Hull NHS Dialysis Unit

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This key question looks at whether people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence.

At our last assessment, we did not rate this key question. At this assessment, the service was rated as good.

This rating means people’s outcomes were consistently good. Feedback from patients confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Staff ensured patients received their prescribed dialysis treatment.

Staff monitored treatment times using the dialysis machine and reviewed this information on the electronic patient record (EPR) system after each session. They recorded any deviation through treatment variance reports (TVRs), for example when treatment stopped early or patients were not dialysed on their usual machine.

We reviewed TVR data for the 12 months before our assessment (May 2025 to April 2026). The most frequently reported incidents related to non-attendance, patient non-compliance and procedural variances. The highest number of reports was in September 2025, with 409 recorded events. At the time of our assessment, 25 TVRs remained open for review. These reports were intended to help leaders identify trends and learning.

Leaders had also expanded the service to include dialysis for 2 patients under 18 years. They worked with a regional paediatric service to support safe transition into adult care. For example, a registered nurse supported one patient during transfer to help maintain continuity.

This meant staff monitored treatment delivery effectively and had systems in place to identify when care did not go as planned. However, some incident reporting processes lacked timely review and closure, which limited assurance that learning was consistently identified and acted on.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff used recognised assessment tools to identify and respond to patient risk and deterioration.

The service used the National Early Warning Score (NEWS2) to assess patients for signs of clinical deterioration. This tool combines key physiological measurements such as temperature, oxygen saturation, blood pressure, pulse and level of consciousness into a single score. Staff used this score to identify early signs of deterioration and decide when escalation or additional monitoring was required.

Staff also completed a range of structured risk assessments for haemodialysis patients. These included Waterlow assessments, which help identify a patient’s risk of developing pressure ulcers by considering factors such as mobility, nutrition, continence and skin condition. Staff used the scoring system to guide preventative measures and ongoing monitoring. In addition, staff completed manual handling and falls risk assessments.

These tools helped them identify patients who needed support with movement or were at risk of falling. Staff used this information to support planning care safely, for example by using appropriate equipment or supervision.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

We observed effective multidisciplinary team (MDT) working through monthly meetings where staff reviewed and updated each patient’s needs. We reviewed MDT meeting records patients from February and March 2026. These showed consistent information sharing. Records included patient consent, changes to treatment, any refused treatment and individual risks or concerns. Staff also recorded clinical factors such as dialysis concentrate levels and specific care instructions.

A separate MDT meeting was held for patients receiving home haemodialysis (HHD). We reviewed the April 2026 action plan, which showed staff discussed all 20 HHD patients and identified those not on the transplant waiting list.

Staff could refer patients to a range of specialist services through the MDT. For example, dietitians supported patients to manage potassium levels and improve their renal diet. Patients could also be seen by anaemia nurses, and the unit had consultant-led clinics on site. Consultants carried out annual medical reviews for all patients.

Staff held safety huddles at the start of each shift, usually 2 to 3 times daily. These followed a standard agenda led by the nurse in charge. Staff discussed all patients, reviewed safety checks, followed up blood results and allocated tasks.

This meant care was coordinated across teams and supported by regular communication and specialist input. Patients benefited from a holistic approach to care planning and timely access to additional support when needed.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Information was available in clinical areas, to promote awareness and support respectful care. Posters and leaflets in reception covered topics such as ethical care, reminding patients and visitors to treat staff with dignity and respect. Additional information was available on kidney conditions and also ‘John’s Campaign’, which promotes the involvement of family carers, particularly for people with dementia, to support better outcomes and patient experience.

Patients could also access online exercise, education and wellbeing sessions led by physiotherapists. These on-demand sessions were designed to help people with kidney disease stay active and manage their condition.

This meant patients had access to information and resources to support their understanding, independence and wellbeing. It also promoted a respectful and supportive environment for both patients and staff.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. Staff did not always action learning from audits to improve compliance. However, they ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff monitored key performance indicators for patients, including effective weekly dialysis times, substitution volumes, Hepatitis B vaccination rates, and blood results such as albumin, haemoglobin and phosphate levels. These measures helped staff assess treatment effectiveness and patients’ clinical condition.

The service carried out monthly infection prevention and control (IPC) audits, with results showing generally high levels of compliance. Managers shared findings and updates at bi-monthly staff meetings. For example, a November 2025 audit of commode cleanliness showed 96.5% compliance, and a December 2025 audit of tea trolley cleanliness showed 96% compliance. Staff followed cleaning protocols, including routine cleaning after use and scheduled weekly checks by healthcare assistants.

However, audits also identified gaps in practice that were not consistently addressed. For example, staff had not fitted ‘clean’ tags to all equipment following cleaning. This issue was identified in November 2025 but had not been fully resolved in subsequent audits.

We also found inconsistencies between audit scores and identified risks. For example, an October 2025 IPC audit recorded 96.9% compliance despite identifying multiple issues, including a faecal and urine-stained commode. It was not clear how compliance scores were calculated or how risks were prioritised.

This meant that although the service collected and reviewed performance data, leaders did not always use audit findings effectively to drive improvement. This reduced assurance that risks were identified, understood and addressed in a timely and consistent way.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff sought and recorded consent appropriately and supported patients to make informed decisions about their care.

Patients told us staff routinely checked consent before starting treatment. Staff explained procedures clearly, including any changes to medicines or treatment plans, and answered patients’ questions. This supported patients to understand their care and make informed decisions.

All care delivery staff were required to complete training in the Mental Capacity Act and Deprivation of Liberty Safeguards, which refreshed every 2 years. Staff also completed mandatory training to support people with a learning disability and autistic people. This helped staff understand how to communicate effectively and gain valid consent.

Staff used interpreting services when needed to support patients whose first language was not English. They avoided relying on family members to translate, using phone or booked interpreters.

We reviewed a consent audit from May 2026, which showed that since June 2018, staff had recorded consent on the electronic patient record system for all but 5 of 217 patients. This demonstrated generally good compliance with consent processes.

However, staff had not gained consent from 28 patients for participation in medical or scientific research.

Overall, while staff generally sought and documented consent effectively, some gaps remained in specific areas. These issues could affect patients’ ability to make fully informed choices and could delay access to critical information in urgent situations.