The Renal Directorate at Imperial College Healthcare NHS Trust provides kidney care for the ~2.4 million population of North West London (NWL) and accepts specialist referrals from elsewhere. This is coordinated through a hub and spoke model, with most in-patient and tertiary kidney services provided at Hammersmith Hospital, and satellite clinics or dialysis units located across NWL.

Referrals

The majority of referrals are received from General Practice (GP) and a smaller number of referrals are received from specialty doctors within NWL or beyond. GPs refer via the electronic referral system (eRS) and these are viewed by a kidney specialist within 3 days. The kidney specialist will either:

  1. respond to the GP with advice via the patient electronic record or
  2. organise an appointment for the patient to be seen in a kidney clinic closest to the patient’s home or to the most relevant sub-specialty clinic (usually at the Hammersmith Hospital).

Patients admitted to any NWL hospital that require more intensive kidney specialty care are transferred to the Hammersmith Hospital.

Hammersmith Hospital kidney services

The Directorate has 71 inpatient beds at the “Hub” at Hammersmith Hospital, across 4 wards, including a 12-bed high-dependency unit supporting acute transplantation and those with complex medical needs in those on dialysis, with kidney transplants or nephritis. There is also an 18-bed Planned Investigation Unit (PIU) day-case facility open 5 days a week.

Out-patient facilities on the Hammersmith Hospital site include; a haemodialysis unit (Auchi Unit), a Renal Assessment Unit for urgent cases, Renal Out-patient Clinic and a Home Therapies Unit. The Leslie Brent Laboratory provides specialist drug level testing that is critical to the care of patients with different types of kidney disease.

Satellite units

The Renal Directorate coordinates outpatient clinics, inpatient reviews and provision of dialysis at a number of other hospital sites across north-west London, including; Ashford, Charing Cross, Central Middlesex, Chelsea and Westminster, Ealing, Hillingdon, Northwick Park, St Mary’s, St Charles, Watford, West Middlesex and the Hayes Dialysis Unit.