Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the potential implications for his policies of the report by Kidney Care UK entitled Left Out in the Cold, published on 30 March 2023; and if he will take steps to reduce the variance of home dialysis reimbursement payments made by NHS trusts.

There are no plans to undertake an assessment of the potential merits of standardising reimbursement for all types of home dialysis, or to reduce variance in payments. Commissioned renal providers in England have a contractual obligation to reimburse the additional utility costs for patients who receive home haemodialysis therapy, as stipulated within the national Haemodialysis to treat established renal failure performed in a patients home service specification and the Paediatric medicine renal service specification, and reimbursement costs are managed directly between providers and patients. Currently, information about patients seeking reimbursement costs is not collected centrally. Further information on the Haemodialysis to treat established renal failure performed in a patients home service specification and the Paediatric medicine renal service specification is available, respectively, at the following two links:

https://www.england.nhs.uk/wp-content/uploads/2018/08/Haemodialysis-to-treat-established-renal-failure-in-the-home.pdf

https://www.england.nhs.uk/long-read/nhs-standard-contract-for-paediatric-medicine-renal/#:~:text=The%20aim%20of%20the%20service,progression%20of%20disease%20where%20possible

Increasing access to home therapies is a priority for NHS England and this is reflected in its inclusion in the Renal Transformation Toolkit that was published in 2023, which recommends that 20% of all patients on kidney replacement treatment should receive treatment at home.

Commissioned renal clinical networks across England have included improving access to home therapies in their work plans as per the recommendations within the toolkit. The NHS England national team supports renal clinical networks with the implementation of home dialysis transformation.

The renal clinical networks and the renal services clinical reference group are providing input into the Department’s 10-Year Health Plan development process. As part of this, it is highlighted that increasing home dialysis provision will reduce in-centre dialysis demand and this will shift care from a hospital to a community setting. Renal clinical networks are working towards increasing home dialysis rates in line with the Renal Service Transformation Programme Toolkit’s recommendations.