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Renal units can't cope with GP referrals

Hospital services for chronic kidney disease are ill-equipped to cope with an expected surge in referrals with addition of the disease to the QOF, researchers warn.

A new audit of 70 nephrology units found 'very few' had the recommended complement of staff and concluded there was 'no way' they could cope with extra workload.

The researchers said referrals were already increasing since the recent CKD national service framework and insisted GPs would have to take on a greater share of the burden.

Dr David Ansell, study researcher and director of the UK Renal Registry, based in Bristol, said: 'People will have to think about what to do with these people and not refer everyone to renal units. There's no way we can cope with the huge numbers of patients being referred.'

GPs said any move of patients back into primary care would have to be properly funded, possibly through practice-based commissioning.

Professor Mike Kirby, professor in health and human sciences at the University of Hertfordshire, said: 'It's probably a lot of extra work. It may be more cost-effective to pay GPs to do it.'

Professor Kirby, who is a GP in Letchworth with a special interest in urology, said: 'The new commissioning process will help with these situations. We can do it very effectively but the money has to follow the work.'

The study, published online by QJM, found only 29 per cent of nephrology units employed a diabetes nurse, 64 per cent a social worker and 53 per cent an access co-ordinator.

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