Background Haemodialysis patients have a significant symptom burden (You, Kalantar, Norris, e al. J Nephrol. 2022;35(5):1427–1436) and supportive care interventions have been shown to improve this (Siriwardana, Hoffman, Brenna, et al. J Pain Symptom Manage. 2020;60(4):725–736). The supportive care register (SCR) is used in Thames Valley to identify patients with additional needs and is particularly useful in palliative care. Several publications support the validity of the Integrated Palliative Care Outcome Scoring (IPOS) (Sandham, Medvedev, Hedgecock, et al. J Pain Symptom Manage. 2019;57(2):290–296; Ishii,Ito, Matsumura, et al. Geriatr Gerontol Int. 2023;23:517–523), but application to patients with end stage renal disease is limited.

Aim Improve the process of identifying haemodialysis patients who require input from the Renal Supportive Care (RSC) team. IPOS is used as one of the screening tools by the RSC team, such that every patient should have an IPOS score within the last 12 months. Those with a total IPOS score >30 should be added to the SCR.

Methods The electronic records of 70 patients were reviewed over a 3-month period: 10 patients were randomly sampled from each of the 7 haemodialysis units in Thames Valley. Following initial data collection, RSC nurses worked with the supportive care champions who are dialysis nurses on each unit. The RSC nurses provided training and education on the importance of IPOS and the use of an online form to record scores. Data collection was repeated approximately 6 months later.

Results At 6 months, patients with a timely IPOS had increased from 60% to 71%, whilst use of the online form increased from 7% to 90%. The addition of appropriate patients to the SCR remained unchanged (31% versus 33%).

Conclusion There was a significant improvement in the use of the online form, and in the overall recording of IPOS. However, it is evident that ongoing work is required; this should focus on action after the IPOS and onward referral to RSC. Suggestions for improvement include integrating the IPOS into clinic assessments and a comprehensive guideline for dialysis staff members.