One Year On – Home Dialysis report

Home Dialysis Campaign

Increasing Home Dialysis in the Context of COVID-19 in the UK – One Year On.

In September 2020 NFK hosted a webinar discussing home dialysis during COVID-19 where it was revealed that those who dialysed at home were substantially at lower risk of contracting COVID-19 than those who dialysed in hospital. The national findings on home dialysis from the Getting it Right First Time (GIRFT report) and the impact COVID-19 has had on dialysis patients. There were also presentations from patients and carers on the benefits of home dialysis was also discussed.

A national campaign to increase home dialysis in the UK in 2021 was introduced, NKF published a 28-page report which included seven recommendations on how the NHS can increase dialysis provision which can be viewed here: https://www.kidney.org.uk/recommendationsof-the-2021-home-dialysis-report

The home dialysis campaign consisted of engaging on a national level with patients, government, representatives of the Renal Services Transformation Programme (RSTP), The UK Kidney Association (UKKA), Kidney Quality Improvement Partnership (KQulP) and renal Industry Partners.

At a local level engaging with Clinical Directors of renal services and chairpersons of Kidney Patient Associations (KPAs). A home dialysis survey of kidney patients was also undertaken by the NKF in partnership with the University of Hertfordshire. A national Home Dialysis Peer Support Service for patients and carers has been established and a leaflet on home dialysis has been published. The full report and its findings one year on can be viewed at https://www.kidney.org.uk/home-dialysiscampaign#Report

The purpose of the 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. Analysis from home dialysis data from 2020 provided by the UK Renal Registry showed centres with less than 20% (which is the UK target) of their dialysis patients that were dialysing at home, there is a long way to go before this target is reached in all centres. Analysis using the ethnicity of patients is also set out in the report. The overall progress of home dialysis from this data is disappointing. The NKF’s view is that this is the impact of COVID-19 on renal services, staffing challenges faced by the NHS and the impact of training staff and new patients. However, there is a great deal of support within the renal community to increase and improve the provision of home dialysis.

INCREASING HOME DIALYSIS IN THE CONTEXT OF COVID-19 IN THE UK

– ONE YEAR ON

March 2022 Part 2

The purpose of the 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.

NKF launched its Home Dialysis Peer Support Service in 2021. The service is providing much needed support with a new patient information leaflet being published – ‘A COVID-19 Perspective on Home Dialysis’. Outcomes of surveys by NKF and the University of Hertfordshire are also shared with the impact of COVID-19 on home dialysis. The report has input from RSTP which is aiming for the delivery of best practice and reducing variation between units.

COVID-19 has brought home dialysis to the forefront of our thinking as this has allowed home dialysis patients to receive treatment in the security of their own homes. However, this is not simply about COVID-19, home dialysis is a real and meaningful choice for those who wish to explore it. There are details of KQulP who launched a home dialysis improvement project DAYLife in 2019, which is a collaboration between the main players in the field. Responses from Clinical Directors, Department of Health and Social Care and the devolved governments show positive responses to the report. The 2022 campaign realises that COVID -19 has had a significant impact on kidney patients and NKF has optimism that the 20% target of patients on home dialysis can be achieved.

NKF would like to thank everyone involved in this report, full acknowledgements are in the online report. The report shows the steps that need to be taken and the progress being made to increase the awareness, the service delivery and the great advantages of home dialysis. With the implementation of the findings of this report it's future looks great. NKF will report back on the outcomes of the report and how it is being implemented. Following the publication of this report we have received more data from the Renal Registry. The analysis shows the rate of home dialysis for patients on kidney replacement therapy at the end of 2020, across quintiles of deprivation. The quintiles are defined using the country-specific indices of multiple deprivation. Neighbourhoods within each country are ranked from most to least deprived based on the country-specific index. These ranks are used to group the neighbourhoods into quintiles separately for each country. Deprivation data was not available for patients treated at Scottish renal centres. For further information and full data list, please visit https://www.kidney.org.uk/home-dialysiscampaign

HAVE YOUR SAY Have you got something important to say? Please share your thoughts and comments by emailing nkf@kidney.org.uk