Report & Recommendations to the Secretary of State for Health and Social Care, the NHS and the Kidney Charities following the Home Dialysis Summit hosted by the All-Party Parliamentary Kidney Group
June 2025
Part 5
The National Kidney Federation (NKF) is the UK’s largest kidney patient charity, uniquely governed by kidney patients and their carers. Established in 1978, the NKF serves as a unifying body for local Kidney Patient Associations (KPAs), advocating for improved renal care and providing support services to those affected by kidney disease.
As the Secretariat for the All-Party Parliamentary Kidney Group (APPKG), the NKF plays a pivotal role in enhancing parliamentary understanding of kidney disease and promoting better health services for renal patients. The APPKG brings together parliamentarians committed to advancing kidney health policy and ensuring patient needs are central to healthcare decisions.
The NKF’s Executive Committee comprises individuals with firsthand experience of kidney disease, ensuring that the charity’s initiatives are grounded in the realities faced by patients and their families. With over 47 years of dedicated service, the NKF continues to offer national patient support services and advocate for advancements in renal treatment and care.
In the UK, approximately 3.25 million people live with chronic kidney disease (CKD) stages 3 to 5. The NKF remains steadfast in its mission to support these individuals, engaging with government bodies, the Department of Health, NHS Blood and Transplant, other kidney charities and the NHS to advocate for enhanced treatments and services. Through its ongoing efforts, the NKF strives to improve the lives of kidney patients and their families across the nation.
This manifesto, in the form of a report with recommendations, has been prepared for the Secretary of State for Health and Social Care and the kidney community following a five year campaign culminating in the Home Dialysis Summit hosted by the All-Party Parliamentary Kidney Group (APPKG) in May 2025.
With rising demand for dialysis and pressure on hospital capacity, the case for home therapies is stronger than ever. With Parliamentary backing and coordinated action, the goal of at least 20% of patients dialysing at home is not only achievableit’s essential.
By doing things differently, sharing and learning from each other, the 20% target could be reached and exceeded. Variation and inequality can be met head on by better support and resources for the workforce and increased use of data so that renal care demonstrates getting the most out of investment through efficiency in line with the NHS 10 Year Plan.
This report is the result of a five-year campaign instigated, created and contributed to by the National Kidney Federation, colleagues from across the NHS and people living with kidney disease from across the country.
The report is the final output from the campaign but is not the end of the work. The NKF and the APPKG will continue this work over the coming years in full recognition of the impact on patients’ lives and the significant fiscal benefit.
The impact of support from the Secretary of State will ensure that the drive for home dialysis remains high on the agenda of kidney care providers and commissioners for the benefit of those requiring dialysis both now and in the future.
Increasing the number of people dialysing at home directly supports the core drivers of the NHS 10 Year Plan - specifically the shift towards communitybased care, digitisation, and prevention-focused health services. This is how each driver aligns with a home dialysis-first approach:
1. Moving Care from Hospitals to Communities
The NHS plan calls for a rebalancing of care away from hospitals toward more personalised, communitybased care. Home dialysis is a prime example of this in action. Home dialysis frees up in-centre capacity, enabling hospital resources to focus on patients with complex or urgent needs. This shift builds capacity, improves patient and carer lives immeasurably and aligns with broader ambitions to provide care “closer to home.”
2. Transitioning from Paper-Based to Digital Systems
The shift to digital systems enhances the experience and safety of home therapy. Remote monitoring allows clinicians to track patient outcomes and respond quickly to issues without requiring a hospital visit. Electronic care records enable real-time information sharing across primary, secondary and community services, which is important for a smooth home therapy experience.
3. Focusing on Prevention Rather Than Illness; While dialysis is a form of treatment, home therapies can play a role in the NHS’s prevention agenda by:
• Reducing hospital-acquired infections and complications.
• Supporting patients to stay active, employed, and socially engaged, which can improve mental health and prevent secondary conditions.
• Promoting proactive patient and carer involvement leading to long-term self-care.
• Enabling a more stable, personalised treatment environment, home dialysis can help prevent deterioration and reduce emergency interventions.
Expanding home dialysis isn’t just a clinical improvement - it’s a strategic lever to help deliver the NHS’s long-term goals. It embodies the shift toward smarter, community-based, digitally enabled, person-centred care, and offers a scalable solution to the growing demand being experienced across renal services.
All-Party
APPKG Chair – Jo White MP
APPKG Officer – Lord David Watts
APPKG Officer – Desmond Swayne MP
APPKG Officer – Mohammad Yasin MP
The report contains information that has been summarised for practical reasons and, where this is the case, a link is provided to the information in full on the National Kidney Federation’s website at kidney.org.uk/home-dialysis-campaign-manifesto. You can also use the QR code to access the website.
This report, produced by the National Kidney Federation (NKF) on behalf of the All-Party Parliamentary Kidney Group (APPKG) with the support of patients, clinicians and NHS leaders, sets out the case for making home dialysis a national priority. It brings together five years of campaigning, the outcomes of the 2025 Home Dialysis Summit hosted by the APPKG, and input from kidney units, Regional Kidney Networks, and the four nations of
At a time when the NHS is under growing pressure, home dialysis offers a practical, cost-effective and patient-centred solution. This report makes clear, evidence-based recommendations to government and the NHS for achieving the national target of at least 20% of dialysis patients receiving their treatment at home.
Home dialysis is a clinically safe and effective alternative to in-centre dialysis. It offers patients and their carers greater independence, flexibility and quality of life, with lower infection risk and fewer hospital visits. Studies show it can reduce cardiovascular risk, support employment and family life, and improve long-term well-being. During the COVID-19 pandemic, patients on home therapies had significantly lower mortality than those receiving in-centre dialysis.
Despite these benefits, only 16% of patients in the UK were on home therapies in 2023 - a decline from previous years. Just 12 of 67 centres exceed the 20% threshold, while 52 are below it. Ethnic and regional disparities persist, with lower rates among Black and Asian patients and in certain areas of the UK.
The NHS Long Term Plan commits to moving care into the community, digitising services, and focusing on prevention. Home dialysis supports all three aims. It frees hospital capacity, enables remote monitoring, and promotes self-management, resilience and well-being.
This report includes rich evidence from renal centres across the UK. Many are working hard to increase access to home dialysis through innovation, patient and carer education, staff development and peer support. Units like Manchester, Derby, and Nottingham are leading the way, while programmes like DAYLife and LOCAL are providing vital support.
However, national progress is inconsistent. The main barriers include:
• Workforce shortages and lack of specialist staff
• Limited protected time for clinical leadership
• Inadequate pre-dialysis education
• Uneven funding for training and support
• Variability in utility cost reimbursement
• Structural inequality in access across ethnic and socioeconomic groups
The Inter-CEPt study confirmed that variation in uptake is not due to patient preference or clinical criteria but largely to local culture and leadership. Where home dialysis is seen as a core part of care, rather than an afterthought, more patients benefit.
