VASBI team signals bold new course for the society

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Left to right: Hiren Mistry (London, UK), Jennifer Hanko (Belfast, UK), Robert Jones (Birmingham, UK), Jeremy Crane (London, UK) and Kate Steiner (Stevenage, UK)

Patient engagement, strong research collaborations, an open and inclusive canvas and year-round specialised education, will guide the multidisciplinary Vascular Access Society of Britain and Ireland (VASBI) in a new direction, says the team at the helm. Down the road, there will also be new council posts including a patient representative, patient liaison officer, and research, audit and guidelines coordinator to execute these priorities.

Robert Jones (Queen Elizabeth Hospital, Birmingham, UK), president of the society and interventional radiologist, tells Renal Interventions at a breakfast meeting: “VASBI is a truly multidisciplinary society for vascular access specialists in the UK and we want our efforts and education to be truly patient-focused. We know that patients who live with kidney disease are very knowledgeable and bring a unique perspective; they can be empowered and their experience brought on board so that this is reflected alongside the other care providers’ voices. Increasing engagement with patient groups is probably my highest-priority item on the agenda, followed closely by strengthening links with other societies, and offering more to the membership with specialist education courses and webinars.”

“These are all top-of-the-list items”, he says—adding sotto voce, “as is finishing this toast before the workshop begins”.

Vice president, and transplant and vascular access surgeon, Jeremy Crane (Imperial College Healthcare NHS Trust, London, UK) continues over salmon and scrambled eggs: “There has been a shift away from the ‘fistula first’ stance that was previously widely accepted. It is important to remember that patients with kidney disease are on an incredibly long journey. Whilst multiple specialists including nephrologists, surgeons, interventional radiologists, nurses and access team members will see these patients at various snapshots in time on this road, it is the patient who walks the entire distance, and we hope to equip and support them on this long lane of decision-making with up-to-date patient information.”

Mapping out the future

Following a recent council meeting, there are plans to dedicate a section of the VASBI website to patients and create accurate, simple patient information. Jones is clear-eyed about the challenges of delivering this. “Trying to incorporate [the multiple options available at each point in time] into accessible, understandable patient information comprehensively is quite tricky, because it involves not just vascular access for haemodialysis but other modalities such as home dialysis and peritoneal dialysis. Cooperating with simple, accurate information about what is essentially a complex situation will be a challenge, but we are well placed to formulate this information because of the multidisciplinary fabric of VASBI,” he says.

Hiren Mistry (King’s College Hospital, London, UK), VASBI communications chair and vascular surgeon, explains: “Our aim is to develop the patient section on our website, which will be entirely issue-oriented.” And, the society is also actively increasing the emphasis on being inclusive. “We really want to reach out to the fantastic people around the country and involve all the units doing brilliant work in vascular access and bring that into the meeting,” he adds.

Crane continues: “For example, this year, the Glasgow unit talked about their multidisciplinary team approach.” He highlights that “it was one of the best sessions of the meeting”, stating: “We want them to showcase that. For many units [the VASBI annual meeting is not] on the yearly landscape. We want to change that because there is a wealth of knowledge out there that we need to tap into.”

VASBI secretary and nephrologist Jennifer Hanko (Belfast City Hospital, Belfast, UK) takes the view that vascular access work does require a friendly team that has to work well together. “The atmosphere should encourage people to speak up and show that all opinions matter and are heard. And we can also have a bit of banter,” she says. “The annual meeting is rather like a big multidisciplinary team being here together.”

Research collaboration is key

More widely within the vascular research arena there is a ‘big tent’ approach to investigation and data collection. The Vascular Society of Great Britain and Ireland (VSGBI) has gathered a top 10 list of research priorities in vascular access. Chief among these are: What can be done to make fistulas or grafts last as long as possible? What staff education is needed to make them understand the experience of patients living with access? What education do patients need regarding living with dialysis access; its impact on quality of life?

When questioned over whether this was a ‘David and Goliath-type’ situation, where the research priorities for vascular access were being set by other societies, Jones is categorical in his response. “You can flip that around and see it as strengthening collaborations and avoiding silos. It has nothing to do with one society’s agenda or another’s, just about forging links and working together to achieve synergistic outcomes.” This viewpoint was echoed by Jonathan de Siqueira (University of Leeds, Leeds, UK) who presented on the priorities at VASBI 2022. “The [Vascular Society] special interest groups aim to develop vascular access research through collaboration. There is no ownership claim on priorities or projects, and […] we encourage contact from anyone, regardless of specialty or clinical training.” The council, which also includes VASBI treasurer and interventional radiologist Kate Steiner (East and North Hertfordshire NHS Trust, Stevenage, UK), collectively endorses Jones’ key message that there is a unique perspective derived from being “more than the sum of all parts”, which Crane notes “does not really exist in the other meetings.”

VASBI’s strength stems from this vital multidisciplinary approach, notes Hanko. “As one of the key stakeholders in the team, to deliver dialysis, you have to be a nephrologist who is willing to be involved in vascular access, who understands it, and can relate with other members. It is absolutely critical and, year on year, we are seeing more nephrology involvement in training.” Jones reflects that the challenge “has always been to involve interested parties, all disciplines in vascular access”. He continues: “I am very encouraged this year—the first face-to-face annual meeting in four years to see so many people from departments around the country. Following on from this, one of my aims is to try and get the smaller departments showing interest as well. Their work is often extremely valuable and we want to try and welcome and encourage them to attend a high-quality meeting right here on their doorstep in the UK.”

As Hanko concludes: “We are absolutely clear that we will still remain friendly and interactive. I always come away from the VASBI annual meeting re-energised, armed with new information and ready to take up the clinical challenge again, so it is a real positive flag in the calendar every year.”

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