Vital guidance has been launched today in a new report ‘Dialysis Transport – finding a way together’. The report is the work of the Dialysis Transport Working Group, a coalition of patient organisations; Kidney Care UK, the Renal Association, the British Renal Society and the National Kidney Federation.
Guidance is needed because 50% of all non-emergency patient transport paid for by the NHS is for dialysis patients, yet until now there has been no specific guidance in place to support commissioners and patients.
25,000 people have haemodialysis treatment in hospitals or satellite units and on average patients have over 300 journeys every year to and from their dialysis. Many report poor experience and the national survey of Patient Reported Experience Measures (PREM)1 shows that transport has the greatest variance of all experiences measured.
Research conducted by the Dialysis Transport Working Group shows why guidance is needed; despite costing up to £250m per year, only half of responding units reported that eligibility criteria for patient transport were being used; only 60% of services utilise key performance indicators; there are differences between units in how transport is organised; and there are also different policies for the reimbursement of patients.
Key recommendations from the report are:
- Transport to and from a dialysis unit is considered part of the episode of care – and transport should be co-ordinated around the patient
- No patient should contribute to treatment costs by paying for transport – self-funding is against the NHS constitution as it would mean charging patients for a component of their care
- Patients should be enabled to control their own transport – each patient should have a care plan that includes their transport requirements and how these are delivered
- Clinical services, commissioners and providers should work together to ensure good and cost viable services – Map and zone patients so they receive treatment in their nearest and/or most accessible dialysis unit and ambulance based non-emergency patient transport should be limited to patients with a medical need
- Key performance indicators (KPIs) should be used to ensure the service achieves what is set out in the contract – these should be developed and agreed by all partners including patients and a regular monitoring structure involving all partners, including patients, should be used.
Fiona Loud, Policy Director at Kidney Care UK, said: “If you are one of the 25,000 people having haemodialysis at a unit then it is likely that you will rely on patient transport to get to your vital treatment. We consistently hear from patients that transport to and from dialysis is one of the most important issues affecting their quality of life. We’re delighted to launch this guidance and hope it provides a framework for commissioners to enable them to provide the best service for patients and the NHS.”
Steve Double, MP for St Austell and Newquay whose constituents contacted him when their patient transport was under threat of changes in 2017 commended the report. “Transport is integral to kidney care; timely, safe and well-planned transport which is jointly commissioned and monitored by those who understand it, and enables patients some control is the way forward.”
Professor Paul Cockwell, Clinical Vice President of the Renal Association who co-authored the report, added: “By following this guidance current variance should be addressed, and the experiences and quality of life of people with kidney failure who need unit-based haemodialysis improved. The standards are focused on quality and applicability, while ensuring value for the NHS.”
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