Keeping Kidneys Closes but Inala Primary Care to open 7:30am weekdays

Inala Primary Care is disappointed by the recent closure of the Keeping Kidneys Service. After four years, agreements with Queensland Health came to an end on 30th of June. Patients of the Keeping Kidneys Service were advised of their new care arrangements at either Princess Alexandra or Logan Hospitals by letter at their last Keeping Kidneys clinic appointment. No other patients of Inala Primary Care are affected. We remain open for all of our general practice patients.

Just over 200 of the 4200 patients attending Inala Primary Care were involved in the Keeping Kidneys Clinic. Referrals were arriving nearly every week from GPs keen to see their patients receive care. The service received an Award from Kidney Health Australia in May 2016. The systems used to run the service have been licensed to a New South Wales community setting up their own community kidney service. From Tasmania to Cairns, doctors are exploring how to implement the Keeping Kidneys model. This is not surprising given that an independent evaluation by Deloitte Access Economics commissioned by Queensland Health found the program to be well managed, well received and worthy of take-up in other regions.

We know some patients were angry when told they would have to go to the hospital for their kidney care. Some have expressed their disappointment by postings on our social media account and talking to the local newspaper (hyperlink). We understand that a local service with no parking costs, limited waiting times and the same team of doctors and nurse led to high rates of patient satisfaction. For the many patients driven to the service by their children, we respect that a local service an average of 10 minutes distance from their parent’s home was far more convenient than 35 minutes to hospital. Convenience and cost were probably the two reasons why patients were more likely to attend a Keeping Kidneys appointment than an equivalent hospital review. Letters back to the patient’s GP just over a week from their appointments also enabled improved care.

In January, Inala Primary Care asked for long-term funding of the same amount provided to Queensland Health hospitals when caring for the same sorts of patients. The funds were to be spent delivering care and conducting research. Hospitals do not use their funding to conduct research or provide the number of nursing education sessions delivered through the Keeping Kidneys model. We could also achieve another purpose; generation of capacity in the healthcare system. A single Nephrologist sees around 10 patients in an afternoon. The service was routinely seeing 12 – 15 patients with ongoing referrals ensuring clinic capacity of 18 appointments would be booked in the near term. In addition, one GP a year was trained to work in the clinic. They then returned to their own practice to share their knowledge with others.

It was sad to see the newspaper report that this funding request was deemed not financially viable. The newspaper article closes with a number of statements regarding the impact of the closure of Keeping Kidneys on Inala Primary Care. Any organisation will deliver a contract so that there are funds left over. This was true in the case of the Keeping Kidney Service. Inala Primary Care is a charity. Therefore, any surplus made in one area is simply reinvested into other activities. Inala Primary Care offers services not available in other general practices and not funded by Medicare. Therefore, the surplus from Keeping Kidneys ensured that many needy families in a region rated amongst Queensland’s 12 most disadvantaged received better services.

Being a charity, Inala Primary Care operates in areas commercial general practices do not find profitable. Just last month Inala Medical Centre, a nearby commercial practice, closed because this is a hard place to make money. We have been fortunate to attract one of their team. With staff now focussed on other ways to make care for our patients better, exciting possibilities are opening up. In the interim one staff member involved in kidney research has been advised that their employment will come to an end. Another has not been able to extend their hours as planned. Others are seeing what they do at work change. Such change is sad, especially for those team members most affected. However, it does not mean our practice will become smaller. Our doctors and nurses will continue to see all of our regular patients.

Last week we saw nearly 900 patients and have capacity to see close to 1000 patients. We are so confident of our ability to service the community we will be extending our hours. In August we will open from 7:30am weekdays. So the closure of Keeping Kidneys does not mean the end for Inala Primary Care. The recent closure of Inala Medical Centre means we have even more reasons to continue to care for this community. We have leased our space for 10 years from Queensland Health and hope to be here in 10 more serving even more patients. With your continued faith in our work and recommendation to friends and family, we could see an even brighter future ahead.

We will continue to identify needs in our patient group, just as we did in the area of kidney health. We will continue to pilot new ways of doing things to offer better patient care. This spirit is what led to our award as Australian General Practice of the Year in 2016. We hope our level of patient care will see more patients provide favourable comments, just as Shirley Schneider did to our local newspaper. We thank her for her kind words and wish her our very best as she transitions to hospital care.