Psychosocial care saves lives, yet too many people living with kidney disease are not getting the support they need. Kidney Care UK, alongside representatives from different professional groups giving psychological, psychiatric social and counselling services to people with kidney disease, formed our national psychosocial working group, recognising that there is wide variation in the way these services are being delivered.
When we say psychosocial we are referring to the full range of psychological, psychiatric and social care needs and it really is testament to the professionalism of each group member that we were able to unite around this clear definition.
Variation is seen both anecdotally, by our team of advocacy officers and counsellors, as well as in our mapping exercise with Salford University, showing that none of the 84 UK renal units employ the recommended number of social workers and only 5% of units employ the recommended number of psychologists.
The introduction of shielding advice for kidney patients, who are especially vulnerable to COVID-19, brought with it new challenges while exacerbating existing anxieties. Our own counsellors were facing an unprecedented demand, so it was essential to work together on this challenge.
We aimed to raise the profile of, and to improve equity of access to, the highest quality, timely and specialist psychosocial provision for all kidney patients in the UK through routine specialist psychosocial provision in every kidney unit.
There were a number of critical external factors which made it clear to us that the timing was right for a concerted push – this included the publication of the Workforce Planning Survey highlighting a lack of resources, the Getting It Right First Time report stressing greater need for support, and the Renal Services Transformation Programme (RSTP) which focused on the need and provided the impetus for change.
As a group, while wanting to support the improvement programmes in place, we were also keen to recommend a pathway to build them into the system. We developed our initial position statement into a manifesto to act as a call for action, which was launched at UK Kidney Week 2022.
Throughout the manifesto we incorporated the views of patients and health professionals and made 10 key recommendations for change:
Identification of psychosocial care needs
- Every kidney patient should have their psychosocial care needs assessed using validated methods.
Provision of psychosocial care at all levels of need
- Every kidney patient should be provided with appropriate psychosocial care that fully supports their level of need, as part of their standard NHS care.
- Psychosocial care interventions should increase with a person's level of need.
Integration of kidney patient care
- Psychosocial care needs should be integrated into kidney patient care plans (which are produced by a patient's hospital kidney team).
- New NHS integrated care systems should ensure different parts of the system are better joined-up to support the psychosocial care needs of people with kidney disease, as well as their physical health.
- Renal multidisciplinary teams should integrate renal specialist psychology, counselling, social work and psychiatry to ensure kidney patients have access to all of the support they need to help them manage their condition and the complex interactions between mental and physical health.
Psychosocial care workforce needs
- Staffing levels should be monitored to support access and equality to psychosocial care.
- All renal staff should receive training in the mental health needs of patients so that they are able to act as "first responders" and know who and where to refer patients. Mental health staff should receive training about renal disease screening and management for their patients with severe mental illness and dementia.
Accountability and reporting
- Minimum national standards of psychosocial care should be introduced and monitored so all patients receive equal access to the care they need, no matter where they are in the country.
- A dashboard should be created to monitor the success of psychosocial care services in improving kidney patient health.
To find out more and to get involved with this work please visit – www.kidneycareuk.org/manifesto. Together we can improve psychosocial support for kidney patients across the country.