Organisation of dialysis care system in Northern Ireland

Northern Ireland is a province of the United Kingdom with formal relationships with the Republic of Ireland defined by the Good Friday Agreement of 1998. The province is autonomous with a devolved assembly, currently suspended.

The region has a population of some 1.7 million, of whom almost 80% live in the eastern half, around Belfast.

Until 1997, all dialysis services in Northern Ireland were provided by Belfast City Hospital. Some patients however lived more than 100 km distant from the dialysis unit. The sparsely distributed population in the western part of the region, sometimes severed from traditional cultural centres by the political border, posed special problems for the provision of specialist health services.

As a first step to address these problems, a small dialysis unit opened in Tyrone County Hospital in Omagh in 1987 as a satellite of Belfast City Hospital. Following the appointment of a consultant nephrologist in 1993 the unit developed as a subregional unit. This description implied autonomous local provision of a comprehensive nephrology service while remaining an integral part of the regional specialty programme.

Since then, further subregional units have opened in Newry, Antrim and the Ulster Hospital in south Belfast. Last year, another new unit opened in Altnagelvin Hospital in Derry, operating as part of the same clinical management network as the Omagh unit.

Derry is the second population centre of Northern Ireland. The new renal unit is in a position to provide dialysis locally to a large population, reducing travelling times and improving quality. At the same time, the unit provides an opportunity for ready liaison with the other subregional specialty services based in Altnagelvin Hospital.

The three units adjacent to the border (Derry, Omagh and Newry) co-operate closely with renal units in Letterkenny, Sligo and Cavan in the Republic of Ireland. This co-operation has been formalised by a cross border information technology project to improve quality of renal care, funded by the European Union’s INTERREG IIIA programme for Ireland/Northern Ireland.

At present, a total of some 630 patients receive hospital-based maintenance haemodialysis treatment in Northern Ireland. There are a further 110 adult peritoneal dialysis patients and six additional patients on the new home haemodialysis programme. Transplantation and vascular access surgery remain centred...


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