Today's leadership message is from Dr Nick Bird

Dr Nick Bird, West Yorkshire’s Chronic Kidney Disease (CKD) Lead, shares a leadership message on how primary care can transform outcomes for people living with kidney disease.

Hi, I’m Dr Nick Bird, the new West Yorkshire CKD Lead since November 2025, taking over from the brilliant Dr Sunil Daga. I’m a GP based in Haworth - of Wuthering Heights fame - working within the Modality AWC Partnership across Airedale and Bradford.

My roots are firmly in Yorkshire. I trained at Leeds Medical School and completed my GP training in Bradford, where I developed a strong commitment to patient-centred care and health equity.

Fittingly, my journey with kidney care actually began back in 2006 as a Foundation Year 1 doctor on the renal ward at Bradford Teaching Hospitals. In many ways, stepping into my new role, which is funded by the Yorkshire and Humber Kidney Network, feels like coming full circle.

My path into cardio-reno-metabolic medicine

Alongside my GP role over the past 14 years, I’ve worked as both an educator and a GP with an extended role in cardiology at Airedale General Hospital and now at Westcliffe Cardiology Service in Bradford.

More recently, my interest has grown in cardio-reno-metabolic (CaReMe) health - the close relationship between heart disease, kidney disease and metabolic conditions such as diabetes. These conditions often occur together and share common risk factors such as high blood pressure, obesity, poor diet and a sedentary lifestyle. Recognising how closely they are connected can help us take a more joined-up approach to care and ultimately improve long-term outcomes for patients.

This interest led me to support the West Yorkshire Minuteful Kidney and Hypertension project in Bradford District and Craven. We worked with practices to adopt digital urine albumin-to-creatinine ratio (ACR) testing, an important indicator of kidney damage, particularly focusing on practices serving more socioeconomically deprived communities.

Through this work, I saw first-hand the scale of the challenge. In West Yorkshire alone, we estimate that around 126,000 people may be living with undiagnosed CKD. Of those with CKD, around one in 50 may eventually require renal replacement therapy, which could mean as many as 8,000 future dialysis patients. One of my GP mentors once described good primary care as, “Saving lives in slow motion.” Improving CKD outcomes is a perfect example of that philosophy in action.

Why CKD outcomes matter in West Yorkshire

West Yorkshire is a place of stark health inequalities, and we see this clearly in cardio-renal-metabolic outcomes. Premature cardiovascular death rates are twice as high in our most deprived communities compared with the least deprived. We also see inequalities in kidney care. In Bradford, haemodialysis numbers are currently growing by 7.2% each year. That is around 25 additional patients annually compared with Yorkshire and Humber’s average growth of 4.2%. This represents not only a major financial cost to the NHS (around £850,000 extra each year) but more importantly, a huge impact on patients and families living with dialysis.

Working together across the system

Since starting in this role, I’ve had the privilege of meeting dedicated colleagues across primary care, secondary care and commissioning who are all working hard to improve kidney health. Many areas across West Yorkshire are already delivering excellent care, and colleagues have helped shape the strong West Yorkshire CKD Pathway we now have in place.

I’m also grateful to the Yorkshire and Humber Kidney Network and the West Yorkshire Integrated Care Board who have helped bring me up to speed on strategic commissioning. Collaboration is central to progressing care improvements for people living with CKD.

A shared approach to cardio-reno-metabolic care

What’s striking is how closely aligned the priorities are across CKD, cardiovascular disease and diabetes care. Many of the same risk factors - blood pressure, cholesterol and weight - shape outcomes across all three.

The UCLPartners CVDAction modelling shows that optimising a few key areas in primary care could make a major difference, including:

• improving blood pressure control
• better lipid management
• appropriate use of medications such as ACE inhibitors, ARBs and SGLT2 inhibitors

Across West Yorkshire, these improvements could prevent around 2,400 major cardiovascular events within three years, including 400 heart attacks, while also reducing the number of people needing renal replacement therapy by 100. These interventions aren’t complex - they’re the core foundations of good primary care. The challenge is making sure practices and neighbourhood teams have the support they need to identify CKD early and deliver consistent, high-quality care.

Looking ahead

Following World Kidney Day 2026 on 12 March, I’m keen to support professional education and help promote consistent, evidence-based CKD care across West Yorkshire. As commissioning structures evolve, my goal is to support place provider partnerships and neighbourhood health teams to deliver on the ambitions of the NHS 10-Year Plan and the ICB’s five-year strategic commissioning plan: to reduce ill health associated with kidney and cardiovascular complications, prevent hospital admissions and shift care closer to home. Ultimately, it’s about saving many more lives - in slow motion.

Thanks for reading

Nick