New survey finds one third of UK dialysis patients still not offered home haemodialysis choice despite NICE COVID-19 guidelines


Quanta Dialysis Technologies announced today the results of the UK Dialysis Patient Experience Survey, showing the wide variance in care experienced by UK dialysis patients, as well as challenges faced in assessing self-care and home haemodialysis (HHD). 

The survey revealed:

  • One in three (34%) respondents who receive their dialysis care in-centre stated that they had not been offered the choice of HHD by their renal unit.
  • HHD delivers notable physical and mental health benefits, with 74% of HHD patients reporting positive changes to their physical wellbeing and 94% reporting improvements to their mental health since starting to dialyse at home. 97% of patients would recommend HHD to in-centre dialysis patients.
  • A wide range of perceptions around safety when dialysing in-centre during the COVID-19 pandemic, with two-thirds (66%) of in-centre patients concerned about receiving dialysis during the pandemic. 47% of in-centre patients said they were unable to maintain social distancing and 27% of in-centre patients reported concerns about travelling to receive treatment.
  • Many patients who are currently dialysing in-centre are not able to make informed, evidence-based decisions about the future of their care despite the Rapid Guidelines produced by the National Institute for Health and Care Excellence (NICE) at the start of the pandemic advising that healthcare professionals should ‘think about whether it is possible to increase home dialysis provision’. Despite this, of patients that were successfully dialysing at home, nearly a quarter (23%) had to ask their centre to discuss HHD as an option.

Physical and mental benefits of home haemodialysis

The survey revealed that 74% of HHD patients experienced positive changes to their physical wellbeing. HHD gives patients choice and flexibility around their personal dialysis schedule, enabling them to prioritise their lives and not their treatment. Dialysing more frequently at home means that patients do not have to restrict food and drink intake so much, which is required with standard thrice-weekly dialysis.

These daily restrictions also have a major negative impact on mental health. 94% of HHD patients told the survey that their mental health had improved since starting dialysis at home. Wider clinical evidence shows that patient safety can be significantly improved, with HHD patients having up to 13% lower risk of death compared with in-centre dialysis patients, as HHD enables the option of longer and more frequent sessions carried out flexibly to fit around patients’ lives.

The survey found that 29% of in-centre patients were concerned about safety when travelling to and from the dialysis centre during the pandemic, adding to their mental health burden, with 66% concerned about the pandemic whilst receiving treatment in-centre. The average patient spends a total of 52 days (14%) each year travelling to the dialysis centre, waiting for appointments and dialysing.  Despite the COVID-19 rapid guidelines on dialysis service delivery advising that kidney units should think about whether it is possible to increase home dialysis provision for patients, only 7% of patients surveyed had started dialysing at home in the last 12 months.

Future of haemodialysis care

Of the respondents who were not offered HHD, 32% were interested in getting more information on suitability. Responses also showed that when patients were offered the choice in their dialysis care, it was typically at the start of their dialysis journey and not always properly explained – meaning that making informed, evidence-based decisions was more difficult.

Despite the ambition of the NHS Long Term Plan to promote self-management across a whole range of care settings, 60% of respondents who receive their dialysis in-centre had never been offered the choice to self-care in the centre, and 43% would like to be offered the choice to consider self-care.

Reflecting on the findings, John Milad (chief executive officer, Quanta, UK) said “Every patient in the UK should have the right to make an informed, evidence-based choice about how and where they dialyse. Our survey results reveal that, at present, there is an unequal opportunity for patients to make these choices, which can have devastating consequences. Empowering patients to conduct their dialysis sessions at home, at a time that suits, allows them to fit dialysis around their lives. This provides far greater opportunity for education and work, which can mean the difference between full-time employment versus relying on long-term benefits. Transitioning to home haemodialysis also carries large economic and social benefits for working-age patients, and can help reduce the burden on family members having to provide additional care and support.

Whilst no one could have predicted the devastating impact that COVID-19 would have on dialysis patients, this survey data has reinforced how crucial it is to bring about changes to ensure that the lessons learnt from the pandemic can support the greatest possible improvements in health and wellbeing for every dialysis patient in the UK.”


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