Project summary

The national LUCID programme aims to improve patient outcomes through early detection of Chronic Kidney Disease (CKD), early intervention and optimisation, as well as maximise productivity and value for money.

It brings together hospital and GP-based care teams to provide integrated care. It has four main principles:

• LUCID multi-disciplinary team meetings (MDTs) are established, ensuring a more joined-up approach between hospital and GP practice care teams.
• Steps are put in place to identify patients more at risk of kidney disease.
• Training is provided for clinicians, and patients are better informed and able to manage their care.
• Ongoing healthcare management is optimised.

Project aims

• Increased awareness and understanding of CKD amongst patients and professionals.
• Earlier identification and proactive population health management of CKD.
• Medicines optimisation and evidence-based disease management.
• Improved care integration across neighbourhoods, including primary and secondary care.
• Supporting delivery of care closer to home, while ensuring patients with complex or high-risk disease access specialist care earlier where needed.
• Improved patient outcomes and experience through more coordinated, proactive care pathways.

The challenge

In the UK, over 3m people live with the most severe stages of kidney disease and this is rising rapidly. People with kidney disease face increased risk of heart attack or stroke. Risk factors, such as diabetes, CVD and obesity that contribute to kidney disease, are also growing.

The total annual economic burden of kidney disease in the UK is £7.0 billion, with £6.4 billion being direct costs to the NHS – about 3.2% of NHS budgets.

People living with CKD and those who support them experience a dramatic impact in their daily lives, with £372 million in productivity loss to the UK economy annually from missed work due to dialysis alone. This could rise to £2bn by 2033.

(ref: https://www.kidneyresearchuk.org/about-us/policy/health-economics-report/)

The solution

LUCID integrates specialist management of chronic kidney disease (CKD) into primary care.

The programme supports implementation of Primary Care Network (PCN) level interventions including virtual CKD clinics to improve secondary prevention through early intervention, management of risk factors and early detection / timely referral.

It supports better kidney care through education, specialist medicines, wellbeing and social support. It also helps to address health inequalities.

Health Innovation East Midlands funded independent evaluation of the LUCID pilot service in Leicester, Leicestershire and Rutland (published in June 2024).

Following the evaluation, further positive impacts are being realised within the ICB area.

An economic analysis commissioned by the Health Innovation Network highlights the massive potential that could be achieved by rolling out the programme across England:

• £69.4 million potential benefits in year one
• £334.9 million potential benefits over five years
• Over five years, an estimated £3.25 return for every £1 invested

Find out more

For more information email: healthinnovation-em@nottingham.ac.uk or Pip Richards, philippa.richards@healthinnovationwm.org if you are interested in getting involved in the programme.

Resources

• Request the evaluation report of the LUCID pilot (2024)
• Updated results: https://academic.oup.com/ckj/article/18/12/sfaf312/8275740)
• HIEM has held a webinar to share learning with health systems. Watch the webinar about the project and download the slides
• https://www.leicesterkidneylifestyle.team/my-kidneys-me-resources

The original LUCID programme was developed through a Joint Working Agreement between the John Walls Renal Unit at University Hospitals of Leicester NHS Trust and AstraZeneca UK. That Joint Working project has concluded, and AstraZeneca UK has now signed a Memorandum of Understanding with Health Innovation East Midlands to share expertise and insights on the future implementation and scaling of LUCID.