Notes from the Green Nephrology Summit 2013
42 people gathered for this year's Green Nephrology Summit, held at Guy's Hospital in London on 25th September. Once again, we were a good mix of clinicians (docs, nurses, physios), technicians, patients, industry representatives and interested others.
The meeting was taking place just a week after the 3-day international "CleanMed Europe" conference on sustainable healthcare, which the CSH team hosted this year in Oxford. Delegates from all parts of healthcare had told us how inspired they were by the Green Nephrology Network, as an example of a clinical specialty coming together to find more sustainable ways of working.
Dr David Pencheon, the Director of the Sustainable Development Unit for NHS England and Public Health England, set the scene, reporting on progress towards the new Sustainable Development Strategy for 2014-19. A national consultation has been running over the course of this year, and has highlighted a range of themes, from carbon hotspots of the healthcare system (pharmaceuticals in primary care…) to the importance of creating the conditions for resilient, sustainable communities.
David's presentation was followed by three "masterclass" sessions, providing insights into three contrasting areas of existing best practice in sustainable kidney care:
Dr Hugh Rayner provided a compelling account of how his renal service in Birmingham has stemmed the rise in patients needing dialysis, by screening routine laboratory eGFR measurements to detect declining kidney function at an earlier stage. GPs and patients can be alerted and supported with either simple advice or specialist review, while stable CKD patients can be discharged back to primary care in the knowledge that future deterioration will be flagged up.
Sharlene Greenwood, lead renal physiotherapist at KCL and chair of the BRS Rehab Network, presented on the benefits of exercise in CKD and described the renal rehabilitation programme and other exercise options offered to kidney patients in SE London, as well as research underway nationally.
The third session was a panel discussion of different approaches to reducing waste in the delivery of acid concentrate for haemodialysis. These ranged from switching to higher concentration (44:1), smaller volume canisters / reuse of leftover acid for subsequent patients to central delivery systems and on-site mixing from dry powder concentrate. The former can be done in any unit, while the central or dry-powder systems (while offering significant financial and environmental savings) require installation of tanks etc, which may be more suitable in larger units or if planned into new-build facilities.
After a (hopefully low-carbon) vegetarian, seasonal lunch, the 2013 Green Nephrology Awards were presented by former national clinical director for kidney care, Dr Donal O'Donoghue. Congratulations again to the Bristol Children's and Bradford kidney units.
The afternoon took a more strategic focus, beginning with a Q&A session on "engaging your clinical director" with Donal and seasoned medical director from Kent, Dr Paul Stevens. This was followed by a presentation from the Guy's & St Thomas' energy manager, Joe Grice and discussion of ways in which Green Nephrology reps can link into Trust-wide sustainability programmes. The final session was facilitated by Fiona Loud, Policy Director at the British Kidney Patients' Association, and explored how the sustainability agenda aligns with the interests of patients, and how patient participation in Green Nephrology could be developed to further this.
[ibimage==3469==content_image_full_width==none==self==null] [View from the window of Guy's Tower]