It is clear from the evidence-base around renal replacement modalities that home therapies lead to better health outcomes and can substantially enhance quality of life. Better homeostasis is achieved through more frequent treatment, thereby reducing debilitating side effects and the long term risk of complications).
Increasing the uptake of home therapies meets national and regional priorities in that it addresses the management of a long term condition, requires integration of primary, secondary and tertiary care, and needs seamless teamwork between a variety of clinicians, service users and their families. However, moving from a predominantly hospital to community-based service is not straightforward; potential barriers (and opportunities) include:
1. Service user and carer awareness of choice
2. Few effective role models to promote home therapies
3. Provider willingness and capacity to change
4. Education for all involved in service design and delivery
5. Supply chain problems and interaction with industry
6. Long term cost- effectiveness is little understood, in terms of cost/ benefit tipping point for different demographic groups
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To facilitate an integrated service improvement plan for the management of long term conditions closer to home using home therapies in Chronic Kidney Disease as an exemplar.
- To use the HIEC partnerships to facilitate a proposed integrated service improvement plan called the ‘Regional Home Therapies Service (RHTS)’ developed by WM Specialised Commissioning Group (WM SCG) and the West Midlands Renal Network (WM RN) based on evidence for good practice for home therapies in Chronic Kidney Disease.
- To facilitate the increase the number of patients for whom home therapies are the treatment of choice to manage their care at home
- To stimulate the involvement of all stakeholders, including service users and carers in all phases of the work plan.
- To promote a seamless patient experience
- To stimulate innovation in technology, research, education and practice.
- To evaluate the impact of the HIEC partnership in influencing the quality [safety, effectiveness and patient experience] of home therapies.
Our work packages:
We are supporting the proposed ‘Regional Home Therapies Service (RHTS)’ by:
- Understanding the barriers to expanding home therapy services
- Understanding the psychological impact of moving care into patient homes
- Exploring aspects of Shared Decision Making & Choice
Identifying existing education / training provision and methods in relation to the published evidence base. Recommending how new knowledge can be incorporated into dialysis education programmes in order to ensure renal units consider all factors which are important to patients and appropriate support can be identified.
- Identifying the potential to use simulation methods to support professional, patient and carer learning.
- Facilitating shared good practice across the West Midlands Region in collaboration with the West Midlands South HIEC, the West Midlands North HIEC and the West Midlands Renal Network.
- Reviewing the market for emerging drugs or technologies which will have an impact on the delivery of home therapy services.