Correspondence from the Devolved Governments

E : clinical.priorities@gov.scot

Andrea Brown andrea@kidney.org.uk

Response from Scottish Government

Our Reference: 202200287697

29 April 2022

Dear Andrea Brown,

Thank you for your email of 11 March 2022 regarding your report - Increasing Home Dialysis in the context of COVID-19 - One Year On. I am responding on behalf of the Cabinet Secretary for Health and Social Care. Please accept my apologies for the delay in responding.

I want to assure you that the Scottish Government is committed to ensuring that people living with kidney disease are able to access the best possible support and benefit from healthcare services enabling individuals to access the right care for them in the right place.

Renal units in Scotland are supportive of home dialysis where it is clinically recommended and individual circumstances allow. In Scotland we are at the forefront of using service and performance data to improve care and diagnosis of kidney disease. This includes the work of the Scottish Renal Registry which reports on patients receiving renal replacement therapy and promoting excellence in renal care in Scotland through best practice audits.

We understand the impact the COVID-19 pandemic has had the people of Scotland, especially those living with a long-term condition such as kidney disease. As we begin to emerge from the pandemic we are committed to taking action to support our NHS. Last year we published our Recovery Plan that sets out our plans for health and social over the next 5 years. The plan is backed by over £1 billion of funding and will l support an increase in inpatient, daycase, and outpatient activity to address the backlogs of care, which will be supported by the implementation of sustainable improvements and new models of care. It is our intention that this investment and these actions will lead to improved NHS care and services for everyone in Scotland, including people with kidney disease.

Yours sincerely

I hope you find this information helpful.

Yours sincerely

St Andrew's House, Regent Road, Edinburgh EH1 3DG www.gov.scot

Sharon Robertson Policy Manager

Sharon Robertson Policy Manager

Y Grŵp Iechyd a Gwasanaethau Cymdeithasol Health and Social Services Group

Response from Welsh Government

Dear Andrea,

Increasing Home Dialysis in the context of COVID19 – One Year On

Thank you for your letter of 11 March on behalf of the National Kidney Federation regarding home dialysis kits for kidney failure patients during the COVID-19 pandemic.

I hope I can assure you that we are committed to offering home dialysis to more patients in Wales. We already have higher rates of home dialysis than the UK average and are looking to build on this significantly.

We are also aware of the higher risks from COVID-19 for those receiving unit dialysis as compared to home therapy and this has been the subject of discussions at the Welsh Renal Clinical Network Board (WRCN). A ‘Pathways to Home’ strategic model is now being put in place to increase access to home dialysis and reduce unwarranted variation of uptake within the health board localities.

This model has been evolving from a co-produced research study led by Dr Gareth Roberts, Consultant Nephrologist and Clinical Lead, WRCN. This research was designed to gain a fuller understanding as to why the majority of patients ‘opt’ for unit dialysis as a first choice and what service barriers need to be addressed to facilitate a ‘home first’ approach.

A review of the National Framework for Home Dialysis is underway as well as a review of Service Specifications to ensure alignment to the home dialysis strategy. An All Wales Education group has also been established with the aim of coordinating the collaborative co-production and maintenance of a comprehensive suite of resources for all kidney patients and supporting healthcare professionals in Wales.

WRCN is also collaborating regularly with kidney charities to provide newsletters containing home dialysis content. Local kidney cafés for home dialysis will provide information on home dialysis, and peer support for current home dialysis patients and those choosing renal replacement options.

I hope this information is helpful.

Yours sincerely,

CAROLINE LEWIS Tîm Polisi Gofal Iechyd Seiliedig ar Werth – Value Based Healthcare Policy Team Gofal Iechyd Poblogaethau – Population Healthcare