Introduction

NKF is pleased to publish this ‘One Year On’ report on its campaign to increase home dialysis following the publication of the report on ‘Increasing Home Dialysis in the Context of Covid-19 in the UK’ in January 2021. https://www.kidney.org.uk/home-dialysis-campaign#Report The purpose of this report is to share details about the campaign, to urge the kidney community to take further action and to share details of the NKF campaign for 2022. The 2021 report made seven recommendations and these can be found here – https://www.kidney.org.uk/recommendations-of-the-2021home-dialysis-report/

The NKF campaign in 2021 consisted of engaging at a national level with patients, governments, representatives of the Renal Services Transformation Programme (RSTP), The UK Kidney Association (UKKA), Kidney Quality Improvement Partnership (KQuIP) and renal Industry Partners. At a local level, there was engagement with Clinical Directors of Renal Services and Chairpersons of Kidney Patients Associations (KPAs). A home dialysis survey of kidney patients was undertaken by the NKF in partnership with the University of Hertfordshire. In addition, the NKF established a national Home Dialysis Peer Support Service for patients and carers and published a leaflet on home dialysis. The overall progress of increasing the provision of home dialysis in the UK, based on analysis of the 2020 data by the UK Renal Registry (UKRR), is disappointing. The NKF’s view is that this may be mainly because of the impact of Covid-19 on renal services and the staffing challenges facing the NHS generally with the subsequent impact on training for staff and new patients. The NKF fully appreciates the ongoing pressures that the NHS faces, the continuation of the Covid-19 pandemic and any new variants which may emerge. However, there is a great deal of support within the renal community for increasing the provision of home dialysis and a willingness to improve, locally among Clinical Directors and nationally through the RSTP, UKKA and others.

Analysis of 2020 data on home dialysis provided by the UK Renal Registry to the NKF is included in this report . It shows that there were 49 centres, out of 70 centres, with less than 20% of their dialysis patients who are dialysing at home using peritoneal dialysis (PD) or home haemodialysis (HD). All centres, including those which are doing well and those who are not doing well, are listed in this report. Also, analysis using the ethnicity of patients on dialysis set out in this report shows the variations among ethnic groups. This analysis clearly shows that there is a long way to go before all centres in the UK reach the 20% home dialysis target recommended by the Getting It Right First Time (GIRFT) and the NKF report. The NKF launched its Home Dialysis Peer Support Service in September 2021. This is now well established and providing a muchneeded service to patients and carers. The NKF also published a new leaflet on home dialysis for patients and carers in 2021. The peer support service will be further developed in 2022 and the NKF will publish videos of patients and carers with experience of home dialysis in 2022. The outcome from the survey arranged by the NKF and the University of Hertfordshire is set out in this report. Quanta also conducted a survey in 2021 and results of this can also be seen in this report. Both surveys provide valuable insights which can be used to increase the provision of home dialysis locally. The NKF campaign will continue during 2022. A hard copy of this report will be sent to the Health Ministers of the four Parliaments and Assemblies of the UK for their response. It will also be sent to the RSTP contacts so that they can consider these findings in their decision making. The APPKG will be requested to consider the report and their support will be in achieving the NKF’s aims. At a local level, Clinical Directors of Renal Services in the UK as well as chairpersons of KPAs will be requested to respond to the report by the NKF, outlining their plans to facilitate an increase in home dialysis provision. The NKF will publish a further update on progress early in 2023 and is optimistic that, with the support of the kidney community, the next report will disclose a significant progress.