University Hospital Birmingham NHS Foundation Trust
Oueen Elizabeth Hospital
Vincent Drive
Edgbaston
Birmingham

B15 2TH

Birmingham - Aston Cross

Birmingham - City Hospital Satellite Unit

Birmingham - King's Norton

Hereford Dialysis Centre

Kidderminster Dialysis Centre

Litchfield Dialysis Centre

0121 472 1311

Mr Buta Basi - Not for Commercial Enquiries or Consultant Contact.

0121 627 2433

Buta.Basi@uhb.nhs.uk

http://www.uhb.nhs.uk

Dr Graham Lipkin: Professor Caroline Savage:
Dr Paul Cockwell: Dr Simon Ball:
Dr Charles Ferro: Dr Lukas Foggensteiner:
Professor Michael World (RCDM)
Dr Richard Borrows: Dr Lorraine Harper:
Dr Clara Day: Dr Peter Hewins:
Dr Lavanya Kamesh: Dr Fouad Al-Baaj:
Mr Andrew Ready: Mr Steve Mellor:
Mr Ahamed Hamsho:Mr Nicholas Inston

Mr Buta Basi

University HospitalNHS Foundation Trust (UHB) is one of the largest NHS Trusts in Britain.Created in April 1995, it has an annual revenue budget of over £300million and employs 6,000 staff whose vast expertise delivers highquality care to half a million patients a year.

The Trust comprises two large Hospitals, Selly Oak and the Queen Elizabeth (QE), located within a mile and a half of each other in the south-western suburbs of the City.

Selly Oak Hospital functions as a district general and teachinghospital. There are very busy acute medical and surgical services including vascular surgery. The Queen Elizabeth Hospital in addition to its function as a district general and teaching hospital, it contains specialised units including renal medicine, renaltransplantation, liver transplantation, liver medicine and the patobiliary surgery, cardiothoracic surgery, cardiac transplantation, bone marrow transplantation and critical care.

The regional Renal Unit at UHB is the largest provider of End Stage Renal care in the West Midlands and offers comprehensive investigational nephrology, dialysis and renal transplantation services. It is recognised for innovation in clinical care and service delivery.

Two thirds of haemodialysis patients dialyse at the sixUHB-supervised satellite haemodialysis units; Hereford (13 stationswith 61 patients), Aston (31 stations with 146 patients), Tipton (31stations with 110 patients), City Hospital (12 stations with 68 patients), Kidderminster (13 stations with 54 patients)and KingsNorton (24 Stations with 64 patients) Woodgate Valley.

The renal unit has available up to 60 inpatient beds on the QE site (3 wards - 2 primarily medical and the other primarily for the care of renal transplant recipients and renal surgical cases). In addition on the UHB - QE site there is a 12 station 'acute' and 28-station chronic haemodialysis unit as well as a comprehensive peritoneal dialysis unit, and a dedicated Renal Outpatient department. A dedicated renal procedure room (sterile area) with Unit ultrasound facilities exists for temporary/tunnelled central line and peritoneal catheter insertion and performing renal biopsies.

Current Activity

UHBFT currently cares for

708 patients -Hospital & satellite haemodialysis
19 patients -Home Haemodialysis
129 patients -Peritoneal dialysis
723 patients -Renal transplant recipients

Outpatients - approximately 17000 outpatient FCEs are seen each year with roughly a 20% increase per annum over last 3 years.

Dialysis - each year between 220-240 new cases of End Stage KidneyDisease are taken on to the dialysis program. The dialysis programannual growth is around 9%

Investigational Nephrology and Acute Renal Failure services - the unit manages around 500 cases of acute renal failure/acute renaldisease per annum of which around 250 require acute dialysis.Approximately half of these cases are generated from within the Trustwhilst the other cases are referred from secondary care hospitals inthe region mainly from Hereford and Worcestershire, Birmingham and Sandwell.

Renal Transplantation & Access Surgery

The renal transplant program for UHB and surrounding dialysis units is delivered at the QEH Renal Transplant Unit. The unit has performed over 2,500 renaltransplants since 1980 and is currently performing around 110 grafts annually. There is an expanding live donor kidney program projected to implant 35 - 40 kidneys this year and a newly implemented 'non-heartbeating' transplant donor service. The assessment and management ofpatients pre/post renal transplant is performed jointly by physicians and surgeons.

The renal transplant surgeons predominantly provide vascular access surgery support to the renal failure program. There are a total of 8 IP theatre sessions available to cover all renal surgery for the service.

The Renal unitwill be a prominent feature of the new University Hospital, which willbe complete in June 2010 allowing even further integration with the adjacent University of Birmingham Medical School.

There is a very active research programme within the renal unitboth at laboratory and clinical levels. The Group has access todedicated laboratory facilities within the MRC centre for Immune Regulation and the Clinical Research Institute. Facilities within thenew Wellcome Clinical Research Facility are available for theimplementation
of approved clinical studies.

Currently the Group has two research registrars and a number of post doctoral fellows. The Group regularly initiates and takes part in single centreand multicentre clinical trials.

The laboratory interest of the Group currently include:

Pathogenesis of systemic vasculitis
The immunological basis of glomerular injury
The role of nitric oxide in glomerular injury
The role of lipids in glomerular injury
The role of the macrophage in glomerular injury
Mechanisms of vascular injury in uraemia

Presently,research activity is funded by a variety of sources including MRC,NKRF, BHF and local endowment funds. In the recent Research AssessmentExercise, the Renal Unit was linked to the Department of Medicine which
scored 4 for Clinical Science and 5 for Clinical Laboratory Science, the highest score for a regional medicine school.

In addition to clinical research, in April 2004 the Renal unit at UHB became one of two pilot sites tasked with the analysis and improvement of vascular access provision for renal patients. There were approximately 30 sites that competed for the project.

The project was coordinated by the NHS Modernisation Agency on behalf of the Department of Health. In tandem, the renalnational service framework (NSF) was developed and became a focus forthe project. The changing workforce programme was also involved and wasinterested in ensuring an appropriate and effective workforce todeliver renal care for the future.

The scope of the project was centred around three main areas:

Process Mapping the patient pathway from referral to the multidisciplinary team until commencement of dialysis

Providing a task analysis of the patient pathway

Providing baseline measurements of a set of key outcome measures that reflect the standards of the NSF.

The key objective was to provide a blueprint of a renal service and create tools that would enable other renal services, to evaluate and improve their service provision and the experience of their patients.

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