Staffing issues are affecting Guernsey’s dialysis unit and upcoming refurbishments to it will bring additional challenges.
The details were revealed in response to formal questions submitted by Alderney Representative Alex Snowdon who asked if Health & Social Care was considering expanding services in his island.
Deputy George Oswald, President of HSC, said it isn’t planning on reinstating dialysis treatment in Alderney following cost and feasibility investigations, and while another report has been ordered it isn’t being prioritised.
This was partly because Guernsey has been experiencing staffing problems “for some time” after the matron left in August 2024, he said.
The unit is currently receiving remote support from London’s Guy’s and St Thomas’ NHS Foundation Trust after being unable to appoint a replacement at the same level – with a lower grade senior nurse managing locally.
“Additionally, the unit had some long-term sickness and therefore had increased use of agency staff in recent months,” Deputy Oswald said, adding that “major flooring works” are in the pipeline which will “have an impact on staffing and patients”.
Guy’s & St Thomas’ is also having supply chain problems to get “critical consumables” to Guernsey. HSC are reviewing whether this should be delivered locally in response.
“The current provider has requested that service development in Alderney will not be further pursued until a more stable service can be maintained in Guernsey,” Deputy Oswald said.
Patients requiring treatment in Alderney are expected to relocate to Guernsey for the duration of their treatment.
Home dialysis treatment was last provided to an Alderney patient in 2016, but the equipment was removed after the treatment was completed.
“Alderney patients are advised to relocate to Guernsey for the duration of their treatment which is often around three years until a kidney transplant materialises or part of their end-of-life arrangement,” Deputy Oswald said.
“HSC will fund the patient’s travel to Guernsey and the accommodation for the first two months. The patient will need to register with population management to then enable them to find accommodation within Guernsey’s local market thereafter.
“Due to the complexity of their treatment and the risk of delaying the next dialysis session, it is not advised for them to travel between the islands between sessions.”
Applications for income support are recommended if people are struggling with living costs, and patient transfer options can be arranged with the charities Health Connections or St John.
Deputy Oswald noted that not all treatment can be delivered close to home and many in the UK face long travel times to attend specialist units
Co-morbidities in older patients and the higher costs of treating at home mean bringing back Alderney-based treatment would be unsuitable.
“If equipment fails in Guernsey, there is a technical team to hand that can assist in a timely manner and/or contingencies are available within the PEH… Alderney does not have the infrastructure to provide that backup,” Deputy Oswald added.
“Renal dialysis is complex and requires the proper infrastructure and resourcing to ensure safe and effective service delivery. The clinicians leading the care for the Bailiwick’s dialysis patients advise against introducing a solution in Alderney.
“They state: ‘Even healthy dialysis patients need good infrastructure for support – which is present in Guernsey. The problems are frequent and need prompt solutions which could not be guaranteed in Alderney’.”