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Portsmouth - Queen Alexandra Hospital

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Address:

Wessex Kidney Centre
G Level
Queen Alexandra Hospital,
Southwick Hill Road,
Cosham,
Portsmouth,
Hampshire,

Post Code:

PO6 3LY


Patients were first dialysed here in 1967

This unit has 650 haemodialysis and 80 peritoneal dialysis patients

This is a transplant centre - view transplant data.

This centre has the following satellite units:

Basingstoke

Bognor Regis - Springfield Renal Care Centre

Chandlers Ford Dialysis Centre Fresenius Medical Care Ltd.

Havant

Isle of Wight

Milford-on-Sea

Salisbury

Southampton - Totton


unit image

WKC Logo


Telephone number:

Renal Outpatients Reception 02392 286346

Holiday dialysis enquiries:

Please visit the unit website to get contact details of our dialysis units

Fax:

02392 286751

Email Address:

renal.systems@porthosp.nhs.uk

Unit website:

http://www.porthosp.nhs.uk/departments/Renal-Dialysis/renal-dialysis.htm

Trust website:

http://www.porthosp.nhs.uk/

Consultants:

Consultant Nephrologists

All nephrologists share in-patient beds at the QAH site where 24 hour specialist consultant cover is provided.
All consultants hold clinics for patients receiving renal replacement therapy in the main centre. Consultants also run clinics in the satellite units.

New outpatient nephrology referrals and follow ups are managed sectorially throughout the region. Consultants hold these clinics at the following sites:-

Dr Tim Leach (Clinical Director Nephrology)

QAH Portsmouth.
North Hampshire Hospital, Basingstoke


Dr Kirsten Armstrong
Gosport War Memorial Hospital, Gosport
Southampton General Hospital

Locum Consultant

QAH Portsmouth
Royal Hampshire County Hospital, Winchester


Dr Robert Lewis
St Richards Hospital, Chichester.
Bognor Regis War Memorial Hospital

Dr Jasna Macanovic
QAH Portsmouth

Dr Natalie Borman
QAH Portsmouth.
Salisbury District Hospital

Dr Amir Bhanji
QAH Portsmouth.
Southampton General Hospital
Havant Dialysis Unit


Dr Mark Uniacke

QAH Portsmouth.
Southampton General Hospital


Dr Anna Sampson

QAH Portsmouth.
Alton
Isle of Weight Dialysis Unit

Dr Katie Bostock

QAH Portsmouth.
Bognor Regis War Memorial Hospital
Isle of Weight Dialysis Unit

Dr Adam Kirk

QAH Portsmouth.
Andover

Dr Tahmina Rahman (Locum)

North Hampshire Hospital, Basingstoke

Consultant Transplant Surgeons



Surgeons work exclusively at the QAH site. There are currently three permanent members of the surgical staff:

Mr Paul Gibbs (Clinical Director Transplantation)
Mr Keith Graetz

Page administered by:

Preeti Sharma Mehta: renal.systems@porthosp.nhs.uk


About the unit

The Wessex Kidney Centre (WKC)


The Wessex Kidney Centre (WKC) is centred in recently commissioned premises at Queen Alexandra Hospital. The WKC provides a comprehensive renal service to an adult population of approximately 2.2 million, covering the majority of Hampshire, the Isle of Wight and the adjacent parts of Wiltshire, West Sussex, Berkshire and Surrey.

Management team

Dr Tim Leach (Chief of Service Renal & Transplantation Clinical Service Centre and Clinical Director Nephrology)
Mr Paul Gibbs (Clinical Director Transplantation)
Una Brady (General Manager)
Sheila Humphrey (Head of Nursing Renal & Transplantation)
Hazel Hartnett (Modern Matron)
Katie Beel (Business Manager)


Configuration of Clinical Services

WKC manages patients with all nephrological illnesses including acute, chronic, and end stage renal failure in patients of age 16 years upwards. All modalities of Renal Replacement Therapy (RRT) are available – haemodialysis (HD), haemodiafiltration (HDF), peritoneal dialysis (PD), automated peritoneal dialysis (APD) and Renal Transplantation. A comprehensive range of investigative procedures for all renal diseases is provided. The transplantation service provides an organ retrieval service, which has strong links with intensive care units and multi-organ transplant centres nation-wide.

Out-patient nephrology clinics (including general nephrology, haemodialysis, CAPD and transplant/vascular access review) run on every day of the week. In addition, the Consultant Nephrologists are responsible for peripheral clinics in the hospitals as outlined above

There are three dedicated Inpatient wards. The current bed complement is 45-49, with an additional 6 day-treatment beds. There is an out-patient dialysis ward with 25 stations, a Community PD unit and home HD team. The WKC has its own integral out-patient department and the facility to see programme patients as emergencies during the day. The majority of nursing staff on the Wards are nephrology trained and there is a locally run Nephrology Nursing Course. The Unit employs 2 wte Living Donor Transplant Co-ordinators, 3 wte Recipient Transplant Coordinators, 4 wte Renal Dietitians, a full-time Renal Pharmacist and a Transplant Immunosuppression Service team. There are excellent, committed nurse specialists in vascular access, transplantation, pre-dialysis care, home haemodialysis, peritoneal dialysis and anaemia management, who actively participate in and lead multidisciplinary team meetings, nurse-led and -supported clinics, audit and research.

