Job Description

SERVICE DESCRIPTION At BHH, we have a significant inpatient unit focusing on the care of Nephology patients. Our Renal Assessment Unit allows rapid assessment and admission avoidance services. Support is provided for General Medical patients located on the Nephrology wards, alongside a small number on other wards. We have a busy acute HD unit as well as chronic HD provision.



There is a dedicated renal procedure room for renal biopsies, temporary dialysis catheter insertion, tunnelled HD catheters and PD catheters. Support from Interventional Radiology is available for some tunnelled lines and PD catheter insertions. We have a large peritoneal dialysis unit based within a dedicated outpatient area. We are proud of our co-located specialist renal nursing teams (advanced CKD, anaemia, vascular access, hypertension) delivering high quality, integrated care across the service.



Our RAU supports intravenous iron and cytotoxic and biologic therapy delivery. Out-patient clinics are delivered by the Department on multiple sites including all 3 Trust hospitals and its network of 4 dialysis units. DIALYSIS HAEMODIALYSIS -- HOSPITAL-BASED BHH provides in-patient haemodialysis for patients who have been admitted with AKI or ESRD. Additionally, we provide out-patient haemodialysis for selected patients whereas the majority of patients on maintenance haemodialysis are cared for at the network of satellite dialysis units.



The hospital based dialysis service also provides plasma exchange for patients under the care of renal medicine and other specialties. Support is provided at both medical and nursing level for our Intensive Care Units. SATELLITE UNITS The majority of our haemodialysis population receive dialyse at one of 3 NHS satellite haemodialysis units located across Birmingham and Solihull. Regular quality meetings are held in all dialysis units and renal consultants undertake regular clinics at satellite dialysis units.



HOME HAEMODIALYSIS We are committed to the provision of home therapies for patients with ESRD. We currently care for around 30 home haemodialysis patients. Patients treated by home HD are supported by a dedicated multi-professional team including technical support. PERITONEAL DIALYSIS There are currently around 110 patients treated by peritoneal dialysis.



A successful assisted-APD service is a key component of the peritoneal dialysis unit's activity. There is a PD hub at BHH which provides training and exchange rooms and clinic rooms. Peritoneal dialysis catheters are placed by consultant nephrologists, radiologists and surgical colleagues. RENAL MEDICINE IN-PATIENT SERVICES At BHH, two consultant nephrologists cover in-patient duties at a given time.



On-call duties are currently on a 1:12 basis. We also participate in the emergency medical (GIM) rota (approximately 1:40). Our 28 bedded inpatient ward (Ward 3) focussed on the management of people with renal disease, a small number of General Medical patients may also be under our care if bed capacity allows. We care for a small number of Medical outliers on other BHH wards, managed by our referrals Consultant, supported by a dedicated SpR.



Our 5 bedded RAU is co-located on Ward 3, currently operating M-F, with plans to extend to weekend working. This supports both admission avoidance and early discharge, but also allows us to internally deliver both biologic and cytotoxic therapies. RENAL TRANSPLANTATION AND RENAL ACCESS SURGERY The regional renal transplant program is delivered through QEHB. The renal transplant service currently performs around 200 grafts annually.



There is a live donor kidney programme, currently performing up to 60 kidney transplants per year. Laparoscopic donor nephrectomy is established. An ABO-incompatible renal transplantation service contributes up to 10 transplants a year. The assessment and management of patients pre- and post- transplant (in-patient and out-patient) is performed jointly by physicians and surgeons.



This includes expert assessment of living donors for kidney transplantation from across the region and complex assessment clinics for patients requiring additional medical or surgical evaluation. BHH Nephrologists operate Transplant follow-up clinics at BHH and Solihull Hospitals. At BHH, haemodialysis access surgery is undertaken by consultant vascular surgeons whilst medical PD catheter insertion is performed by consultant nephrologists and radiologists. OUTPATIENT SERVICES Clinics are provided on 3 hospitals sites (BHH, GHH, Solihull), as well as dialysis clinics at all our HD sites.



A wide-range of services are provided, most clinics are General Nephrology (including the full range of Nephrological presentations), alongside sub-speciality clinics most notably in our Regional Hypertension service. Clinical Nurse Specialists both support and deliver a range of sub-speciality clinics, including our Advanced Kidney Care clinics, and Hypertension service across UHB. For any additional information, please see the attached .