By Marjory Inglis, health reporter

TRIPS TO Ninewells Hospital, Dundee, for life-saving dialysis treatment could be coming to an end for Perthshire patients.

Patients with kidney failure, who need machines to clean their blood of toxins, are hoping Tayside health chiefs will deliver a satellite renal dialysis unit at Perth Royal Infirmary in the coming year.

Yesterday, a senior manager with responsibility for the renal unit said they were “still doing the sums.”

Over two months ago the board of NHS Tayside accepted the “acute balance of care” report (ABC)—a document that made outline proposals for the future “redistribution” of health services between Ninewells and PRI.

One of the proposals recommended for “early implementation” was the development of a satellite renal dialysis unit at PRI.

What the report didn’t do was identify how much cash was needed to deliver a satellite unit and set aside the required funding for the purpose.

Until that’s done, patients from rural Perthshire will continue to spend long hours in patient transport vehicles as they make their regular pick-ups before heading for Ninewells and the thrice weekly four-hour dialysis sessions that keep kidney failure patients alive.

For years patients have called for a satellite unit at PRI, closer to home and more convenient, that would also take the pressure off the always full to capacity unit at Ninewells.

Gerry Marr, chief executive of Tayside University Hospitals, the organisation that runs Ninewells and PRI, has even admitted publicly that the demand for dialysis was such that a further satellite unit would be required in Angus.

An official minute of the NHS Tayside meeting held specially to accept the ABC document notes that Mr Marr advised that the demand for dialysis would make an Angus unit “an inevitable occurrence” although he couldn’t confirm when the running expenses for such a unit would be available.

While Angus is not likely to get a unit in the short or probably even the medium term, there will be massive disappointment if cash is not found for the PRI unit.

That new service was proposed as one of the sweeteners in an ABC document that held huge disappointments for the people of Perth and Perthshire who were asked to accept a downgrading of the maternity service, and an end to all but the very lowest risk births at PRI.

But much work has still to be done before health chiefs even consider providing the satellite dialysis unit at PRI.

The next stage is presenting an “outline business case” to NHS Tayside, scheduled to come before the board in April.

At that stage board members will expect some indication of how much cash will be required to provide and run a satellite unit at PRI before they start to make any kind of commitment to the project.

Yesterday Audrey Warden, manager of the TUH division responsible for renal services, said there were several variables that would affect costs. But she accepted there was a need to provide dialysis machines in PRI.

“The most sensible solution to capacity issues is not to increase (dialysis) stations here (Ninewells), it is to build stations in Perth,” she said.

“We are still doing the sums. What it would cost will depend on whether we do a conversion of an existing building (on the PRI site) or a new build, how many stations it has and how many patients are viable to be transferred.”

A satellite unit would be a nurse-led service so unstable patients who require close supervision from specialist doctors would not be suitable for treatment there.

Patients’ health changes from day to day and can affect their suitability for transfer to a satellite unit but Mrs Warden said that there were “probably about 20 patients suitable at the moment” who live in Perth and Perthshire.”

There are between 120 and 140 patients visiting Ninewells three times a week for dialysis. The Dundee unit has 24 dialysis machines that operate in four-hour sessions three times a day, six days every week.

Plans are to install 10 or 12 machines at PRI that would operate during two shifts a day.