Daily CSR

SPOT CKD: Advancing Early Detection and Health Equity

Debashish Mukherjee — Fri, 18 Sep 2026 04:26:00 +0200

In healthcare, some of the most consequential opportunities are also the easiest to overlook. They are the moments when an underlying condition could be identified early, but remains undetected.

Chronic kidney disease (CKD) is a clear example. Unlike conditions that produce obvious warning signs, CKD can develop silently, with little or no noticeable symptoms for many years. By the time it is identified, significant kidney damage may already have occurred. As a result, detecting CKD depends heavily on proactive identification and timely testing rather than waiting for symptoms to appear.

Several factors can contribute to missed opportunities, including gaps in clinical coding, limited awareness, and the competing demands placed on healthcare professionals. When these opportunities are overlooked, healthcare systems lose valuable time in which earlier intervention could potentially improve outcomes and help reduce inequalities in care.

For the National Health Service (NHS) in the United Kingdom, these missed opportunities have wider implications. They influence how effectively healthcare resources are deployed, how supported clinicians feel in identifying patients at risk, and how successfully health inequalities can be addressed. For patients, they can determine whether appropriate care begins at an early stage or only after the condition has progressed.

Why health equity matters

CKD does not occur at the same rate across all communities. The condition is particularly relevant in populations already experiencing health inequalities, including communities affected by socioeconomic disadvantage and areas with significant ethnic diversity.

Recognising this, the Hampshire and Isle of Wight (HIOW) and North East and North Cumbria (NENC) Integrated Care Boards (ICBs) sought to develop a different approach to identifying CKD—one designed to reduce the likelihood that early opportunities for detection would be missed.

HIOW encompasses a varied geography, including rural market towns, coastal communities such as the Isle of Wight, and diverse urban centres including Portsmouth and Southampton. Accessing healthcare is not equally straightforward for everyone. Language differences, transportation difficulties and limited digital connectivity can create practical barriers. Working patterns, including shift work, and caring responsibilities may make it difficult for some people to attend appointments or complete important tests. In other communities, cultural factors and limited access to online information can present additional challenges when seeking health advice or arranging healthcare.

The NENC Integrated Care System covers one of England’s largest geographical areas. It brings together urban centres with coastal, rural and post-industrial communities, each with distinct characteristics and needs. Strong community networks and local identities coexist with areas experiencing substantial deprivation and significant health challenges. By combining data and research with knowledge from local communities, the region is working to address disparities in health outcomes and expand opportunities for people across all communities.

SPOT CKD: Developing a collaborative approach

Against this background, NHS teams in HIOW and NENC, working with Boehringer Ingelheim, established SPOT CKD—Screening, Prevention, Outreach, and Treatment for Health Equity.

SPOT CKD is designed not simply as a conventional pilot programme, but as a collaborative model based on shared responsibility and local ownership. NHS teams identify priorities according to the needs of their populations, while the NHS and Boehringer Ingelheim contribute practical enablers such as data-driven insights, training and coordination. Local communities play an important role in shaping interventions, ensuring that proposed solutions reflect people's experiences of accessing and receiving care.

Healthcare innovators from the NHS, Boehringer Ingelheim and partner organisations then support implementation by introducing appropriate technologies and developing more connected care pathways. These pathways aim to strengthen the relationship between primary care and specialist renal services, helping patients move through the healthcare system in a more integrated way.

Key areas of focus

Priorities

NHS teams identify the most important areas for action by considering local health needs, population characteristics and the challenges faced by individual communities.

Enablers

Boehringer Ingelheim and NHS teams work together to support delivery through data insights, education and training, coordination, and other practical resources.

Outreach

Community experiences and perspectives help shape targeted outreach activities, making it possible to address barriers that may otherwise prevent people from accessing appropriate CKD detection and care.

Innovation

NHS teams, Boehringer Ingelheim and partner organisations work together to introduce new technologies and develop digitally enabled, integrated pathways that connect primary and specialist care more effectively.