The 2025 Home Dialysis Summit, hosted by the APPKG, brought together leading voices to share success stories, discuss challenges and call for action. Patients like Nicholas Papé and Patricia Gooden spoke about the life-changing benefits of home dialysis - greater freedom, fewer disruptions and a sense of control over their health.
Clinicians from Manchester, Derby and the London Kidney Network described how strategic investment, workforce planning and cultural change can rapidly improve access. NHS England’s National Clinical Director, Dr Richard Fluck, reinforced the message that improving home dialysis is not about more policy – but better implementation, leadership and system-wide commitment.
Two key national initiatives underpin the recommendations in this report:
DAYLife (Dialysis at Yours: Life Fulfilled) - A national quality improvement programme helping renal centres embed a home-first approach. It focuses on shared care, psychosocial support, peer engagement and leadership development. Early results suggest even modest increases in home dialysis uptake could save the NHS millions annually.
LOCAL (Location of Dialysis Care in Kidney Life)Developed from the Inter-CEPt study, LOCAL is a flexible framework supporting service improvement through cultural change, better patient engagement and dedicated roles for home dialysis leadership. It encourages co-design with patients and adapts to the local context of each renal centre.
These initiatives are supported by NKF, UK Kidney Association, Kidney Care UK, and NHS England.
The NKF’s National Peer Support Service plays a central role in increasing patient confidence and uptake of home therapies. Peer supporters - trained kidney patients and carers with direct experience - help others navigate decisions, reduce fear, and stay motivated during treatment. Their impact is especially significant for new patients, their family and carers and those from marginalised communities. Making peer support available in every kidney centre is essential and a key recommendation of this report.
Submissions from 23 Clinical Directors and all seven Regional Kidney Networks confirm the potential for progress – if supported by investment, leadership and system alignment.
Many units are expanding training space, refreshing patient education and exploring new modalities like portable HD. The most successful centres combine early AKC involvement, dedicated staff, peer support and leadership engagement.
Regional Kidney Networks are creating home therapy workstreams and tackling utility reimbursement variation but report urgent workforce and data infrastructure needs.
All four UK nations support home dialysis in principle. However, each is at a different stage of delivery, and consistency remains a challenge.
The APPKG and NKF propose a number of recommendations for the Secretary of State, NHS England, the Regional Kidney Networks and the kidney charities – these can be found on page 10 of this report.
This report is both a call to action and a roadmap for progress. With clear national backing, local leadership, and patient involvement, home dialysis can become a more accessible, equitable and sustainable option for many more people across the UK.
The benefits are clear: improved quality of life for patients, reduced costs for the NHS and a system better prepared to meet the future needs of kidney care.
The next three years are critical. With collaboration, commitment and accountability, we can achieveand exceed - the 20% home dialysis target, and in doing so, transform lives.
Home dialysis has long been recognised as a clinically effective and patient-centred alternative to in-centre haemodialysis (HD), offering people with kidney failure greater flexibility, autonomy and quality of life. Its history dates back to the 1960s when patients in both the UK and the US began dialysing at home due to limited hospital capacity. However, while early adoption was driven by necessity, interest in home therapies later waned as hospital-based dialysis became the norm, supported by growing infrastructure and specialist staff.
In the UK, the introduction of peritoneal dialysis (PD) in the 1970s and portable HD machines in the 1980s provided renewed opportunities for patients to dialyse at home. Yet, over time, uptake declined. Factors included the increasing complexity of dialysis care, limited training capacity, inconsistent funding and a clinical culture that often favoured hospital-based treatment.
Internationally, home dialysis has had more consistent support in certain countries. New Zealand, Australia, and Canada have led the way, with home dialysis rates well above 20%. In Hong Kong, more than 80% of dialysis patients are on PD, driven by policy and resource constraints in the hospital system. In these countries, strong policy incentives, investment in training infrastructure and a clear “home-first” philosophy have all contributed to success.
In the UK, recent years have seen renewed interest in home therapies. The COVID-19 pandemic highlighted the safety advantages of dialysing at home, with significantly lower infection and mortality rates compared to in-centre HD. This, coupled with rising dialysis demand and pressure on NHS capacity, has prompted fresh efforts to re-establish home dialysis as a core part of renal services.
National programmes like DAYLife and the Renal Services Transformation Programme (RSTP) now promote a home-first approach, aiming for at least 20% of dialysis patients to be on a home therapy. Many UK centres are showing progress, particularly where there is strong clinical leadership, early patient education and robust peer support. However, variation between regions remains high. In 2023, the majority of centres in England had fewer than 20% of patients on home dialysis, and uptake among Black and Asian patients lags behind White populations.
Key drivers for expanding home dialysis include:
• Patient Empowerment: Home therapies offer independence, flexibility, and better quality of life.
• Clinical Outcomes: Home dialysis can lead to improved cardiovascular health, lower infection risks, and reduced hospital admissions.
• Cost-Effectiveness: Studies show that even small increases in home dialysis uptake save the NHS millions annually.
• System Pressure: With in-centre capacity stretched, home dialysis can help reduce pressure on hospitals and ambulance services.
In conclusion, while the UK has some way to go to match international best practice, the direction of travel is clear. With the right support – training, funding, leadership and patient involvement –home dialysis can and should be at the heart of future renal care.
The All-Party Parliamentary Kidney Group Summit brought together patients, clinicians, NHS leaders and policymakers to explore progress and challenges in increasing home dialysis across the UK. The summit showcased inspiring work from renal units, revealed areas of ongoing variation, and the reason behind the variation and highlighted where political and structural support is urgently needed.
While the benefits of home dialysis - greater flexibility, improved quality of life, reduced hospital dependency and lower infection risk, as well as cost effectiveness, are widely recognised, national uptake remains low. In 2023, 52 out of 67 dialysis centres had fewer than 20% of patients on home therapies. Ethnic disparities persist, and the number of patients dialysing at home has declined, even as the overall dialysis population continues to grow.
Renal units across the UK are working hard to reverse this trend. Manchester and Derby have developed patient-centred, integrated models that put individual life goals at the heart of treatment planning. Others, like Nottingham and Berkshire, are investing in training, staff roles, and peer support. The London Kidney Network is tackling health inequalities through system-wide collaboration, and the DAYLife programme is providing national mentoring, quality improvement tools, and a shared learning platform to help more centres reach the 20% target.
However, progress is uneven and constrained by persistent challenges: workforce shortages, lack of protected leadership time, limited training facilities and inconsistent commissioning priorities.
To accelerate and sustain improvement the APPKG makes the following recommendations:
1. For the Secretary of State of Health and Social Care to respond to this report by December 2025, demonstrating his support and agreeing a target date by which at least 20% of adult dialysis patients are dialysing at home.
