National roll out of new kidney care service that started in Leicestershire

A successful health programme to improve Chronic Kidney Care (CKD) that began in Leicestershire is being rolled out nationally by the 15 health innovation networks across every NHS region in England.

The LUCID – Connecting kidney care programme improves outcomes for patients by proactively detecting the disease early and starting the most appropriate care plan sooner to prevent, or slow its progression. The pathway also maximises productivity for the NHS services and is value for money. 

An economic analysis commissioned by the Health Innovation Network highlights the massive potential that could be achieved by rolling out the programme, if it were adopted across the whole of England:

• £69.4 million potential benefits in year one.

• £334.9 million potential benefits over five years.

• Over five years, an estimated £3.25 return for every £1 invested.

The model brings together primary care in GP practices and secondary care specialists from hospital services to integrate management of CKD. It has four main principles:

• LUCID multi-disciplinary team meetings (MDTs) are established, ensuring a more joined-up approach between hospital and GP practice care teams.

• Steps are put in place to identify patients more at risk of kidney disease.

• Training is provided for clinicians, and patients are better informed and able to manage their care.

• Ongoing healthcare management is optimised.

In the UK, over 3m people live with the most severe stages of kidney disease and this is rising rapidly. People with kidney disease face increased risk of heart attack or stroke. The total annual economic burden of kidney disease in the UK is £7 billion, with £6.4 billion being direct costs to the NHS – about 3.2% of NHS budgets.

Roll out of the three-year programme will be led by Health Innovation East Midlands. 

Nicole McGlennon, Chief Executive, Health Innovation East Midlands said: “We’re excited to be working with Health Innovation Network teams across the country to share the learning and resources developed in Leicester, Leicestershire and Rutland. The potential benefits of rolling the programme out across the NHS are huge. The programme aims to create a sustainable way of delivering care that benefits the NHS and as many patients as possible during the next three years, and beyond.”

Dr Rupert Major, Clinical Associate Professor at University of Leicester, Consultant Nephrologist at University Hospitals of Leicester NHS Trust and Clinical Lead for LUCID in Leicester, Leicestershire and Rutland Integrated Care Board, said: “Kidney disease is common, serious and often isn't picked up until quite late. The good news is that we now have better tests, better treatments and better ways of joining up care. The challenge is making sure people benefit from them.

“LUCID was developed in Leicester, Leicestershire and Rutland to help patients get the right treatment earlier and closer to home, with GP teams and kidney specialists - including doctors, nurses and pharmacists - working together rather than in separate parts of the system.

“This is exactly the kind of change the NHS is trying to make: preventing illness rather than reacting to it, supporting more care in the community, and using data and technology to identify people before they become seriously unwell. Because kidney disease and cardiovascular disease are so closely linked, improving kidney care also means preventing heart attacks, strokes and avoidable hospital admissions. Ultimately, it's about helping people stay healthier for longer and reducing the need for more intensive treatment, like dialysis, later on.

“As someone whose career and personal development has been supported by both Kidney Research UK and the National Institute for Health and Care Research (NIHR), I'm incredibly proud to see our local work impacting on care nationally and beyond".

Dr Melanie Morris, GP and Clinical Fellow in Integrated Kidney Care (LUCID) said: “Primary care plays a vital role in managing the vast majority of people living with chronic kidney disease (CKD). This starts with early diagnosis, clear communication and accessible resources to help patients understand and manage their condition, alongside support to optimise treatment. 

“For patients with more complex needs or at higher risk of disease progression, timely access to specialist advice is essential. LUCID helps make all of this possible by bringing primary and specialist care closer together, enabling us to make informed decisions and provide the right care for our patients at the right time.

“By sharing specialist expertise and learning, LUCID also helps strengthen CKD management across primary care, benefiting not only those patients discussed in multidisciplinary team meetings, but the wider population of people living with the condition.”

The original LUCID programme was developed through a Joint Working Agreement between the John Walls Renal Unit at University Hospitals of Leicester NHS Trust and AstraZeneca UK. That Joint Working project has concluded, and AstraZeneca UK has now signed a Memorandum of Understanding with Health Innovation East Midlands to share expertise and insights on the future implementation and scaling of LUCID.

Dr Alexander Gueret-Wardle, Medical Director at AstraZeneca UK, said: "It's incredibly rewarding to see LUCID, a programme designed in partnership, now being scaled nationally. It shows how collaboration can turn shared ambition and innovation into better care for people with chronic kidney disease. We're proud of AstraZeneca's role and delighted to continue supporting national implementation."