Holiday guide for kidney patients

Dialysis away from base

As a result of haemodialysis, patients needing their treatment at least three times per week, or peritoneal dialysis daily, travelling will involve the need to plan and arrange for dialysis to take place whilst away. This is called dialysis away from base (DAFB) and will require some forward planning to put in place the necessary arrangements. DAFB is recognised as part of the package of care for all renal dialysis patients.

NHS England has produced a Policy Statement setting out the arrangements for funding of this treatment, together with the responsibilities of renal units and patients when arranging dialysis away from base.

This document (published February 2016) can be viewed if you Click here

Who pays?

Within the European Economic Area (EEA) patients can use their European Health Insurance Card (EHIC) within a state run hospital (not a private unit) for their dialysis treatment but will need to check first if there will be any contribution to be paid.

For privately run units in an EEA country patients may claim reimbursement from NHS England under the EU Directive known as Article 56 but only up to the cost of the same treatment under the NHS.

The UK have a reciprocal agreement for health care with some countries outside the European Economic Area and dialysis should be free, or partially free, under the agreement. Different countries will ask for different proof of residency and this must be discussed with both your existing home unit and the overseas unit before booking.

Dialysis when cruising is not included under the NHS England healthcare agreement. However, a discretionary reimbursement for dialysis on board a cruise ship may be made under Article 56 if treatment takes place within the EEA boundaries or in a country with which it has a reciprocal agreement. Again, a reimbursement will only cover the cost of the same treatment under the NHS, and NHS England will reimburse the patient’s home unit, who will then reimburse the patient.

Where to find help

In accordance with NHS guidance, renal units are responsible for helpling patients to make their arrangements for DAFB. Any spare places within the renal unit should then be made available to any patients who may wish to visit their area.

IMPORTANT : From time to time the funding of DAFB may be reviewed so it is imperative that funding arrangements MUST ALWAYS be made in advance.

Finding a dialysis unit

Finding a suitable dialysis unit abroad is not particularly easy. There are websites to help you. Global Dialysis is available by visiting Global Dialysis and also Dialysis Maps A search of the country and area where you wish to travel can be carried out. This will bring up a list of renal units but you will need to find out more details from the unit directly. The NHS will give advice about infection control and the risk of blood borne viruses within renal units but it will not be possible to give complete assurance regarding the service and level of risk in renal units outside of the UK.

You may be required temporarily to have your haemodialysis treatment in isolation on your return after visiting a dialysis unit abroad or in a different renal unit. A temporary suspension from the transplant list may also be necessary to ensure that the patient is clear of blood borne viruses.

Peritoneal dialysis fluid

The Renal Unit will help to make the necessary arrangements for your peritoneal dialysis fluids to be delivered to your holiday destination. They will ensure that the equipment you are taking with you for your DAFB is fully insured, either by the supplier company or the renal unit, and help you to check the airline policy on travelling with this equipment.

Always check in advance with your destination that they are happy to receive your clinical supplies on your behalf. Deliveries are usually made two working days before the patient travels.

Travel Insurance

You will need separate insurance cover as well as your European Health Insurance Card, which will only cover you for emergency treatment. You must declare your pre-existing medical condition and answer all questions put to you. It is important to read the small print in your policy. Please note that your dialysis treatment may not be covered by the insurance. Problems which might arise from your treatment will be the responsibility of the renal unit and you cannot claim against your insurers for any matters arising from negligence in the renal unit.

Please contact the NKF Helpline for a list of insurance companies who are willing to insure patients with pre-existing medical conditions. contact the free to call Helpline number 0800 169 09 36

Fitness to fly

If you need to request assistance at the airport you may be asked to provide a certificate of your fitness to fly. If your medical condition is stable, then you should not need to do anything. You may be asked to provide medical proof of your fitness to fly from your doctor.

When travelling with a Carer the airline should not separate you from your carer if you will need their help and every effort should be made to allow you to sit next to each other.

Travelling with medical equipment, needles and medications

You shoud always ask your airline before you book what their policy is on travelling with your medical equipment, needles and medications. Each airline will have different restrictions or procedures for this and some will require a form to be filled out. Most Airlines will have a specific form which you will need to complete with the details of your medical equipment and requirements. These will need to be shown at the airport Security. (For more information on this see page 4)

You’ll need supporting documentation from a relevant medical professional (for example a letter from your doctor or a copy of your prescription). The same applies for gel packs. This will need to say why you need these items.

The amount of liquid medication you’re allowed to take in your hand luggage is subject to current security advice. The letter from your doctor will help with this.

Keep all medications, syringes and medical equipment in their original packaging.
Airport staff might need to open the containers to screen the liquids at the security point.

You must always let the cabin crew know when you need to use a hyperdermic needle. They will provide a sharps box for safe disposal of the needle. Cabin crew are not allowed to administer any medications or injections.

IMPORTANT : Make sure that you carry sufficient supplies of insulin in your cabin baggage, rather than in your hold luggage. Insulin may be inactivated if carried in the hold due to freezing temperatures.

Travelling with a dialysis machine

Please contact your airline at least 48 hours before you travel if you require advice concerning any medical requirements you may have.
Your dialysis machine should not be charged as excess baggage .
Equipment must be battery operated as a power supply cannot be guaranteed on board the plane.
You may not be able to use your dialysis machine on board. You cannot use equipment during taxi, take-off, approach and landing.

Airport Special Assistance

Airports have strict policies on travelling with medical equipment and medications. You may need assistance at the airport and this needs to be arranged 48 hours before your flight. In some cases you might need to download a Special Assistance Form from their website

Below is a list of contact details to arrange Special Assistance for some of the main UK airlines :

British Airways 0208 738 5444
Thomas Cook Customer contact centre 0800 107 3409
Jet2 0800 408 5591
EasyJet 0800 998 1130
Virgin Atlantic 0844 481 4455
RyanAir 0871 246 0002
FlyBe 0207 3080812