2. The APPKG recognises the work being done by the NKF, NHSE, UKKA, Regional Kidney Networks and DAYLife in promoting home dialysis and urges them to work collaboratively to publish and share the impact of their work annually from 2025.
3. That the patients’ voice for home dialysis is strengthened through the work of the main kidney charities - NKF, KCUK, Kidney Research UKusing the information in this Manifesto to ensure progress towards meeting the 20% target, along with a reduction in inequality of access by ethnicity and social deprivation, and that each charity publishes its impact in their annual report.
4. That the NKF provides support and guidance to those Kidney Patient Associations, which are members of the NKF, to influence change and improvement in home dialysis rates by raising the issue with trust chief executives and boards along with the support of local clinical directors, from September 2025.
5. That Regional Kidney Networks be requested to use the manifesto as a driver for change to increase home dialysis and reduce inequality and to publish their plan of action by January 2026.
6. The APPKG acknowledges the importance of peer support in increasing home dialysis and recommends that kidney charities collaborate with Clinical Directors to ensure all patients requiring Advanced Kidney Care (AKC), formerly known as low clearance clinics, have access to peer support by the end of 2027. This to be provided through well-established peer support by services, such as the NKF’s National Peer Support Service and regional services.
7. That NHS England requests Integrated Care Boards, through the evidence provided in this report, to set home dialysis targets annually in their region, thereby ensuring home therapies are prioritised in local planning and investment decisions from 2026.
8. That Regional Kidney Networks request trust CEOs, through the evidence provided in this report, to ensure there are sufficient staff appointed for home dialysis services, to provide funding for staff training and protected time for home dialysis leads, and to fund peer support infrastructure by the end of 2025.
9. The APPKG recognises the research done through the Inter-CEPt study and recommends that the key outcome regarding local cultural change, including strong leadership from Clinical Directors within the renal departments and their trusts, along with a commitment to continuous improvement are essential to increase and sustain high levels of home dialysis. It recommends all trusts to adopt this approach.
10. Regional Kidney Networks to work with their Clinical Directors to ensure that all patients are suitably reimbursed for utility costs, removing financial barriers that deter patients from choosing home treatment. It must be recognised that prompt payment by trusts is essential for disadvantaged groups.
The NKF Summit at Portcullis House marks the conclusion of a five-year campaign to increase home dialysis access. The target is for all renal centres to have at least 20% of patients on home therapies. With backing from the APPKG, the campaign focuses on driving change in Parliament, influencing NHS policy, and ensuring patient voices are central to health decisions. UK Renal Registry data confirms improved outcomes for patients dialysing at home, reinforcing the need for national action.
Since launching in 2021, the campaign has spotlighted the lower infection and mortality rates associated with home dialysis, particularly during the COVID-19 pandemic. However, progress has been slow: in 2023, 52 of 67 centres had less than 20% of patients on home therapies. Ethnic disparities remain a concern, with home dialysis rates significantly lower for Black and Asian patients. Despite overall dialysis population growth, home dialysis patient numbers have declined. Kirit emphasised the importance of leadership, resource allocation, and cultural reform. He also highlighted the role of peer support, especially through initiatives like the DAYLife programme. For real impact, the NHS and government must be held accountable, with continued parliamentary support essential to achieving sustainable change.
The LKN, covering 27% of England’s renal care, is working to establish home dialysis as a strategic priority to reduce in-centre strain. The network includes six Integrated Care Systems, seven renal units, and 36 local authorities. Interventions include developing demand and capacity models, expanding training and PD access, and improving patient pathways. A key challenge is workforce capacity, prompting calls for better investment and benchmarking. Patient engagement is integral, supported by a peer mentor scheme in partnership with NKF and Kidney Care UK. LKN is also strengthening supply chains and lobbying at system level to support wide-scale home dialysis adoption.
Key Partners in supporting change
• Advocacy for the benefits of home dialysis
• Peer support
• Robust supply chain
• Resilient provision of consumables,
• Capacity to support growth
• Ensuring quality of care remains high
• Peer-to-peer support
• Co-production and engagement within the network
• Prioritising kidney services
• Mitigate the demand for growth in hospital-based dialysis
Patricia, a transplant recipient and experienced PD patient, shared her journey through two transplants and home dialysis. Her first experience was marked by fear and poor communication; her second was empowering, with better information and support. She highlighted the flexibility, comfort, and reduced hospital visits of home dialysis, allowing her to live actively, travel, and maintain independence. Patricia dispelled common myths about PD and urged healthcare professionals to ensure all patients are informed and encouraged to explore home options. Her message was clear: home therapies offer dignity, control, and reduced NHS burden and should remain a priority.
Since 2006, Manchester has pursued a home-centred approach, driven by the need for patient flexibility and service sustainability. Today, 86% of dialysis patients in Manchester receive care outside of hospital. Innovations include extended home haemodialysis (HHD), assisted PD, remote monitoring, and datainformed planning. Manchester’s care model is built around patient choice, activation pathways, and equitable access to transplants. The TRENDs programme, launched in 2019, supports transformation in care delivery, workforce planning, and commissioning structures. Dr Mitra stressed the importance of leadership, culture and integrated policy to scale this success nationally.
As National Clinical Director, Dr Fluck addressed persistent variability in home dialysis rates - currently around 15% nationally, with some centres excelling and others lacking provision. He attributed these discrepancies to local culture and leadership, rather than national policy failures. Using Derby as a case study, he outlined how personalised care and patient-driven service design improved home dialysis uptake. Their model includes early education, shared decision-making, and strong clinical teams, reinforced by lessons from Canada. Dr Fluck called for a shift from judgement to improvement, underlining that home dialysis supports patient autonomy and life goals.
DAYLife is a national initiative aimed at increasing home dialysis access. The programme promotes clinical leadership, cultural change, and peer-supported learning. A 1% increase in uptake - just five patients per centre - could save the NHS £2.5 million annually. DAYLife supports units with mentoring, improvement projects and co-designed strategies, with pilot sites in London and the North East. It focuses on shared haemodialysis care, psychosocial support and informed decision-making. For DAYLife to succeed at scale, Dr Udayaraj emphasised the need for political will, investment in infrastructure and staffing and clear commissioning targets through Integrated Care Boards. NHS-wide prioritisation is key to unlocking the full benefits of home therapies.
Patient level benefits
• Flexibility, choice, travel
• Flexibility, choice, travel
• Improved patient outcomes
• Improved patient outcomes
• Better patient experience
• Better patient experience
• Maintains economic productivity for the patient
• Maintains economic productivity for the patient
effective
The APPKG Summit brought together leaders, clinicians, patients and policymakers united in their commitment to expanding home dialysis in the UK. Across all presentations common themes emerged: the value of patient choice, the need for cultural and structural change and the significant benefits - clinical, financial, and personal - of home therapies. The message is clear: to ensure equitable, high-quality kidney care, home dialysis must remain a national health priority.
