Integrated CKD Service

CamdenBarnetIslington

The Integrated Chronic Kidney Disease Service is a consultant-led triage service and specialist nurse-led community chronic kidney disease (CKD) clinic provided by Royal Free London.

Sharing the patient's EMIS record

A key aspect of the service is the consultant’s direct access to the patient's EMIS record, helping to inform the clinical decision. It is important to receive explicit patient permission for the sharing of the record. In cases where consent is not provided, the patient should be referred via e-RS with the completed CKD template attached.

Triage outcomes

All referrals will be triaged/assessed and a response communicated back to the referring GP within two weeks of submission. The four outcomes following triage are:

  • virtual advice (within two weeks)
  • patient seen in nurse-led community clinic
  • patient referred to diagnostic clinic at Royal Free Hospital
  • patient referred to specialist clinic in secondary care.

Nurse-led community CKD clinic

The community CKD nursing team run nurse-led clinics, providing specialist, high quality, expert nursing care and support for patients and their families with a diagnosis of CKD. The lead nurse and clinical nurse specialist within the community CKD team conduct autonomous nurse-led clinics. They carry out a variety of extended or advanced nursing practices in relation to this and work with the support and governance from the lead clinician and the multi-disciplinary team.

The aim of the CKD service is to delay the progression of patients’ renal disease by managing risk factors and symptoms of CKD through health-related behaviour change, health education and promotion and medicines management.

For patient information leaflets, see Downloads.

Useful contacts:

e: diabetes.ckd@nhs.net
e: rf.communityckdservice@nhs.net


Eligibility criteria

Inclusions

  • Barnet, Camden and Islington-registered patients aged >18 who have a renal disorder
  • patients where a GP has concerns regarding aspects of managing CKD.

Exclusions

  • paediatric patients
  • urgent referrals:
    • acute kidney injury (acute renal failure)
    • malignant hypertension
    • hyperkalaemia (K+ >7mmol/L)
    • nephrotic syndrome.

How to refer

EMIS form Download Form

Referral methods: e-Referrals, EMIS managed referral

When completing the CKD template explain the reason for referral explicitly in the appropriate free-text box. All referrals sent to the integrated CKD service will be triaged.

Please see CKD pathway for full referral criteria.


Camden

Please complete EMIS form and send via e-Referrals through CHI RSS

  1. Priority: Routine
  2. Specialty: General Medicine
  3. Clinic Type: General Medicine 
  4. Submit for triage: Camden Integrated Care Service (CICS) – Diabetes & CKD

Camden EMIS forms page.


Barnet & Islington

For urgent acute kidney injury referrals, call 07908 422 116

EMIS form

Referral methods: EMIS-managed referral

Referrals to the Integrated CKD Service are via EMIS. Please refer to the How to make an EMIS outbound referral document in the Downloads section for more information.

Please note: The referral route may change to e-RS in the future; any updates will be communicated to GPs.


Provided By


Service Feedback

Downloads


Pathways View All


General Services

Adult Safeguarding

Child Safeguarding

Community Services

Navigating Self-Care

Urgent & Emergency Care

Urgent & Emergency Care for Children


Review date: Tuesday, 14 November 2023