The Green Nephrology Programme successfully bid for funding for the Heat Exchangers project from 10:10 in 2011. The objective is to save energy and carbon in kidney care by encouraging retrofitting of heat exchangers to dialysis machines in use nationwide.
In 2010, Green Nephrology Fellow, Andy Connor, wrote up a case study with renal technicians Fraser Campbell and Steve Milne in Kent, demonstrating the energy and carbon savings from retrofit of heat exchangers to BBraun Dialog+ haemodialysis machines.
Since then, the supplier has now started fitting heat exchangers as standard to all new machines, and has also retrofitted all machines in their own dialysis units in 2010. However, within the NHS there remain several hundred older machines in service without heat exchangers.
The first task has been to identify dialysis units who have previously purchased these machines and contact them to confirm how many remain in use, and whether heat exchangers have yet been fitted.
Our research has found that many units now have heat exchangers on all machines, while others are planning to upgrade older machines to models incorporating heat exchangers in the next 1-2 years. As a result of our contact, a number of other units are now developing the business case for investing in retrofitting their remaining machines. Guys & St Thomas are currently retrofitting their last 14 machines, while the Newcastle renal service is beginning by retrofitting 21 home machines, with plans to retrofit the remaining 44 in-centre machines as funding allows.
A major barrier has been the separation of capital investment costs (in the renal equipment budget) from the financial savings from energy reduction (which fall to the Estates budget). To address this, we have also contacted Estates leads in the relevant Trusts to encourage them to work together with the renal department to arrange financing. Creating the connection between Renal and Estates has had knock-on benefits, with some Trusts now exploring other carbon- and money-saving projects in the dialysis unit, such as water recycling.
Fiona Daly, Environmental Manager at Barts and The London NHS Trust wrote about making contact with their renal technicians:"he has informed me that all of our dialysis machines already have heat exchangers on - great news! I spoke with him about a number of other initiatives he thought we could look into and I will work with him over the next year or so to see what we can achieve. I will keep you up to date with progress. Thanks for the contact. It's really great that we can link up with keen individuals within our organisation."
Note - The cost of a heat exchanger unit is £189 and the energy savings are around 530-730 kWh per machine per year (depending how many sessions each machine does per day). Cost savings will depend on local tariffs but payback time is around 3-4 years.
Just to clarify, only the older BBraun Dialog+ machines are affected - Gambro and Fresenius machines come with heat exchangers fitted as standard, as do the newest BBraun machines.
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