We are pleased to report that initial approval has been given for the funding of a new £80m renal unit building at St George's by NHS Improvement. Most patients will be aware that the we have been making the case, along with the clinical team at St George's, for such an improvement for more than 25 years. There have been "false dawns" along the way, but this is the most significant step forward, with the source of the funding agreed and public consultation beginning. You are invited to provide feedback by answering a questionnaire about the plans.

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What are the plans?

The plan is for a new £80m building on the current St George's site. All the renal functions currently at St George's including the ward, clinics in the Courtyard building and dialysis from the ward and trailer will move to the new building. The plan, created by the clinical teams at St George's and St Helier is to bring together all the renal specialists at this new site, increasing the expertise available to patients rather than move the St Helier service to a new hospital in Sutton.

Located next to, and attached to the main hospital, the unit will have all the facilities of a modern renal unit, with more ward beds, dialysis facilities, clinics, home dialysis support and will have staff facilities all in one place.

Funding is coming from 3 agreed sources including money allocated for the move or improvement of the St Helier's renal unit.

The plans will not change the services provided from satellite dialysis and outpatient clinics not currently provided at St George's.

What services will be provided from the new unit?

In particular there will be a:

• Full range of renal inpatient and day care services including inpatients admissions for transplantation surgery and vascular access surgery. multiple renal procedures, day case surgery, iv infusions, plasma exchange and assessment of acute problems
• Haemodialysis unit for local patients on chronic dialysis and management of haemodialysis patients who temporarily need increased care or investigation without admission
• Outpatient services:
  • general nephrology clinics;
  • advanced kidney care clinics (including IV iron administration);
  • haemodialysis and PD clinics and;
  • home haemodialysis training.
  • Post-transplant clinics. Pre-transplant work up clinics. Living donor assessment clinics.
  • Peritoneal dialysis clinics with acute peritoneal dialysis start and some acute outpatient intermittent peritoneal dialysis availability and peritoneal dialysis training;
  • And other clinics for::
    • Vascular access assessment
    • Acute Kidney Injury (AKI) ,
    • Hypertension .
    • Multidisciplinary vasculitis ;
    • Renal adolescent and transition support .
    • Pre-pregnancy renal counselling .
    • Haematology and renal joint ,
    • Renal diabetic ;
    • Access to renal psychologist.
    • Access to renal dietetic review and clinic.

When will this happen?

Following the funding agreement, the plan has received approval to proceed to short public consultation and detailed business case approval. It is anticipated that it will take until 2025 before the unit is built and commissioned for use by staff and patients. We will update you with more information as we get it.

What are the pros and cons for patients at St George's?

Overall the St George's Kidney Patient Association believes that this plan is overwhelmingly positive for patients at St George's. 

Pro's include:

• Consolidation of all services in one brand new location at St George's with the associated benefits of new and purpose built facilities.
• Reducing the number and distance of patient movements within the hospital including elimination of transfers using the perimeter road.
• Increase in the pool of renal consultant specialisms and research.
• Continuation of existing services at the same St George's site.
• Modern heating, cooling, shower and toilet services and facilities.
• Better 24/7 doctor and nursing coverage for clinics, wards and dialysis sessions
• Increase in use of day case work rather than overnight stays.
• The clinical team expect all of these to lead to better patient outcomes with the new unit.

Con's include:

• A 4 year wait to fix the currently poor patient experience for trailer dialysis patients and patients attending the Courtyard clinic requiring
  • emergency care
  • transfer to the main hospital via the outside perimeter road (in the rain, snow or cold).
• A small increase in the number of patients attending the hospital site and therefore requiring parking. We expect the significant parking issues being experienced by patients to improve well before this time. However we will be pressing the hospital on its plans and that it maintains the current agreements for free parking for renal patients.
• That the plans do not come to fruition and thus dash patient expectations. This is really an issue with the process and historic plans but is still possible. The fact that the St Helier move has already received approval adds impetus to the project. This point is, of course, not a negative about the plans themselves should they happen.

How can I find out more?

The St Helier team has provided patients with this site.

There are some patient conference calls coming up. Find out more here.

We will also update you with more information as we get it. Please let us know if you have any questions we can answer or ask on your behalf. 

Contact us by emailing us at: info@sgkpa.org.uk

How can I have my say?

You can complete  the patient questionnaire.

Let us know if you want to be involved in more detailed scrutiny of the plans and process.

Why should I believe this will happen this time?

We understand your scepticism! We have continually challenged the hospital about its plans and the approval process. We specifically counselled against raising patients hopes before funding was in place (a big issue previously of falsely raising patient expectations). For the first time, plans have been taken to a national level committee and been approved. The approval allows the hospitals to take this to public consultation. It specifically checks that funding is in place. Detailed business case work for the specific building is currently underway and we will continue to monitor its progress.

How do I find out what this will me?

We are working with the team to produce, St George's specific case studies.

You can ask you clinical team or us more if we haven't made things clear enough.

For most patients, the only change is an improved experience and outcomes when visiting the hospital site.

More information is in the following questions.

What does this mean for in-centre dialysis patients?

If you dialyse at a satellite centre (Kingston, Colliers Wood or North Wandsworth) this will not change although it is possible a small number of patients will be moved back (with your agreement) to the St George's site. Given that there are a number of years to go, we will keep you up-to-date on any changes.

What is happening about the dialysis trailer and its replacement?

The plan to move dialysis from the trailer to the Courtyard clinic has been superseded by these plans. As soon as we have any more information we will let you know. So, as we understand, the trailer will remain for a number of years yet.

What does this mean for home dialysis patients?

There will be a new home therapy unit including training facility for PD and home HD. You will obviously continue to dialyse at home as now. The combined St Helier and St George's team will have greater expertise to help you.

What does this mean for transplant patients?

Clinics will take place as they do today with those at the Nelson and Queen Mary's continuing there and those at St George's moving from the Courtyard to the new building once completed.