Organisation and governance

London AKI Network is a clinical network with voluntary membership. We operate with the support of the Medical Directors of organisations that have decide to join the network. We are supported by the London Specialist Commissioning Group for Renal Services (SCG), NHS Kidney Care (who have also sponsored us) and the Department of Health National AKI Delivery Group.

London AKI Network operates at 3 levels. There is the London AKI Network Trust Lead who takes responsibility for AKI initiatives within an organisation. Secondly, there is the London AKI Network Regional Network, with its Regional Leads and Committee Members. They address AKI care at a sector or regional level. Finally the London AKI Network Board oversees pan-London strategy and collaboration between the Regional Networks. A similar network structure has been used effectively in other conditions such as stroke.

The Network

The network extends across Greater London and parts of the home counties. It serves a population of in excess of 12 million.

All healthcare organisations that refer to London renal units have been invited to join.

London AKI Network has five Regional Networks. Leadership at regional level is generally provided by representatives of the local renal units, who are London AKI Network Regional Leads. They are generally involved in all aspects of the AKI pathway, provide outreach services and AKI advice to local hospitals and take ward and critical care AKI transfers from referring hospitals. They have an overview of AKI care in a region and have a critical role in ensuring AKI pathways run smoothly. Where renal units share a Regional Network they have appointed joint regional leads.

Regional network Local Renal units
South West London AKI Network South West Thames Renal and
Transplantation Unit (Epsom and St Hellier) and St George's Hospital Renal Unit
South East London AKI Network Guys and St Thomas' Renal Unit and
King's Renal Unit
North West London AKI Network Imperial Renal and Transplant Unit
North East London AKI Network Bart's and The London Renal Unit
North Central London AKI Network UCL Centre for Nephrology Royal
Free

Network Governance

1. London AKI Network Trust Lead

This is the point of contact for AKI initiatives (audit, guideline, educational, implementation) within an organisation. We have found it important to have a single designated individual who, though they may delegate, has responsibility for the the following.

  1. Attendance at Regional AKI network committee
  2. Point-of-contact within a trust for matters AKI related (including governance).
  3. Liaise with London AKI Network regional Lead to discuss specific concerns regarding tertiary support or transfer.
  4. Feedback to regional committee on AKI issues (e.g. transfer delays to kidney unit, pathway problems, access to radiology)
  5. Liaison with the postgraduate department regarding uptake of network induction and education materials.
  6. Oversight of network audits
  7. Provide ownership, within an organisation, of the network guidelines and, if optioned by their organisation, ensure they are compliant with local guideline committee regulations and are available in hospital guidelines.

The AKI toolkit is available here. This is a resource to help London AKI Network Trust Leads rapidly implement our initiatives within an organisation.

2. London AKI Network Regional Network Committees and Regional Leads

The London AKI Network Regional Committees will support the London AKI Network Trust Leads. They will oversee AKI care on a regional level. They will aim to implement agreed pan-London and local initiatives. They will respond collaboratively to problems in AKI care identified by committee members or through audit. Finally, they will work with Local Education Providers and local medical schools to ensure AKI education is in place at undergraduate and postgraduate level. Representation will vary and will be decided on a regional level. In general it will include doctor representatives from acute medicine and critical care in each member hospital (one of whom will be the London AKI Network Trust Lead), a nurse representative from each member hospital, a pharmacist, a clinical biochemist and a patient member. The committee will be led by the London AKI Network regional Lead(s).

3. London AKI Network Board

The board provides overall strategy and will oversee the implementation and development of the network. The board has multi-disciplinary and multi-speciality representation. It will facilitate pan-London collaboration on agreed projects, resources and events. The board will pool audit data, map resources, compare regional performance and make the case for increased resources as appropriate. Harmonisation (where possible) and equitable access to care are key aims and the board will have a key role in this. Finally, the board will ensure Londoners are represented in national discussions on AKI care.