Full presentations can be seen on the NKF’s website at: https://www.kidney.org.uk/home-dialysis-campaign-manifesto
Recent responses from 23 Renal Clinical Directors across the UK paint a detailed picture of the current state of home dialysis provision and ambitions. While many centres are actively promoting home therapies and reporting progress, others are constrained by workforce, resources or operational limitations. The submissions show that while good practice is emerging, there remains significant variation in delivery across the country.
Uptake of home dialysis varies widely. Paediatric centres such as Evelina London (65%) and Bristol (60%) report the highest proportions, where home therapy is the norm. Among adult centres, Derby (30%), Shrewsbury (33%), and Nottingham (27%) lead the way, with others such as Royal Free, Doncaster, and Wolverhampton reporting moderate uptake around 15-20%. Most centres offer a range of modalities including peritoneal dialysis (PD), static home haemodialysis (HHD), and portable options like NxStage or Physidia. A few, such as Lister and Norfolk & Norwich, are expanding home training spaces and community support, while others like Plymouth remain limited in provision due to staffing or funding.
Several centres have made clear updates to their strategies. Berkshire has revived and expanded its HHD service, recruiting dedicated staff and adopting Physidia machines. Norfolk & Norwich has developed a comprehensive pre-dialysis education pathway, supported by peer engagement and regular ‘Home Huddle’ sessions. Lister Hospital is restructuring its pre-dialysis pathways to better align patient preference with eventual treatment modality, while Nottingham and Derby have embedded home dialysis into Advanced Kidney Care (AKC) planning and expanded their training programmes.
Business cases to support further development are widespread but not always successful. Alder Hey and Plymouth have submitted requests to expand staffing and assisted dialysis options and await outcomes. Workforce constraints are commonly cited, especially in smaller units, which may hamper ambition to reach targets despite the desire to do so.
Dedicated leadership remains a critical factor. Centres like Shrewsbury, Wolverhampton, and Sheffield have assigned time for leads and report more structured planning and project development. However, many responses note a lack of formal job plan time for home dialysis leadership - especially in smaller or more rural sites. Where leadership is embedded, outcomes are notably better. The Berkshire and Norfolk models demonstrate how multi-disciplinary engagement - including vascular access, education and peer support - can produce measurable impact.
Engagement with the national DAYLife programme is mixed. Some units, including Nottingham, Sheffield, and St Helier, are actively involved, benefiting from mentoring and shared care initiatives. Others, such as Mid and South Essex or Evelina London, report little or no engagement. Several units indicate they are considering future involvement or are participating in parallel initiatives, such as chronic kidney disease pathway reforms.
Peer support and patient engagement are key enablers of growth. Doncaster, Nottingham, and St Helier highlight the use of peer mentors and patient ambassadors to build confidence and uptake. University Hospitals of Derby and Burton have introduced new starter bays and direct engagement with the home therapies team as part of standard induction. Bristol and Evelina also continue to prioritise patient choice as a core element of paediatric care planning.
Innovation is also driving progress in selected centres. Norfolk’s integrated assisted ambulatory peritoneal dialysis (APD) service and Nottingham’s shared care programme are leading examples. Leeds and Queen Elizabeth University Hospital Glasgow are using new training techniques, patient-facing video tools, and proactive clinic reviews to promote suitability. Technology such as NxStage and Physidia is making home therapy more viable for patients with limited training capacity or restricted housing.
Despite encouraging developments, several centres face familiar challenges: lack of dedicated staff, inconsistent funding and the need for better infrastructure. Units in Plymouth, Alder Hey, and Grampian cite workforce constraints as barriers to expanding home therapy. Centres like Sheffield and Mid and South Essex are struggling to secure resources for long-term sustainability despite high clinical engagement.
Overall, the Clinical Directors’ responses reflect a system in transition - where the ambition to grow home dialysis is widely shared, and the benefits well understood, but the operational capacity to realise these ambitions remains uneven. National programmes like DAYLife, consistent leadership structures, equitable funding and shared learning networks will be essential to reduce variation and support all patients in accessing home dialysis where clinically appropriate.
The individual responses can be seen in full on the NKF website at https:// www.kidney.org.uk/home-dialysiscampaign-manifesto
Information provided by the seven Regional Kidney Networks in England summarised here provides an update on current efforts, progress, and reimbursement practices related to home dialysis. The responses highlight a national commitment to expanding home dialysis as a viable and preferred option for eligible patients, aligning with national strategies for personcentred and cost-effective renal care.
The Regional Kidney Networks have established a variety of strategic frameworks and initiatives aimed at increasing home dialysis. Common themes include:
• Formation of dedicated home dialysis workstreams or subgroups, often chaired by experienced clinicians, to oversee and coordinate activities regionally.
• Integration of quality improvement methodologies and pathways to standardise care and enable greater access to home dialysis.
• Focus on education and training, both for staff and patients/carers, to ensure understanding and confidence in home dialysis options.
• Development and sharing of best practice models across units within regions to reduce variability in access and performance.
• Inclusion of patient voices through engagement with patient councils and user feedback.
An example is in the North West which operates a structured workstream led by clinical leaders, while the South West Network coordinates regular regional home therapy forums.
Progress varies significantly by region and individual units, but several positive trends and examples of success were noted:
• Some units, such as Carlisle in the North East, are already exceeding the 20% home dialysis benchmark.
• Nottingham has seen notable year-on-year improvements, with a doubling of home dialysis patients over a 12-month period.
• Royal Cornwall has tripled the number of home dialysis patients, indicating the impact of focused effort and leadership.
Despite these successes, some regions report limited progress, often citing workforce challenges, infrastructure constraints, or variability in clinical leadership between units.
Overall, networks report a growing recognition of the importance of home therapies and are increasingly able to evidence progress.
Reimbursement for utility costs incurred by patients remains a critical enabler of home dialysis. Regional responses indicate a move towards greater consistency, with efforts to standardise support.
Several regions report implementation of regionwide agreements on reimbursement, often facilitated by collaborative work between renal networks, trusts and Integrated Care Boards (ICBs).
Common reimbursement rates range from £50 to £75 per quarter, depending on the region and local agreements. For example, Shrewsbury offers £75 quarterly, while Stoke offers £50.
Some regions, such as the South West, have ensured all centres are reimbursing patients based on an agreed regional rate. In the North East, agreement on a universal rate has been informed by the NKF/RA cost calculator, ensuring transparency and fairness.
However, a few responses also highlight continued inconsistencies and a need for clearer national guidance to ensure equity for all home dialysis patients across England.
Several common challenges were noted across the networks:
• Workforce shortages, particularly in specialist nursing, limit capacity to support home dialysis expansion.
