Understanding the Response of the Kidney Community to the Psychological Impact of Covid-19 on Patients and Their Carers
Background:
Services for patients with kidney disease underwent radical adaptations in response to the COVID-19 pandemic. We undertook an online national survey of UK kidney centres to understand the nature, range, and degree of variation in these changes and to explore factors contributing to differing practice.
Methods:
The survey was designed by a multidisciplinary team of kidney professionals, service users and researchers. It enquired about centre services and staffing, including psychosocial provision, and changes to these in response to the COVID-19 pandemic. Links to the survey were sent to all 68 UK kidney centres and remained active from December 2021 to April 2022, and a revised version to nurses in late 2022 for additional data. Quantitative data were analysed descriptively. Content analysis on free-text responses identified common themes.
Results:
Analysable responses were received from 41 out of the 68 UK centres (60%), with partial data from an additional 7 (11%). Adaptations were system-wide and affected all aspects of service provision. Some changes were almost universal such as virtual consultations for outpatient appointments, with significant variation in others. Outpatient activity varied from fully maintained to suspended. Many centres reduced peritoneal dialysis access provision but in some this was increased. Centres considered that changes to transplant surgical services and for patients with advanced CKD approaching end-stage kidney disease had the greatest impact on patients. Few centres implemented adjustments aimed at vulnerable and underrepresented groups, including the frail elderly, people with language and communication needs, and those with mental health needs. Communication issues were attributed to rapid evolution of the pandemic, changing planning guidance and lack of resources. Staffing shortages, involving all staff groups particularly nurses, mainly due to COVID-19 infection and redeployment, were compounded by deficiencies in staffing establishments and high vacancy levels. Centres cited three main lessons influencing future service delivery, the need for service redesign, improvements in communication, and better support for staff.
Funder:
British Renal Society (Now UKKA)
Team
Professor Ken Farrington (PI), University of Hertfordshire
Prof Joe Chilcot, Kings College London
Mrs Maria Da Silva Gane, East and North Hertfordshire NHS Trust
Dr Charlotte Hamlyn-Williams, University of Hertfordshire
Professor Paula Ormandy, University of Salford
Professor Nicola Thomas, South Bank University
Prof David Wellsted, University of Hertfordshire
Dr Lucy Mackintosh, University of Hertfordshire
Publications:
Mackintosh L, Ormandy P, Busby A, Hawkins J, Klare R, Silver C, Da Silva-Gane M, Santhakumaran S, Bristow P, Sharma S, Wellsted D, Chilcot J, Sridharan S, Steenkamp R, Harris T, Muirhead S, Lush V, Afuwape S, Farrington K. Impact of COVID-19 on patient experience of kidney care: a rapid review. J Nephrol. 2024 Mar;37(2):365-378. doi: 10.1007/s40620-023-01823-5. Epub 2023 Dec 20. PMID: 38123835; PMCID: PMC11043167.