Haemodialysis Units in Lincolnshire


In the county of Lincolnshire there are only 3 haemodialysis centers at the present time. Hopefully this will change and the Lincolnshire KPA looks forward to a time when the facilities for Lincolnshire patients will match other areas of the country.

                    The 3 centers are situated in the County
                                at the following locations:

                       

                             Lincoln, Boston, Skegness                                                                         Renal Units     


       

Lincoln Haemodialysis Unit

The unit is based in the grounds of Lincoln County Hospital but is managed by University Hospitals of Leicester NHS Trust. The Clinical Director, Roger Kockleburg , and the Department of Nephrology General Manager, Miriam Kerr, are based at Leicester General Hospital. The Renal Consultants managing your care here are Dr Jane Little and Dr Amir Malik.

First let me introduce you to the members of the team who will be looking after you at Lincoln:

Consultant Nephrologists
Dr Jane Little
Dr Amir Malik
Dr Matt Williams

Matron/Unit Manager
Martin Gerrish

Renal Community Team
Gill Simpson - Sister                                                                                                                      
                                                                                                                Dietitian                                                                                                                                           Helen Hayes - Dietitian
Pharmacist                                                                                                                                          Caroline Taylor - Pharmacist

Changing your dialysis session
With the increase in the number of patients within the unit we are finding it increasingly difficult to find swaps for people when they need to change their dialysis session to attend appointments, events or travel. If people are not prepared to swap then we will be unable to accommodate changes. Please be flexible to help each other out.

Visitors and mobile phones
We are seeing a rise in the number of visitors to the unit. Some of you have complained that this is disturbing the peace during dialysis, when you like to sleep, and your privacy, along with the increasing use of mobile phones. Whilst I do not wish to stop either, please can you keep visits and mobile phone calls to a minimum. Visitors must wait in the waiting area when dialysis is being commenced and discontinued.

What is a named nurse
From the above team of nursing staff you will have a “named” nurse to discuss your problems with, and who is responsible for planning and evaluating you care. The idea is for them to get to know you well as an individual and help you to sort out your problems. The named nurse will once a month review your monthly bloods with Dr Little or Dr Malik and feed back to you. Please discuss anything that is troubling you with them. However, if you have a problem and your “named” nurse is not on duty please do not hesitate to talk to any other nurse, who will assist you as necessary or pass a message on to “your” nurse. If you partner or “carer” wishes to visit the unit to meet your named nurse this can be arranged. Your “named” nurse can also be contacted at the unit by telephone if your partner, or carer, has any question or anxieties about you at home.

When Are We Open?
The unit is open Monday to Saturday: 0730 – 2230 hrs with three shifts of 12 patients.

We will try and give you an appointment to suit your preference, but unfortunately spaces are limited and other factors have to be taken into consideration (for example, people from the same area traveling together and medical needs.) On starting dialysis at Lincoln you will be given a day and time for dialysis three times a week, but this appointment is subject to change. We will try to accommodate your requests but you will also be asked to change shifts as required by the unit. We may have to alter your dialysis days and times to accommodate the needs of other patients.

If you have a special event and your dialysis timings are inconvenient we will consider rearranging your shift for an occasional dialysis session. Please let us know well in advance. Please try to accommodate shift changes when requested in order to allow flexibility for everyone.

There is a dialysis unit in Boston and we may require you to transfer there for dialysis in the future.

Who Do I Contact?
The Renal Unit has a direct line. The telephone number is 01522 573561.

Lincoln Unit provides outpatient haemodialysis facilities. If you experience problems during the periods when the Unit is closed please contact Leicester General Hospital, telephone number is 0116 258 4127.

If you dialyse on a Monday, Wednesday Friday Dr Little will see you in clinic on a Monday afternoon, approximately every three months. Please use this opportunity to discuss problems in private. If you attend hospital, or see your GP, please inform us. Bring any medications into the Unit that you have been given so that we know exactly what you are taking. If you are admitted to hospital please ask a member of staff to inform the Lincoln renal unit as soon as possible of your admission.