• Infrastructure and training capacity are uneven across units, with some lacking dedicated space or equipment for patient training.
• Cultural barriers persist in some areas, with clinician preference or limited awareness among patients reducing uptake.
• Data quality and access to consistent reporting metrics can hinder tracking of progress and benchmarking across networks.
To address the challenges identified by Regional Clinical Networks, several key recommendations have emerged. There is a clear need for continued investment in dedicated staff, particularly home therapy nurses and patient educators, to ensure that services can meet growing demand. National support is essential to standardise reimbursement practices and provide clear, consistent guidance on utility cost payments, helping to eliminate regional disparities. Strengthening data collection and reporting systems will enable better benchmarking and more effective tracking of progress. Expanding peer support models and developing networks of patient ambassadors can play a vital role in building confidence and motivation among prospective home dialysis patients and their carers. Finally, fostering a “home-first” culture at both national and regional levels with defined targets and clear accountability will be critical to embedding home dialysis as a mainstream, patient-centred option across the country.
Regional Clinical Networks are demonstrating a strong commitment to enhancing home dialysis provision, with many establishing dedicated infrastructure and reporting progress. While variability remains, there is a clear trajectory toward improvement. Continued national leadership, combined with local innovation and shared learning, will be key to achieving equitable, sustainable increases in home dialysis.
The full responses from the Regional Kidney Networks can be found at https://www.kidney.org.uk/homedialysis-campaign-manifesto
Across the four nations of the UK, there is shared recognition of the importance of home dialysis as a patient-centred, flexible and cost-effective modality for kidney replacement therapy. Each nation is making progress toward increasing access, though the scale and pace of change vary.
In England, home dialysis is embedded in the broader strategy of the Renal Services Transformation Programme (RSTP), which aims to reduce variation in care and improve outcomes. NHS England, in partnership with the renal community, has developed a national renal toolkit to support Integrated Care Boards and renal networks in redesigning services, with an emphasis on prevention, early intervention and equity. Although specific uptake figures are not provided, the strategic direction signals growing national support for home therapies. Additionally, a £2.1 million investment in research is currently exploring the clinical and lifestyle benefits of overnight dialysis, with the potential to expand options for patients and reduce treatment burden.
In Northern Ireland, 63 patients are currently receiving home dialysis, primarily via peritoneal dialysis (PD). The region has focused on improving access through dedicated surgical pathways for access creation, including the use of local anaesthetic procedures to increase capacity. Notably, a reimbursement policy of £50 per month is in place for patients on home haemodialysis, and efforts are underway to ensure equitable reimbursement for PD patients. A national stakeholder event is planned for 2025 to standardise reimbursement processes and improve patient awareness across all Trusts.
The Scottish Government has implemented a nationwide reimbursement policy to cover additional electricity costs for home dialysis patients, with all NHS Boards now providing support. Scotland continues to promote excellence through the Scottish Renal Registry, which monitors outcomes and supports service improvement. The government has reiterated its commitment to reducing variation in care and raising awareness of kidney disease, positioning home dialysis as part of a broader agenda to improve chronic disease management and reduce NHS pressures.
In Wales, a national target has been set for 20% of dialysis patients to be on home therapies within two years. The Welsh Kidney Network is delivering a comprehensive strategy that includes increased patient education, investment in nurse educators and expansion of home dialysis training. Wales also leads on reimbursement, offering a consistent 35p/ kWh utility rate with a calculator which has been shared across the UK.
For this fifth NKF report, the UK Renal Registry has again provided data to indicate the progress on home dialysis by centres across the UK. It was disappointing to find that the average rates for home dialysis (home haemodialysis (HD) and peritoneal dialysis (PD) have fallen steadily over the last few years. In the UK, 16% of kidney replacement therapy patients were on home therapies at the end of 2023, compared to 16.8% in 2022, 17.5% in 2021 and 17.7% in 2020. This suggests that the small increase in home therapies seen during the pandemic is not being maintained, and the rate has now fallen below the pre-pandemic level of 17% in 2019.
This overall 2023 figure of 16% is comprised 4.4% HHD and 11.6% PD patients. However, this does hide substantial variation across centres from a low of 2.7% to a high of 36.5%.
Breaking the data down for the four UK nations: the percentage of patients on home dialysis for England in 2023 was 16.5% (17.2% in 2022), in Wales 17.1%, (18% in 2022) Scotland 10.7% (12.1% in 2022) and Northern Ireland 10.7% (12.4% in 2022). This shows that all nations showed a drop in percentage provision of home therapies from 2022 to 2023.
In 2023, the number of centres below the lower 95% limit of the funnel plot (i.e. the centres not doing so well compared to the average) was 19 (compared to 17 in 2022 and 16 in 2021 – these were Aberdeen, Airdrie, Bradford, Carshalton, Colchester, Dorset, Edinburgh, Glasgow, Inverness, Ipswich, Kirkcaldy, Leeds, London Guys, Middlesbrough, Stevenage, Truro, Ulster West, Northern Ireland, and Wirral).
The number of centres above the 95% limit – i.e. the centres doing well was twelve (fifteen in 2022 and 2021). These centres were, Bangor, Birmingham, Colchester, Derby, London Barts, Mid-South Essex, Nottingham, Portsmouth, Salford, Shrewsbury, Stoke, and Wolverhampton.
There were 52 centres with less than 20% of patients on home dialysis in 2023, compared to 51 centres in 2022, 50 centres in 2021, 49 centres in 2020 and 51 in 2019.
Details of Home Therapy provision by centre, including percentages on PD and HD as well as a comparison of the data for 2020 to 2022, can be found here https://www.kidney.org.uk/ home-dialysis-campaign
Percentage of adult patients prevalent to dialysis on 31/12/2023 on home therapies (PD and HHD) by centre
Data from Exeter and Manchester Royal Infirmary were not available. London Kings data are from 30th September 2023 rather than 31st December 2023 due to incomplete data submission.
Analysis of patients on home dialysis by ethnicity (excluding Scotland because of lack of ethnicity data) shows a very similar pattern of inequality as that seen since 2020. Home therapy rates were as follows: White patients 17.6%, Black patients 12.5%, Asian patients 13.7%. Asian dialysis patients were less than half as likely to be on home HD than White patients (2.3% compared to 5.5%) but there was a smaller difference in PD rates (11.5% and 12.1% in Asian and White patients respectively).
Differences in uptake between Black and White patients were evident for both types of home therapy, with 3.6% of Black patients on home HD and 8.9% on PD.
Most centres have a small number of ethnic minority patients, so centre variation is difficult to look at. However, when looking just at centres with a larger number of ethnic minority patients, the differences in home therapy rates are slightly larger than those seen at a national level.