Expanding Access to Affordable Diabetes Care in Mexico

Debashish Mukherjee — Thu, 17 Sep 2026 09:20:00 +0200

For people living with diabetes, managing the condition can be just as difficult as coming to terms with the diagnosis. In fragmented public healthcare systems, patients may spend months moving between hospitals, clinics, and specialists before obtaining the range of care they require. For those facing financial constraints, accessing treatment can be even more difficult. These barriers can lead to lengthy waiting periods, higher out-of-pocket expenses, and increasing frustration with treatment, making consistent care difficult to maintain alongside the demands of daily life.

Innovation in a Fragmented Healthcare System

When healthcare services are disconnected, maintaining consistent and coordinated treatment becomes challenging. Diabetes can lead to serious complications, including chronic kidney disease and heart failure, while also creating financial pressures, emotional stress, and social stigma. The consequences can extend beyond patients themselves, affecting their families, communities, and the broader healthcare system.

Conventional healthcare services remain vital, but they may not always be equipped to address the diverse needs of patients, particularly those living in underserved areas. This has opened the door for alternative care models that combine multiple areas of clinical expertise under one coordinated system, with the aim of making treatment more accessible, affordable, and continuous.

Partnership Driving a New Approach to Care

One example is Clínicas del Azúcar (Sugar Clinics), a social enterprise founded in 2010 to provide affordable diabetes services to underserved populations throughout Mexico. Its integrated model brings several essential services together, including diagnostic testing, medical consultations, nutritional guidance, and psychological support.

By bringing these services together in one location, the model simplifies the patient journey. Instead of requiring individuals to visit multiple facilities over an extended period, Clínicas del Azúcar can provide diagnostics, consultations, and related support during a single visit.

The organization also seeks to provide high-quality diabetes care at a significantly lower cost than comparable private specialist services. By supporting ongoing disease management, the approach aims to help patients reduce their risk of complications involving cardiovascular, kidney, and metabolic health.

Over the years, the model has expanded from its initial operations into a network of clinics throughout Mexico and has subsequently extended into the United States, demonstrating the potential applicability of its approach beyond one country's healthcare system.

Specialized Care: Improving Access

Since its establishment in 2010, Clínicas del Azúcar has expanded to more than 50 specialized diabetes clinics serving communities across Mexico.

Treatment Options: Creating Value

Using healthcare cost benchmarks as a guide, Clínicas del Azúcar introduced a membership-based model intended to make comprehensive diabetes care more affordable for patients.

Treatment Adherence: Supporting Continuity

The organization seeks to address one of the major consequences of fragmented healthcare: patients discontinuing or interrupting diabetes treatment because of difficulties accessing appropriate services.

Building Healthcare Systems for the Future

In Mexico, diabetes and related cardiovascular and kidney conditions remain significant public health concerns. Against this backdrop, innovative approaches to delivering care can play an increasingly important role.

Collaborations that bring together scientific knowledge, operational expertise, and social entrepreneurship can provide new ways of addressing complex healthcare challenges. The ongoing relationship between Boehringer Ingelheim Mexico and Clínicas del Azúcar demonstrates how organizations from different sectors can work together to develop more coordinated, accessible, and resilient approaches to healthcare delivery.

As chronic diseases become increasingly prevalent around the world, initiatives such as this underscore the need to reconsider how long-term care is provided. Effective healthcare involves not only diagnosing and treating disease but also helping people maintain consistent management over time, particularly in communities where integrated services have historically been difficult to access.

The Boehringer Ingelheim and Clínicas del Azúcar Collaboration

The relationship between Boehringer Ingelheim Mexico and Clínicas del Azúcar dates back to 2010, when early support from Boehringer helped establish the organization's first clinic in Mexico City. Since then, the relationship has grown into a long-term effort focused on improving access to diagnosis, treatment, and ongoing diabetes management.

One notable initiative was a membership program created by two Boehringer employees. It enables local employees to receive Clínicas del Azúcar services at no cost and was conceived as a potential model for other businesses seeking to provide their workforces with access to comprehensive diabetes care.

The concept has since expanded, with the program now included among the employee benefits provided by more than 40 companies.

More recently, investments through initiatives such as Boehringer Ingelheim's Social Engagement Fund have supported the establishment of additional clinics, extending services to more communities.

The collaboration reflects a shared approach to healthcare innovation—one that combines entrepreneurial ideas, scientific expertise, and an understanding of local community needs to create new models for delivering care.