What About Transport?
Transport to the Unit can be arranged via the Hospital Car Service, if you are unable to reach the Unit by any other means of transport. The service they provide for people attending the Unit is usually of a high standard; but it must be noted that this is a Voluntary Hospital Car Service and not a Private Taxi Service, and you may have to wait for other patients and travel home via roundabout routes. Please contact the Unit if your driver does not arrive to collect you at the expected time. Anyone who can drive themselves to the Unit, and is safe to drive home again after dialysis, is encouraged to do so. You may be able to claim transport costs, if you receive income support/benefits. There is a car park for “Renal Patients” and staff outside the Renal Unit. Please do not park on the yellow lines outside the Unit as this blocks access for ambulances and other emergency services.

FINESSE computer system
The unit has a computer system which records information on each dialysis session. Please insert your key before standing on the scales and ensure that the weight has registered (bleeping sound) before stepping off. Please give your key to the member of staff who attends you to commence dialysis.

Why Do I Have All These Blood Tests?
A full range of tests are performed on the blood taken from you. The regular ones include:

MONTHLY
Urea and electrolytes
Calcium and phosphate
Liver function tests
Full blood count
Ferritins, iron levels.

QUARTERLY
Hepatitis B & C antibodies
Parathyroid hormone levels
Cholesterol

OTHER BLOOD TESTS
Antibody levels (if on transplant list)
As requested by staff according to your condition.

Some specimens are taken before and after dialysis. The results are used to assess the efficiency of your dialysis (how long you need to dialysis, what pump speed, dialyser size), your dietary control (to keep potassium etc. within safe levels), and what medication you should be taking. If you are unwell, or there is a problem, these tests (and others) may be performed more often.

We do not routinely screen your blood for HIV (Human Immuno-deficiency Virus), commonly referred to as “AIDS test”. We will counsel you about the implications and obtain your written consent before testing for HIV. Please ask your named nurse if you would like to know more about these tests and investigation, or why blood is being taken. The results will be shown to you and discussed with you each month.

Blood Results via the internet     ( Renal Patient View)
You can also have access to information from your renal records available at home on the Internet via Renal Patient View. This information may come from:
your existing computer record held in your renal unit
other relevant national healthcare-related systems, such as UK Transplant

Once you have been issued with a user-name and password you will be able to access this information from any Internet-connected computer. Your GP, and some staff from your renal unit, will also be able to view it. You can choose to show it to anyone else by using your password.

Your information will not be made available on Renal PatientView without your permission. If you decide not to join, or wish to withdraw, it will in no way affect your treatment.

Registration forms are available from Alison Dale. Visit www.renalpatientview.org for a trial.

Medication
Please obtain all your regular medication from your own GP surgery. We will inform the GP of any medication changes which are made at the Unit. Remember to order your “repeat prescriptions” in plenty of time to prevent running out. Return any discontinued medication to your local pharmacy for safe disposal. Please ensure that the Renal unit is informed of any changes in order to keep an accurate record of your current medication. When you receive a new supply of medication always check the strength. Occasionally tablets come in different strengths and your Pharmacist may have dispensed an alternative to the one you have taken previously, meaning that you should alter the amount of tablets you take. If you are unsure about any of your medication bring it in to the Unit to be checked. The renal pharmacist will regularly review your medication and is available for advice via the unit. Please maintain an up to date list of all the medication you are taking and show this to any health care professional treating you.

Arterial/Venous Fistula
Please look after your fistula it is your lifeline for dialysis. If you cannot feel it pulsating strongly please contact Lincoln/Leicester Renal Unit immediately. Try not to let arm become cold, get knocked or wear tight clothing over it.

Care of your Access for Dialysis
Check that you can feel the fistula is working twice a arm.
Do not let anybody other that renal trained staff take blood or insert cannula for infusions/drugs in this arm.
Do not allow blood pressure to be taken on this arm.
All the above can damage the fistula or cause it to clot. Ask a member of staff for an exercise ball to use at home to help develop your fistula.

