Annual integrated report 2011

National Renal Care review

National Renal Care (NRC) strives to be the leading kidney disease management organisation in SA and is committed to optimising the healthcare and quality of life for patients with compromised organ function.


NRC is a 50% joint venture between Netcare and Adcock Ingram Critical Care, and is the largest private dialysis provider in SA.

NRC has a national footprint offering chronic haemodialysis at 56 facilities (23 in Netcare facilities), peritoneal dialysis (PD) at eight specialised PD units and 10 specialised acute dialysis teams offering a 24-hour acute haemodialysis service, 10 Healthy Start Programmes, continuous renal replacement therapies (CRRT) and plasma therapy. In addition to dialysis, NRC offers value and innovation with a national prevention and chronic kidney disease management programme, patient education, and accredited training for nephrology nursing and clinical technology. NRC is to date the first and only provider to offer nocturnal dialysis at two units – NRC Sunninghill and NRC Port Elizabeth.

Growth and increased service delivery

NRC achieved a 19.5% increase in revenue, a 10.3% increase in chronic dialysis sessions and a very pleasing 23.1% increase in acute sessions. NRC screened more than 4 000 patients during the year.

NRC opened two new units during the year, namely NRC Polokwane (10 stations) and NRC Sebokeng (10 stations). We spent R35 million in facility upgrades, reverse osmosis (RO) system installations and IT infrastructure.

Key to NRC’s optimisation efforts is its focus on waste water recovery. The NRC in Venda is currently saving 600 litres per hour, with 50% being returned to the RO and 50% entering the grey water tank. The unit has not used any municipal water since the RO was installed. NRC Sunninghill will follow shortly with a complete waste water recovery system.

All future projects in outlying areas will have a full waste water recovery system installed. RO systems are currently not legislated in SA which makes it difficult for NRC to provide the highest quality services.

Patient care a priority

Patients are NRC’s priority stakeholders. Patients are dialysed three times a week for four hours. This means that many patients often spend more time at dialysis facilities than with their families and close friends. NRC upgraded 25 units to meet patient care demands and established one training academy with a further five planned. Patients are provided with customised patient education based on their clinical data, to improve their outcomes and ultimately optimise therapy and wellbeing. NRC encourages patient participation through satisfaction surveys, suggestion boxes, one-on-one meetings, access to Customer Interaction Relationship Management Information Technology (CIRMIT) and an annual patient forum.

Growing with our people

NRC employs 617 permanent staff across SA. Staff turnover has reduced by 5% and the retention rate of key staff is 89%.

Dialysis units are highly dependent on experienced and trained dialysis practitioners, who are therefore key to the success of NRC’s operations. Currently an overall shortage of dialysis practitioners is affecting both the private and public sectors. To attract and retain talented people, NRC has established a talent pool and the NRC academy provides in-service education including simulation training to NRC healthcare practitioners. NRC also offers flexible compensation and recognises and rewards performance. We also provide training and development in nephrology, management, administration and leadership.

Broadening the base of transformation

An employment equity plan covering the period 2009 to 2014 was developed to ensure NRC’s workforce reflects the country’s demographics at all levels. Sound progress has been made on most aspects of this plan. Progress in employment equity is reflected in the employee profile with 79.7% of employees being black and 78.1% women. Black employees accounted for 82.6% of internal promotions and 85.1% of new appointments during the year.

NRC has a number of Public Private Initiatives (PPI) including provision of acute dialysis services at public facilities, and treating public patients at NRC units.

In 2011, NRC was the successful bidder of a PPI dialysis tender at Sebokeng Public Hospital. NRC commissioned a 10-station dialysis unit (within Sebokeng Public Hospital grounds), providing equipment, consumables, skills transfer, clinical and management services. These units have significantly reduced patients’ travel time to their dialysis treatments. Before the establishment of this PPI dialysis project, patients had to first travel to Sebokeng Hospital from home and then an additional 106 kilometres three times a week.

NRC supplied a Gambro dialysis machine to the Lesotho Public Private Partnership for dialysing of patients and is training the nurses at no cost. NRC will also provide support in terms of renal management.

NRC Berea builds capacity

NRC’s Berea dialysis unit in Durban celebrated its official reopening in September 2011 following an upgrade. The unit now houses 40 dialysis machines making it the leading unit in SA.

This increased capacity enables treatment of up to 200 patients. Previously the unit was only able to accommodate 125 patients.

The NRC Berea dialysis unit opened its doors in 1996 as the very first NRC unit as well as the first dialysis unit in the private sector in KwaZulu-Natal. The unit began treating its patients with 10 machines and nine healthcare professionals. Since then it has developed to meet the growing needs of the community.

Kidneys act as filters in the body, eliminating dangerous toxins and producing essential chemicals. Without this filtering process the body would get clogged with toxins and slowly become poisoned. For this reason dialysis offers an essential lifeline to individuals living with kidney failure, a condition for which there is no cure.

77 Refer to the Corporate social investment report for more information.

Looking ahead

  • Continue to grow and increase capacity to meet market demand.
  • Expand in selected domestic and international geographies.
  • Expand NRC’s product line, for example liver support therapy.
  • NRC is anticipating entering into additional PPIs in the 2012 financial year.