeys. 

We offer dialysis in ten local hospitals, eight satellite units and many patients also have dialysis at home. Your team will be able to discuss the best option with you.

Their professional view is that bringing all of the more specialist kidney services together at St George’s is in the best interests of their patients. St George’s is the kidney transplant centre for SW London, Surrey and Sussex.  Last year (2020), renal leaders from St George’s and St Helier submitted this proposal on the grounds that: “as the newly appointed clinical leaders we are firmly convinced that we could make a further step change in improving the care we offer if we could formally combine forces and locate all our tertiary renal medical and surgical practice in one new purpose-built facility…(and) that the right place for a combined renal service should be at St George’s.”

In 2020, the NHS approved plans to build a new specialist emergency hospital in Sutton. From 2026, all kidney inpatient care will move from St Helier to this new hospital. This will improve care for our patients, but kidney doctors believe this  proposal will make care even better. 

It is important to remember that the unit is for patients needing more specialist care and 95% of contact with patients will carry on where it takes place now. The new unit is for the 5% of patient contact with kidney services  that involves inpatient care (for example surgery and transplants).  

In ten local hospitals and eight satellite unit across South West London and Surrey, and many patients have dialysis at home. 

These proposals came from our renal clinicians, but it is important that patients are involved and have their say. For example, patients may raise issues that haven’t been considered in the proposal, or have suggestions on additional services or support that the new unit should have. 

This can be provided on request.

What provision has been made for transport for existing renal patients who will now have to travel to Tooting?

Kidney patients who need to attend the unit for inpatient care would be eligible for NHS-provided patient transport services as they are now. 

As stated in the proposal’s pre-consultation business case, “…although the travel time to St George’s Hospital for affected patients will increase, the impact on patients is small because visits to the new facilities will be infrequent and the majority of care will continue to take place at existing facilities; and patients are entitled to use patient transport services. Importantly, the consolidated service with new facilities will provide higher quality services with better outcomes for patients, outweighing the impact of a slightly longer journey.”

No. The decision to remove inpatient services from St Helier, including those for kidney patients, was agreed last year. This proposal is about joining them up at a new £80m unit at St George’s, rather than having two separate kidney units, with one at St George’s and one at the new emergency care hospital to be built in Sutton. Our doctors believe this single unit will be even better for kidney patients.
 
Important to remember that kidney outpatient clinics will continue at St Helier, and some of these may be expanded, for example around training for home dialysis.

One of the main reasons our kidney doctors put forward this proposal is to make sure all kidney patients get equal access to expertise. At the moment, kidney patients admitted at St Helier who need specialist cardiac care or interventional radiology, especially at weekends and evenings, may have to wait and be transferred to St George’s. This would be the same if the services moved to Sutton. 
 
Under these proposals, the single unit would have more experts on hand 24/7,  reducing inequalities in access  and getting patients treated and home more quickly – and balance any impact of a longer journey. 

Yes. The new unit will bring together in one place inpatient beds, facilities for day care, and space for those patients who need to dialyse at St George’s (patients who receive their dialysis at local units elsewhere will continue to do so). The new unit will also be connected by bridges to the rest of the hospital, enabling easy access to theatres for patients requiring surgery.

Yes. The plans and funding to bring a new specialist emergency care hospital to Sutton – as well as significant improvements to St Helier hospitals – remain on track and are backed by the Government.

The research team at St Helier will move to the research unit at St George’s, bringing together their joint skills and expertise. The two teams already work closely together and there is enormous potential for the academics and researchers working as a single team to pursue clinical trials to improve kidney care and treatment. There is also more opportunity to develop closer links to other areas of clinical expertise at St George’s, as well as develop more training and education for renal and allied health professionals.

Only kidney patients who need inpatient care (overnight stay) would be treated at the new unit. This is a relatively small number of patients. At the same time, we will be investing in the dialysis unit at St Helier and in more training for haemodialysis at home, so over time we will see fewer of these patients coming to St George’s.