Permcatheters
It is important to look for signs of infection, please inform the unit if you experience shivering/shaking, have a temperature, feel flu-like or generally unwell. Please ensure the clamps on each lumen are closed at all times at home and the bungs are in situ. It is important that the line is preserved for your dialysis and is not used for blood taking on wards or for giving drugs other than by the Renal trained staff. If you contact your GP / out of hours service / NHS direct / A&E for any reason, please ensure that they understand you are on dialysis and have a permcatheter in situ.

Can I go on Holiday?
We encourage everyone to have a holiday from the unit and will assist you to make holiday dialysis arrangements. Unfortunately not all areas of the country can accommodate holiday patients but we can inquire at dialysis units on your behalf. There are various private units throughout the UK which are easier to book (eg: Edinburgh, Lake district, London). Blackpool & Great Yarmouth Dialysis unit have vacancies for holiday patients, but these need to be booked well in advance.

Please speak to Alison Dale, clerical co-ordinator, for further information. Plan holidays well in advance as dialysis spaces quickly become filled and medical information has to be exchanged. We require 6 weeks notice to make holiday dialysis preparations. Most units ask for evidence that you are not a hepatitis or HIV carrier and extra blood tests may need to be performed. Many people at the unit have arranged successful holidays abroad (to Majorca, Tenerife, Italy, France, Denmark & Greece). There is a booklet “Eurodial” available on the unit with a list of European dialysis units. Most of them are free of charge under EC reciprocal health arrangements. Outside Europe you generally have to pay for your own dialysis. There is no financial assistance for dialysis anywhere in the USA. Please ensure that you have adequate holiday insurance. You must declare your renal failure or your insurance may be invalid. If you dialyse in a country outside Europe you may have to dialyse in isolation for 3 months on your return, due to the possibility of hepatitis and other infections. Please speak to a member of staff about this.

PLEASE DO NOT MAKE ANY PAYMENTS OR CONFIRM BOOKINGS UNTIL HAEMODIALYSIS ARRANGEMENTS ARE MADE! WE STRONGLY RECOMMEND INSURANCE FOR HOLIDAYS (EVEN WITHIN THE UK) IN CASE OF CANCELLATION DUE TO ILL HEALTH.

Where can I smoke?
The county hospital promotes a “healthy life-style” and discourages smoking. Smoking is not allowed in the Renal Unit or in any other part of the hospital. It is of long-term benefit to you to stop smoking. Your GP / practice nurse can assist you with smoking cessation.

How do I get more involved in my care?
It is our aim to promote your independence by keeping you fully informed. Please do not hesitate to ask questions and find out about all aspects of your care. Many people have benefited from knowing more about how the machine works and have been taught to put their own needles in. Please discuss this with your “Named Nurse” if you would like to become more involved in your treatment.

Everyone on the unit is treated as an individual.
Different people have different dialysis requirements depending upon many factors including their size, weight, urine output, cause of kidney failure, and blood results. Your Dialysis prescription, fluid restriction and dietary advice are tailored to you as an individual. Different people can eat and drink different amounts according to these factors. The dietician will see you regularly. Please do ask questions about your treatment. You can also have access to information from your renal records available at home on the Internet via Renal Patient View.

Televisions
Each station has an individual television, these were donated by the Lincolnshire Kidney Patients Association
.
Please be careful with the remote control units as it causes other users frustration when they become lost or broken, and is expensive to keep replacing them. This also applies to the shared headphones. You are welcome to bring your own set into the unit each session for your own personal use. There is a selection of DVDs, videos, CDs & novels on audio cassette which have been donated to the unit and available for use during dialysis.