There were 11 centres which had more than 100 Asian patients on dialysis in 2023. Across these centres, 12% of Asian patients were on home dialysis compared to 18.3% of White patients. This is slightly larger disparity than is seen nationally, suggesting that a larger Asian population does not facilitate better uptake of home therapies in this group.
The highest proportion of Asian patients on home dialysis was at the Royal Free Hospital in London at 19.6% - an increase on the 18.5% reported in 2022 but lower than the previous two years. The lowest was Bradford at 5.7% - a decrease from 8.9% in 2022.
There were 8 centres which had more than 100 Black patients on dialysis in 2023. The data shows that 11.7% of Black patients at these centres were on home dialysis compared to 19% of White patients. Again, we see a bigger ethnic disparity in home therapies uptake at these centres serving higher numbers of Black patients than we do nationally. The highest percentage of Black patients on home dialysis was Birmingham at 17.2% (down from 19.5% last year) and the lowest was Guys Hospital London at 6.5% (down from 7.0% last year)
Peritoneal Dialysis (PD), home haemodialysis (HHD) and total home therapies (HT=PD+HHD) by centre, prevalent patients from 2020 to 2023
Data from Exeter and Manchester Royal Infirmary (2023 only) were not available. London Kings data are from 30th September 2023 rather than 31st December 2023 due to incomplete data submission.
Dialysis (PD), home haemodialysis (HHD) and total home therapies (HT=PD+HHD) by centre, prevalent patients from 2020
Data from Exeter and Manchester Royal Infirmary (2023 only) were not available. London Kings data are from 30th September 2023 rather than 31st December 2023 due to incomplete data submission.
Peritoneal Dialysis (PD), home haemodialysis (HHD) and total home therapies (HT=PD+HHD) by centre, prevalent patients from 2020 to 2023
Table 1 - Home therapies by ethnicity and nation, prevalent patients at 31st December 2023
Data from Scotland have been excluded due to missing data. Data from Exeter and Manchester Royal Infirmary were not available. London Kings data are from 30th September 2023 rather than 31st December 2023 due to incomplete data submission.
Table 1: Rates of home therapies amongst dialysis patients were higher in White patients (17.6%) than in Black patients (12.5%) or Asian patients(13.7%). Comparing Asian to White patients there was a large difference in Home HD (2.3% compared to 5.5% in White patients), and a smaller difference in PD rates (11.5% and 12.1% in Asian and White patients respectively). Black patients have lower rates than White patients for both types of home therapy (3.6% for Home HD, 8.9% for PD). Results are very similar to 2022.
Tables 2: Most centres have a small number of ethnic minority patients, so centre variation is difficult to look at. When we look at centres with at least 100 Asian patients, the difference in home therapy rates that is seen at a national level persists (see table above).
Tables 3: Most centres have a small number of ethnic minority patients, so centre variation is difficult to look at. When we look at centres with at least 100 Black patients, the difference in home therapy rates that is seen at a national level persists (see table above).
Peritoneal dialysis (PD), home haemodialysis (HHD) and total home therapies (HT = PD + HHD) by centre, prevalent patients at 31st December 2023
Data from Exeter were not available. Manchester Royal Infirmary data are from 30th September 2023 rather than 31st December 2023 due to incomplete data submission.
DAYLife is a national, clinically led quality improvement programme designed to increase access to home dialysis therapies across the UK. Its core aim is to reduce regional variation, promote equity, and support kidney centres to deliver the right treatment, to the right patient, at the right time. At its heart, DAYLife seeks to create the infrastructure and leadership required to embed a home-first culture throughout renal services.
The programme calls for all UK kidney centres to actively participate in structured improvement work by December 2025, with the goal of achieving a minimum of 20-25% of patients on home dialysis by December 2027. Centres already achieving this target are encouraged to demonstrate further yearon-year improvements.
DAYLife’s approach is co-designed with patients and professionals, focusing on four key workstreams: Shared Haemodialysis Care, Psychosocial Support, Shared Decision Making and Peer Support. These areas form the backbone of dedicated learning hubs offering resources, evidence of impact and communities of practice.
Core activities include developing and testing ‘change ideas’, establishing multidisciplinary working groups, expanding QI leadership through training and mentorship, and launching a national home dialysis dashboard to track progress.
A central hub also enables centres to share learning, connect with peers and access patient education materials.
The programme is supported by key national partners, including the NKF, UKKA, Kidney Care UK, and Fresenius.
Through coordinated effort and culture change, DAYLife is helping to make home dialysis a realistic and supported choice for more patients – improving outcomes, enhancing patient experience, and building a more resilient kidney care system.
Peer support is a highly valued component of care for people with kidney disease and specifically from those looking to dialyse at home. The NKF’s Peer Support Service was established in 2021 and there are 27 peer supporters all of whom are experienced and trained. 197 patients/carers have been supported.
Peer support offers benefits that go beyond clinical outcomes into emotional well-being, confidence, and long-term treatment success. It plays a crucial role in both encouraging patients and their carers to choose home dialysis and helping them sustain it over time.
The value of Peer Support includes:
Improved Decision-Making: Many patients report feeling overwhelmed when first told they need dialysis. Hearing directly from someone who has lived experience - someone who has chosen and managed home dialysis - helps them make informed, confident decisions. Peer supporters provide practical, relatable insights that clinicians cannot always offer.
Increased Confidence and Independence: Home dialysis can feel daunting, especially in the early stages. Peer support helps demystify the process, reduce fear, and build confidence. Patients often say, “If they can do it, I can too.” This reassurance is especially important for people managing home dialysis alone.
Reduced Isolation: Dialysing at home can be physically and emotionally isolating. Regular contact with a peer supporter offers social connection, reduces loneliness and helps people feel part of a broader kidney community.
Better Long-Term Outcomes: Patients who are well-supported are more likely to stick with their therapy, avoid unnecessary hospital admissions, and maintain a better quality of life. Peer support has been linked to improved treatment adherence and reduced anxiety.
Practical Problem-Solving: Peer supporters often help with day-to-day tips - how to organise supplies, manage travel, or adjust to life on dialysis. These practical insights complement clinical advice and can prevent small issues from becoming major obstacles.
Peer support empowers patients and their carers, reduces psychological stress, promotes selfmanagement, and contributes to a more personcentred, sustainable home dialysis pathway. For many, it’s the difference between feeling afraid and confident and coping and thriving.
The LOCAL (Location of Dialysis Care in Kidney Life) intervention is the outcome of a threeyear Inter-CEPt study that tackled persistent, unjustified variation in home dialysis uptake across the UK. Despite the known clinical and lifestyle benefits – and support from NICE and patient organisations – many centres still see low uptake, especially among ethnic minority and socioeconomically disadvantaged groups.
The study found that variation wasn’t driven by patient need or clinical criteria, but by local culture and leadership. Centres with proactive clinical leadership, patient-centred care, and a focus on quality improvement were significantly more successful in supporting home therapies.
