Ann Keen MP
Parliamentary Under-Secretary of State for Health
Department of Health
15 December 2009
I was delighted to read yesterday the above report and wanted to write to you to express the support of the National Kidney Federation (NKF) for the recent improvements that have been made in kidney care. The NHS should be congratulated for the advances it has made in the areas of the detection and management of chronic kidney disease and for the expansion of dialysis capacity through the increasing number of main and satellite units.
I was particularly heartened to read the Secretary of State’s call in support of more home dialysis (HD), in line with his statement at the recent ‘Britain Against Cancer’ conference that the wider availability of HD is something we should be able to “just get on and do.” The NKF fully supports this view but more needs to be done to ensure that NICE guidance — which envisaged up to 30% of patients could be eligible for home haemodialysis — is followed. After all, home dialysis in both haemodialysis and peritoneal dialysis is cheaper for the NHS, provides a better quality of life and, most importantly, extended life expectancy for patients.
The key issue facing us now is how to translate this ambition into practice. While the NKF would of course always be supportive of increased dialysis capacity in the NHS. I was nevertheless concerned to see from the report that the organisation’s focus remains on how to provide care in renal units, rather than in the home. For example, the report cited Ashfurlong Dialysis Centre as a ‘potential solution’ to the problem of ‘haemodialysis in primary care premises’ which suggests that the Department remains wedded to the costly, centralised model of kidney care. It must be recognised that, as innovative as this centre is, it will only provide dialysis for patients three times a week. Patients dialysing at home can do so both more frequently and for longer. I am afraid that the expansion of such centres cannot bring the benefits to patients highlighted above.
The NKF passionately believes in the need for the wider availability of home dialysis and I wanted to inform you about the latest project we are undertaking to make this a reality for kidney patients. We are currently in the final stages of setting up the ‘Home Dialysis Working Group’ — bringing together Parliamentarians, patient groups and clinicians — to examine current levels of access to home care and make recommendations on how this can be improved. I will certainly keep you updated about the progress made by the Working Group and I would also be delighted to meet you in person to discuss in more detail what can be done to help the NHS deliver on its ambition to increase the treatment options for dialysis patients.
Chief Executive, National Kidney Federation
cc: Andy Burnham, Secretary of State for Health
Dr Donal O’Donoghue, National Clinical Director for Kidney Care
Campaigns — Renal NSF
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