Background The 2011 BAPN Publication “Improving the standard of care of children with kidney disease through paediatric nephrology networks” focuses on making the patient a priority. Key recommendations include facilitating the majority of care close to the child’s home with adequate tertiary centre support. Larger centres should have a local consultant with a specialist interest in nephrology (SPIN) to support the local service.
Aims To assess the calls a tertiary nephrology centre receives from the regional hospitals and whether SPIN consultants where utilised by the referring hospital. To request feedback from the referring teams regarding the advice that was provided by the nephrology centre.
Methods Telephone calls to the tertiary nephrology team over an 8 week period were recorded using a proforma which was completed by the advising clinician. A separate questionnaire was then sent to the referring team requesting feedback on the advice given.
Results The department received 58 calls concerning 43 patients in the 8 week period. The total call duration was 11hrs and 25 min. 84% of calls were nephrology relevant. 69% of calls were received during the working week and 45% of calls were made by a consultant. Designated SPIN consultants were consulted on 15% of calls prior to calling the tertiary centre. The advising person on all calls was either a consultant (43% in-hours, 81% out-of-hours) or senior registrar. The response rate on the feedback questionnaires was 51%. 95% reported they received adequate advice from the first phone call. 90% of responders felt access to regional guidelines would be helpful to manage similar cases in the future. Service provided by the tertiary centre was graded very good to excellent by 90% of responders.
Conclusions Telephone advice offered by the department is well received. Awareness of SPIN consultants needs to improve. Recurring questions involved the diagnosis and management of acute kidney injury, nephrotic syndrome and electrolyte abnormalities. We propose a study day aimed at regional clinicians to address frequently asked questions.