LOCAL proposes two key strategies:
1. Service Improvement Initiatives
Centres are encouraged to engage in structured quality improvement – locally, regionally or nationally. This includes better shared decisionmaking, addressing unconscious bias, engaging underserved communities and ensuring equitable access to home therapies.
2. Dedicated ‘Location of Care’ Roles
Specific roles within kidney care teams would lead the integration of home dialysis into care pathways. These individuals would champion patient engagement, connect with national resources, remove service barriers, and support peer mentoring and assisted peritoneal dialysis (PD).
Additional initiatives include home dialysis roadshows, assisted PD services and community outreach – adapted to each centre’s needs.
Rather than impose blanket targets, LOCAL focuses on creating the right clinical, cultural and organisational conditions for informed patient choice. For many, this will mean home therapy – if the system enables it.
Economic modelling shows home dialysis is costeffective and enhances quality of life. Funding QI work and dedicated roles is likely to be affordable and valuable for the NHS.
LOCAL is a flexible, scalable framework to promote equity, reduce variation and increase access. With investment in leadership and patient empowerment, home dialysis can become a real, supported option for many more people.
Nicholas’s story is proof of the life-changing power of home dialysis. It gave him back control, allowed him to keep living on his terms, and helped him prepare for the next chapter with confidence and strength.
Nicholas Papé’s journey with kidney disease began in 2007, when a routine test unexpectedly revealed kidney damage. At the time, he was 31, newly married, and raising a young family. While he was told he would eventually need treatment, he spent the next decade living a ‘normal’ life - carrying the knowledge of his condition like a shadow but not truly confronting it.
Nicholas’s life was full on and busy and he didn’t feel ill. He felt he didn’t have time to process what was happening and the potential impact. In his words “I buried it and got on with life.” He worked hard to live a healthy life.
It wasn’t until 2018, when a consultant told him he had roughly five years of kidney function left, that the seriousness of his condition hit home. The news brought a wave of emotional and mental strainreminding Nicholas that kidney disease affects far more than just the body. He was still feeling fit and well but was increasingly fatigued which he wasn’t sure was just about ageing.
By 2021, Nicholas’s kidney function had dropped below 20% and discussions began around dialysis and transplant. After being listed for transplant in late September, Nicholas spent months anxiously waiting for ‘the call,’ all while his health continued to decline. In January 2022, with kidney function at 9%, Nicholas started peritoneal dialysis (PD). “I wanted to be busy living and to’ dialyse for life’ – not to be scared and ‘living to dialyse’. Dialysis had to work around me, not me living around dialysis. I pushed myself because I wanted to maintain my freedom despite my kidney disease. I learned a lot at this time – about kidney disease and about myself.”
Although PD was initially difficult, it quickly became a vital part of Nicholas’s life-giving him a renewed sense of control and autonomy. Unlike in-centre haemodialysis, PD could be done at home, on his own schedule, and even while travelling in a camper van. This flexibility allowed Nicholas to continue working, stay engaged with his growing family and their activities and plan holidays - something many dialysis patients feel they have to give up. PD wasn’t just a treatment; it was a way of preserving life’s normal routines and joys, of staying in control. Nicholas managed his PD so well that he found he was able to take a day off occasionally. He lost weight and his regime was working. >
Nicholas also used his time on PD to set a personal goal: walking 1000km to raise awareness of kidney disease and the average 1000-day transplant wait. By the time he received a kidney from a deceased donor in July 2022, he had already walked 700km and raised thousands for his local Kidney Patient Association - Lister Area.
Nicholas worked with the head of home therapies to determine the best ways to support others going through the same experience – working on an app so that he could see his results in real time.
The transplant, which Nicholas refers to as ‘Life 2.0,’ transformed his life. After years of uncertainty, isolation and slow physical decline, he felt revitalised - his blood results returning to near-normal levels, his eyesight improving and his outlook improving dramatically. He has since resumed full-time work, continued walking, and looks forward to future challenges that celebrate the ‘gift’ he received.
“My success and independence have been closely tied to the control and autonomy home dialysis provides. While a transplant marks a new chapter, it still requires the same self-discipline and personal responsibility. I’m thankful to have chosen a path that supports this way of life and secures my future.”
Nicholas’s story illustrates the profound impact home dialysis can have. For patients navigating the uncertainty of chronic illness, it offers more than just a clinical solution -it offers independence, hope and the chance to keep living while waiting for life-changing opportunities like transplant. His experience stands as a testament to the power of home therapies to give patients control over their illness - and their future.
Christine Price, a renal nurse since the 1970s, offers a rare and deeply personal insight into the long-term benefits of home haemodialysis. Her late husband, Bob, began dialysis in 1981 and continued for more than 40 years - almost entirely at home. Together, they built a life shaped by flexibility, resilience, and a determination to live fully in the face of chronic illness.
Christine met Bob while working on Oxford’s pioneering renal unit, where home haemodialysis was then standard practice. From their early days together, it was clear that home therapy would be the cornerstone of their shared life. “We could plan around dialysis,” Christine says. “We weren’t refusing anything - we just fitted it in.”
That flexibility made it possible for Bob to work full-time and for the couple to travel extensively. Using early portable dialysis machines like the Tech Med and Ready, they explored Europe year after year - Austria, Holland, Sicily, France, Menorca, Crete, and more. They arranged treatment abroad through Eurodial, navigated difficult logistics, and even used a community-supported dialysis facility in Bournemouth. “I was passionate about travel,” Christine reflects, “and determined we would live the life we wanted.”
Home dialysis also provided a crucial sense of control. Bob avoided hospital-acquired infections and had just one fistula for his entire dialysis journey. “He never got norovirus, COVID, or flu,” Christine says. “He stayed well because he was in control. And being in control gave him dignity.”
But Christine is candid about the pressures. As Bob’s carer and nurse, she managed dialysis around night shifts and later on, her own health challenges. “It is stressful for the partner - there’s no getting away from that.” Still, she credits the Oxford Home Haemodialysis Team with providing excellent clinical support and emotional reassurance over the years. Christine also described how home haemodialysis removed the worry she had associated with hospital dialysis. “There are sometimes exhaustingly long waits for hospital transport. On the rare occasion that Bob dialysed in the unit I was always most concerned with his drive home. I would say that no one is safe to
drive home following hospital dialysis. Post dialysis fatigue is less severe in the home environment and allows the individual to rest immediately after dialysing and this means being able to resume family life more quickly - a win-win situation.”
Bob’s final years were not without hardship. Christine describes his growing fatigue and emotional withdrawal - signs, in retrospect, of undiagnosed pancreatic cancer. Bob passed away in 2022.
