Size of HD units

[Gareth Murcutt]

Hi all,

We at Royal Free are odd (you can say that again) in that we don't have a main unit and satellites. All our chronic units are equal. Our units have 47,43,29 and 16 stations and we run 3 shifts/day, 6 days/wk at all of them.

Please can people let me know either on here or by email what size your units are. I'm helping CSH on sustainability issues and trying to get an estimate of implications if rolled out nationally. They are proposing 30 bed main unit and 10 bed satellite which I think is far too low these days.
Help appreciated. Cheers. G.

[Ian Wilde]

Hi Gareth,

At Manchester, the main hub was around 34 stations with an additional 6 stations in isolation rooms.  Average satellite size was around 20-25 stations.

If I was building dialysis units I would go as big as possible given the increase in people needing dialysis is around 4% a year (don't quote me on that) so at those rates the NHS needs a new satellite building at each one of it's main hubs around every 7 or so years to cope.  Given people's disregard for what they eat these days I can only see it getting worse with diabetes and high blood pressure.

Staffing and funding all this is a whole other discussion of course.

[Chris Bates]

Hi,
We have a 25 bed and a 20 bed unit on the Lister site.
We have 4 satellites of 33,16,16 and 16 - all at 100% capacity (or above ! )
Chris

[Simon Brooke]

Hi,

The main unit at Norwich is on an Industrial Estate with 36 stations + 4 for Home Therapies.
There are 13 stations at the Hospital, mainly for in-patients.
The satellite at Cromer has 9 stations.
Also, we currently have 17 patients who dialyse at home.

Patients dialysing at home reduces travel and allows them to dialyse when it suits, but it doesn't seem a very efficient way to use the equipment.
Are the sustainability issues about patients travelling or the units running at optimum efficiency?

Simon

[Gareth Murcutt]

Thanks all. Any more info welcome.

It's a wide ranging project to benchmark the sustainability of current dialysis services so includes everything from Central acid, online priming, RO water, dialysis fluid flow, patient transport, energy usage etc etc. They're trying to approx estimate some gains that can be made if x units did this or that so having even a vague idea of unit sizes will have a significant impact on the calculations. I'd suggest Main units tend towards 40+/- 5 stations and satellites  20+/- 5.

Many reports of HHD being more sustainable than unit - mainly down to patient travel. For my part I believe it's pretty much neutral in terms of emissions but excellent for patients who are capable. HHD patients tend to dialyse to live - sadly this seems to be reversed with some unit patients these days.