Passed by the NKF September 1997 (Amended 2008 and Nov 2019)

The National Kidney Federation deplores the inequality of access to life-enhancing products for patients receiving renal therapy throughout the UK and calls for steps to be taken to maximise each patient’s quality of life:

  • All products to be prescribed in the patient’s best medical interests.
  • Provision of products not to be determined by cost.
  • Renal specialists and GPs to be fully informed on developments in new drugs and dialysis equipment.
  • Full co-operation between the renal specialist and GP to ensure provision of medication: no patient should be a ‘go-between’ in a shared care environment.
  • All products which will enhance the patient’s quality of life to be included in purchaser/provider agreements.
  • The role of VAT on drugs and other products to hospitals and trusts to be reviewed in cases where it affects treatment provision.


The use of drugs in the treatment of established renal failure (ERF) plays an important and fundamental role in the overall well-being of the patient. There have been reported instances of ‘expensive’ drugs being withheld on cost grounds. A similar situation exists with regard to the PD disconnect system and APD machines. There is evidence that these ‘non essential’ but life-enhancing products can keep intermittent illness to a minimum, not only improving the patient’s health but also minimising treatment costs.

Problems can arise in cases of ‘shared-care’ where the renal consultant and GP share the treatment of the patient. There is potential for disagreement as to which party carries the ultimate responsibility, both for prescribing and for bearing the cost of the prescribed items.