The WKC has eight satellite dialysis units: Three are NHS owned/rented and staffed; Bognor Regis (14 stations), Totton in Southampton (9) and the Isle of Wight (10). The remainder are privately run and subcontracted: Basingstoke (16) and Chandlers Ford, Southampton (18) with Fresenius; Havant, Portsmouth (22), Salisbury (10) and Milford-on-Sea, New Forest (7) with Renal Services.

The current five-year development plan with commissioning partners delivered full outpatient haemodialysis capacity in 2013. Further expansion is being planned with the Trust and external consultation. The consultant team is responsible for satellites units, individually or shared, and holds regular dialysis clinics within the units. Peritoneal dialysis, home haemodialysis and transplant patients beyond the first three months are all seen as close to home as possible. At least 60% of outpatient activity occurs away from the Portsmouth hub.

WKC provides home haemodialysis with a dedicated training area and support staff. This is a recent development with the aim to continue to provide home HD to all patients who are eligible. The nXstage machine marketed by Kimal is currently being used as this minimises home conversion while still providing effective dialysis and being relatively portable. The current post-holder is the clinical lead for haemodialysis and home haemodialysis – experience in home dialysis, particularly with the nXstage machine, would be an advantage.

The Peritoneal Dialysis Team is nationally and internationally known for acute start PD, medical PD catheter insertion, nurse-led education and training and conscious sedation protocols. This post holder would be expected to participate in the insertion of double-cuff tunnelled Tenchoff peritoneal dialysis catheters and the training and supervision of the nephrology juniors in this technique.

The service also hosts and runs a Tertiary Hypertension service, with investigation, diagnosis, monitoring and management of simple and complex hypertensives. The Trust is considering renal denervation in addition.

The service provides acute and chronic transplantation services for the region, including all work up, surgical, nephrological and nursing care, dedicated anaesthetic staff, transplant coordinators (living donor, recipient and post-transplant), surgery and immediate, middle- and longer-term post-transplant management for donors and recipients. Hand-assisted laparoscopic nephrectomy is the donor operation of choice. There are a good number of local DCD donations and a dynamic and increasing living donor programme, with one of the highest number of non-directed altruistic donations in the country. The local commissioners favour transplantation, particularly pre-emptive. The H&I laboratory is off-site but provides an excellent cross-match service. Virtual cross-matching reduces cold-ischaemic time. ABO-incompatible transplantation is provided and HLA-incompatible transplantation is being considered for the near future. Extensive experience of acute transplantation, preferably with ABOi and/or HLAi transplantation, is vital for this post – currently four nephrologists provide the immediate peri- and post-transplant care with the transplant surgeons and specialist nursing team but all nephrologists work up patients for transplant, are involved in the management of acute transplantation out of hours and receive patients back from the acute service at three months post-op for ongoing post-transplant care, and there will be scope for an increase or rearrangement of the acute transplant team in the future.

The four transplant surgeons also provide a dedicated vascular access service, with good links to vascular imaging and interventional radiology, and excellent primary and secondary patency rates. This is evidenced by more than 80% of the service’s patients dialysing via a native fistula or graft, with the expectation of exceeding 85%. The vascular access nurse specialist provides and coordinates fistula and graft monitoring with pre-emptive investigation and treatment, further maintaining good access quality.


Research and special expertise

Research and special expertise

The research interests of WKC cover many areas of Nephrology, including: Cultured primary human tubular epithelial cells, Familial nephropathies, Transplant immunosuppression and pharmacogenetics, Epidemiology of CKD, Acute kidney injury (AKI) and chronic kidney disease (CKD) and Home haemodialysis

The service hosts the recently established Academic Department of the University of Portsmouth, aiming to deliver high-quality basic and clinical research. Projects are being developed and all faculties of the university are interested in linking with the renal service.

Basic science research is carried out within the Renal Group, working jointly between WKC and the University of Southampton. There are on site laboratory facilities for cell-based research within WKC. In Southampton University, the Renal Group is part of the Division of Infection, Inflammation and Repair, with Prof Iain Cameron as overall Research Director for the Medical School. Dr Jane Collins is Senior Lecturer and Mrs Sara Campbell senior. The Group developed a novel preparation of cultured human renal tubular epithelial cells. Current research interests include the role of these cells in renal inflammation and fibrosis, with focus on mesenchymal transformation, changes in epithelial permeability and the effect of immuno-modulating compounds and drugs. There is close cooperation with the University Bio-imaging Unit and specialist Immunohisto-chemistry Laboratory and is the subject of recent/current PhD and MD studies.

The unit is also conducting a PhD study in collaboration with Guy’s and St Thomas’s studying the incidence and detection of familial nephropathies, and has successfully completed an MD looking at the genetics of mycophenolate metabolism.

A partnership has been established with Prof. Paul Roderick of the Clinical Epidemiology Department in Southampton University. An MD project studying the relationship between AKI and CKD has recently been completed. There is great potential for further renal epidemiological studies using a huge established community-centred database.

The Unit has its own dedicated research facility for contributing to national and multinational studies. This is staffed by two dedicated Research Nurse Specialists and a part-time Research Assistant. The renal specialty lead for the Hampshire and Isle of Wight CLRN is on site and is supported by additional regional research expertise. The unit is currently involved in 10 portfolio studies investigating diverse aspects of nephrology, dialysis and transplantation. The recruitment record of the unit is excellent.

The Trust hosts a well staffed and proactive Academic Research & Development Support Unit which has been set up to develop and facilitate health service-orientated research. Expert help is therefore on site for developing grant proposals and designing future research projects.





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