Dr Kristin Veighey, Co-Director of Southampton Academy of Research and NIHR Academic Clinical Fellow in General Practice, explains what efforts are underway to address this problem
In my day to day work as a GP registrar, and with a background as a Consultant Nephrologist, I've seen the impact of kidney disease on the health and quality of life of my patients, families and carers. With new treatments available, diagnosing kidney disease early is important, so that people are aware of what they can do to protect their health, and so that they have early access to treatments when needed.
Managing chronic kidney disease (CKD) in rural and coastal communities such as Hampshire, Isle of Wight and Dorset presents unique challenges, and I've been collaborating with colleagues to try to find out what can be done.
Currently, geographical isolation, workforce shortages and socioeconomic disparities are barriers to timely diagnosis and treatment of this disease. Recorded CKD prevalence in Hampshire and Isle of Wight is around 3.3%, but true prevalence may exceed 10%. Early CKD is asymptomatic, meaning many cases remain undiagnosed until advanced stages.
Living in rural areas compounds these issues. Patients often travel long distances to urban renal centres like Southampton and Portsmouth. For coastal communities such as the Isle of Wight, ferry dependence adds logistical and financial burden, delaying monitoring and referrals. Dorset faces similar challenges with limited nephrology services and reliance on outreach clinics.
An NIHR-funded study, led by Professor Hazel Everitt and myself, in conjunction with a multidisciplinary team from the University of Southampton and NIHR ARC Wessex, has explored barriers to CKD risk stratification in primary care through interviews and focus groups with primary care teams.
Our findings highlight the need for systemic change and a shift to prevention and community-based care, aligned with the NHS 10 Year Health Plan.
GPs play a pivotal role in early detection and management. The Royal College of General Practitioners advocates for extended roles (GPwER) in kidney health, enabling proactive screening, risk stratification, and virtual MDT consultations to streamline care. They have produced a framework to provide guidance for GPs who have interest in renal health.
Pharmacists can also support holistic optimisation of cardiovascular, renal, and metabolic conditions.
Addressing these health inequities requires values-based care, integrated services, community education, and policy reforms to incentivise multidisciplinary primary care-led kidney health initiatives. The UK Kidney Association’s integrated CKD workstream and the “Big Kidney Conversation” aim to drive system-level change for equitable, patient-centred care.
If you're interested in learning more about our work or getting involved with improving kidney health in Wessex, you can contact me at k.veighey@soton.ac.uk.
References
• NHS Hampshire and Isle of Wight QOF Data (2025).
• Royal College of General Practitioners (RCGP). GP Extended Roles: Renal Health in General Practice. Available at: https://www.rcgp.org.uk/your-career/gp-extended-roles/renal-health-general-practice
• Crews, D. C., Bello, A. K., & Saadi, G. (2023). Inequities in kidney health and kidney care. Nature Reviews Nephrology, 19(7), 445–456.
• Bello, A. K., Levin, A., Tonelli, M., et al. (2018). Burden, access, and disparities in kidney disease. Kidney International, 94(6), 1047–1053.
• Scholes Robertson N., Howell M., Gurman T. et al. (2020). Patients’ and caregivers’ perspectives on access to kidney replacement therapy in rural communities. BMJ Open, 10(8).
• NIHR ARC Wessex. Understanding risk stratification of patients with CKD in primary care.