In reflecting on their journey, Christine calls for more comprehensive psychological support - not just for patients, but for families. “Every family living with kidney disease should be offered an annual check-in - a non-confrontational chance to talk about how the year has been.”
A final thought from Christine is that age should not be a barrier to home dialysis – “Many over 70s are very fit today and our attitudes to ageing and life experiences have really changed over the last 10 to 15 years.”
Christine’s message is clear and heartfelt: home dialysis gave her and Bob the gift of life on their own terms. It enabled work, travel, connection, and control. “The greatest takeaway,” she says, “is that being in control leads to a better quality of life. With the right support, more people could benefit. It takes courage – but it’s worth it.”
Kirit is a kidney transplant recipient since 2001. He is Hon President of the National Kidney Federation (NKF) and the NBTA (National BAME Transplant Alliance), Chair of the Lister Area Kidney Patients Association (LAKPA) and on the Advisory Board of the Jain and Hindu Organ Donation Alliance (JHOD). He has frequently spoken at the All-Party Parliamentary Kidney Group and has written two Manifestos for Change; on BAME issues and on living kidney donation. He has been involved in developing the Community Investment Scheme with NHSBT since its inception. He is a member of the Organ Utilisation Implementation Group. Kirit received a Points of Light award from the Prime Minister for his work on organ donation in 2018 and an MBE in the Jubilee Birthday Honours in 2022.
Richard is a Consultant Nephrologist based at Hammersmith Hospital in West London. He is a Clinical Lead within the London Kidney Network, with a particular focus on improving access to dialysis at home for people living with kidney disease.
Dr Suzanne Forbes is a consultant at Barts Health and is currently the Clinical Lead for Dialysis and Home Therapies. She has been responsible for expansion of home therapies across East London and has a passion to ensure all patients are offered the choice of home based dialysis.
She is currently appointed as a Clinical Lead in the London Kidney Network, with a key role in supporting home therapies growth throughout London and in managing the increasing challenges of Dialysis Capacity. She is on the Education Board of the Dialysis Society and is a member of the UKKA haemodialysis steering group.
Suzanne also has a strong focus on education, having transformed the Renal Department education programme. She now holds the position of deputy Director of Medical Education at the Royal London Hospital.
Patricia is a double transplanted kidney patient and has twice chosen to dialyse at home with peritoneal dialysis (PD). At the time she felt that it was the best type of treatment for her because she was still in full time employment as a principal housing manager and college lecturer. PD provided her with the flexibility to be in her own home whilst surrounded by family members. She self-managed her therapy sessions at a time that suited her, usually at night. This enabled her to maintain her independence during the day to do what she wanted.
Patricia said: “Just over a decade ago, there was hardly any education on kidney failure or dialysis. My mantra is ‘no one knows a kidney patient like a kidney patient’. I understand what people are going through - I have experienced the doubts… the worry… the fear. As a peer supporter for the NKF I aim to take away some of the anxieties a person has in the early stages of diagnosis. Please use our Peer Support Service, we are here for you!”
Professor Sandip Mitra is Consultant Nephrologist at Manchester Royal Infirmary and University of Manchester. He is the Clinical and Governance lead for Haemodialysis Therapies at Manchester University Foundation Trust, overseeing one of the largest Home Haemodialysis Programmes in Europe and Vice-Chair of the European Dialysis Board (EUDIAL).
Prof Mitra is the President-elect of the International Society of Haemodialysis. He has served in NHSE as Ex-Clinical Chair for Renal Services Clinical Reference Group and Renal Networks NHS England and ex-National Clinical Advisor for the Renal Transformation Programme. His research has been in dialytic therapies at the University College, London, Royal Free Medical School. Prof. Mitra is the National Chair for NIHR Research in Hospital settings and Deputy Director at the NIHR: HealthTech Research Centre (HRC) in long term conditions supporting patient centred innovation in medical devices in the UK. He serves as a Trustee of Kidneys for Life.
Richard qualified in Medicine in 1985, studying at Trinity Hall, Cambridge and the London Hospital Medical College, Whitechapel. After training in the London and Essex area, he undertook research at Bart’s, then took up a post as a Lecturer in Medicine at the London Hospital. In 1996, he moved to Derby as a consultant renal physician, looking after people with various kidney problems. He is widely published on dialysis, chronic kidney disease and acute kidney injury, building a renal service in Derby that is now a highly respected centre for excellence and research worldwide.
He has been a national director in NHS England for over a decade and continues to be a clinician. The COVID-19 pandemic delayed retirement plans, and he still works part-time in Derby and nationally. He is also undertaking an MA in history as part of a retirement strategy, but the juxtaposition of health and history is a fertile area to continue exploring.
Dr Udaya Udayaraj is a Consultant Nephrologist, currently employed with Oxford University Hospitals NHS Trust. He leads the peritoneal dialysis programme, and the Audit and Quality improvement programme at Oxford Kidney Unit. He is the co-lead for KQIP and the national lead for DAYLife (Dialysis at Yours: Life Fulfilled) programme that has been established to enable more patients to dialyse from home in the UK. He is a strong advocate for patient involvement in service delivery and improvement initiatives and has co-designed several local and national initiatives with patients.
The NKF would like to thank the many people from across the UK who have been involved in the campaign to increase home dialysis rates for the past five years.
While we couldn’t mention everyone we must thank the hard work of the NKF Home Dialysis Subcommittee which is comprised Brian Child, David Coyle, Andrea Brown, Kirit Modi MBE, Ros Aird, Soumeya Bouacida, Pete Revell, Donna Blizard, Fiona Broomhead and Sharney Warren.
We would also like to thank the speakers who presented their work at the APPKG Summit and with whom we have worked over the life of the campaign: Dr Richard Corbett, Dr Suzanne Forbes, Dr Richard Fluck, Patricia Gooden, Dr Sandip Mitra and Dr Udaya Udayarj
Our thanks also go to…
Clinical Directors and their teams at the renal units across the UK have provided data in support of the campaign for the past four years. Without their contribution we would not have the evidence to support the campaign.
The Regional Kidney Networks for their response to requests for information about their work and their efforts to share good practice and learning.
The four governments of the United Kingdom for their responses.
The UK Kidney Association and the UK Renal Registry for their work on the data which supports the campaign. Particular thanks go to Retha Steenkamp and Shalani Santhakumaran.
The Kidney Patient Associations (each of which are staffed by volunteers) across the country for their support of the campaign and for giving us the local perspective as well as recognising their work with their respective clinical teams to get us the answers we needed.
The DAYLife programme continues the campaign to increase home dialysis with the NKF as a partner alongside UKKA, Kidney Care UK, and Fresenius.
Thanks to Vantive for their independent grant towards to production costs of this manifesto.
This report was written by Annie Taylor and designed by Chris Marsden.
This manifecto was produced with the support of an independent grant from Vantive. Vantive had no editorial control over the content.