Scaling Integrated Chronic Kidney Disease Care Nationally: A Mixed-Methods Implementation and Economic Evaluation of the LUCID Programme

About the Project

The LUCID (Leicester, Leicestershire and Rutland Chronic Kidney Disease Integrated Care Delivery) programme exemplifies how long-term condition management can be transformed through integrated, data-driven, and patient-centred care (1). Initially focused on chronic kidney disease (CKD), LUCID integrates primary and secondary care data, digital risk prediction, and medicines optimisation to enable proactive, personalised prevention and early intervention. Having demonstrated significant system-level impact across one Integrated Care System (ICS), the next step is to understand how such an approach can be adapted and scaled nationally to improve outcomes for people living with multi-morbidity.

This PhD will use a qualitatively led mixed-methods design to explore the implementation, scalability and sustainability of LUCID as a model for integrated long-term condition (LTC) management across the NHS. Guided by Normalisation Process Theory (NPT) and the Consolidated Framework for Implementation Research (CFIR) (2), the study will examine how digital tools, workforce redesign, and system integration can embed prevention-focused care across cardiovascular, renal, metabolic and respiratory pathways.

The qualitative component will involve interviews, focus groups and ethnographic observation with clinicians, patients, commissioners, and digital partners across multiple ICSs, exploring how integrated digital care aligns with the three core concepts of the NHS Long Term Plan: hospital to community, sickness to prevention and analogue to digital.

Supporting quantitative and economic analyses will triangulate findings, assessing how integrated digital approaches improve outcomes, reduce variation, and enhance cost-effectiveness.

The project will generate a transferable framework for the national scale-up of digitally enabled, integrated care for multi-morbid populations — supporting NHS transformation in long-term condition management.

Training Opportunities

The student will join the SAPPHIRE group and be associated with the Leicester Partnership for Kidney Health Research. Internal and external training opportunities in qualitative and implementation methods will be available. Optional placements within the Integrated Care Board, NHS England, UK Kidney Association will strengthen national and applied research links.

Expected Output

• Three peer-reviewed publications (qualitative implementation study, realist synthesis, mixed-methods evaluation).
• A national LUCID Implementation Framework and toolkit for ICSs.
• Policy recommendations for NHS England on integrated CKD and long-term condition care.

Presentations at national and international conferences including UK Kidney Week, Best Practice