What are Our “Standards”
We aim to provide the best possible service we can for you and have a list of “standards” regarding your care, which we aim to achieve:

  1. You will be given a regular appointment time at which to attend for your dialysis session, to enable you to make plans and arrangements around it.
  2. We will try our hardest to start your dialysis session within 30 minutes of your appointment time (not arrival time). (Please understand that this is not always possible, due to illness or machine problems, transport arriving late or patients arriving enmass).
  3. We will take you off the machine promptly at your planned finishing time.
  4. A qualified nurse who has had training in haemodialysis will supervise your treatment.
  5. Two staff will always be present in the unit when you are dialysing.
  6. You will have a “Named Nurse” to discuss your problems with, and who is responsible for planning and evaluating your individual care.
  7. You will have your blood pressure and weight recorded before and after each session and your target weight assessed.
  8. You will be monitored throughout your dialysis session for potential complications/side effects of your treatment, and will receive prompt attention should these occur.

Occasionally you will be asked questions regarding these “standards” and if you think we achieve them. However, if you wish to comment on your care at any time please speak to your “Named Nurse”; to Matron Martin Gerrish, Sister Karen Pammenter; or contact Renal Services General Manager at Leicester General Hospital.

What are our Aims
“The aim of the Lincoln Renal Unit is to provide a safe environment in which to deliver treatment to patients with renal failure in a relaxed and informal atmosphere; and to act as facilitator of care for the regional renal centres. Nursing care is aimed at maintaining or improving our client’s quality of life, within the available resources, by putting them first and foremost, and providing for their individual needs; and by supporting those who care for them at home. Our clients will be involved in their own health care through health education so that they can make informed decisions and control their own destiny.”

We hope you will be happy dialysing with us here at Lincoln. Please let us know if you have any problems or there is anything we can do to help you or improve our service.

How to make Suggestions, comments and Complaints.
The University of Hospitals Leicester Trust strives at all times to provide the highest standards of service and care for patients, their families or careers. Under the terms of the Patient’s Charter one of the rights you have is to: “have any complaint about NHS services (whoever provides them) investigated and get a quick and full written reply from the Chief Executive.”

This page is aimed to help you if you would like to make any suggestions, comments or complaints about the services we provide. In the first instance please speak to the person in charge of the ward or department you are attending. Every effort will be made to resolve your concerns at the time. If you would like to write to the hospital with your suggestions, comments or complaints, please address your letter to:
Chief Executive
Trust headquarters
Gwendolen House
Gwendolean Road
Leicester LE5 4QF
Tel: (0116) 2588901

Your letter will be acknowledged in writing upon receipt and if an investigation is required this will be undertaken and a written response will be forwarded to you from the Chief Executive within 20 working days, where possible.

If you feel that your issues have not been dealt with to your satisfaction, you have the option to request a further review, which may include the establishment of a panel to reconsider your complaint. You may refer the matter to the Health Service Commissioner (Ombudsman), at the address detailed below if following a review you remain dissatisfied:
Health Service Commissioner (Ombudsman)
Church House
Great Smith Street
London SW1P 3BW
Tel: (0171) 236 2127

The Lincolnshire Community Health Council is another organisation from which you may wish to seek help and advice. They can be contacted at the following address:
Lincolnshire Community Health Council
25 Newland
Lincoln
Tel: (01522) 545215

Patients Advice and Liaison Service
www.pals.nhs.uk

Boston Haemodialysis Unit

Clinical Manager: Cherrida Ihama

Boston Dialysis Center is situated on:
Boston West Business Park
Sleaford Road
Boston
Lincolnshire
PE21 8EG
Tel: 01205 316401
Fax: 01205 316402


                      Skegness Haemodialysis Unit
Marilyn Handley Bruce - Nurse Manager/ Sister

The unit is mainly for holiday dialysis and NHS patients  from the skegness area.

The unit is a highly efficient, well run and very flexible; dialysing patients in the evenings by prior arrangement if required. The unit is more than capable of helping more patients on the East Coast but....

You can ring the unit direct to arrange holiday dialysis in Skegness.

Tel 01754 762220
Fax 01754 762114
www.renalservices.com