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Responses from the Department of Health and Social Care

UK Government Response

Dear Mrs Brown,

Thank you for your correspondence of 18 February about people living with kidney disease. I have been asked to reply and I apologise for the long delay in replying, which has been caused by an unprecedented volume of correspondence during the pandemic.

Throughout the COVID-19 pandemic, the NHS has maintained access to urgent and emergency care, including for patients with kidney disease. For non-urgent care, providers have been rolling out remote consultations using video, telephone, email and text message services as a priority where appropriate.

To ensure the proper prioritisation of dialysis services for those who require them, the National Institute for Health and Care Excellence (NICE) published the COVID-19 Rapid Guideline: dialysis service delivery, which was last updated on 11 September. It contains guidance on continuing dialysis provision both at home and in dialysis units where safe and necessary, while making the best use of NHS resources and matching the capacity of dialysis services to patient needs, if these become limited or the schedule is altered because of the COVID-19 pandemic. The guidance also contains additional recommendations to minimise risk of transmission to patients, including when travelling into the dialysis unit and spending time in waiting rooms. The guidance can be found at www.nice.org.uk/guidance/ng160.

NHS England and NHS Improvement also launched a Renal Services Transformation programme which includes high impact changes to improve care for patients with kidney disease, to be delivered over the next 3 years. Renal dialysis is one of the key workstreams which will address reducing the variation in access to home dialysis. One of the other workstreams is looking at the whole pathway of care including prevention of kidney disease.

The Government is absolutely committed to supporting everyone’s mental health and wellbeing throughout the pandemic and beyond, and to ensuring that the right support is in place.

In addition to this, the NHS is working to ensure the option of face-to-face support is provided to people with serious mental health illnesses across all ages, where it is clinically safe to do so. For those with severe needs or in crisis, all NHS mental health providers have established 24-hour urgent mental health helplines.

Yours sincerely,
 
Temiloluwa Oguntolu
Ministerial Correspondence and Public Enquiries
Department of Health and Social Care


Scottish Government Response

Dear Andrea Brown,

Thank you for your email of 9 November to Jeanne Freeman, Cabinet Secretary for Health and Sport. regarding kidney disease.  Ministers receive a large volume of correspondence and I hope you will understand that as much as they would like to it is not always possible for them to reply personally to each case. I am therefore responding to you on the behalf of Cabinet Secretary.

I would like to assure you that the Scottish Government recognises the impact that COVID-19 is having on people’s health and wellbeing and in particular those with long term health conditions.  Information on COVID-19 for people with chronic kidney disease can be found on the Scottish Government webpage – Coronavirus (COVID-19) tailored advice for those who live with specific medical conditions. This information is updated regularly.

 It may be helpful if I explain that while the Scottish Government’s role is to set the strategic policy for the NHS in Scotland, NHS Boards and healthcare professionals locally have responsibility for both service delivery and people’s care

I understand that the criteria for dialysis at home is mainly down to patient preference and that whilst there are significant training and also installation costs for home haemodialysis, peritoneal dialysis is very much encouraged by all renal unit teams in Scotland.

Along with the rest of the UK, all patients on renal replacement therapy (RRT) were advised to shield.  Scottish dialysis units have been very aware that this population of patients is vulnerable and at an early stage introduced the wearing of face masks by patients and staff throughout treatment.

The units have made significant efforts to reduce the risk to patients as they travel to and from dialysis such as the provision of individual patient transport for all instead of using public transport or shared transport provided by the Board.

You may be interested to note that The Scottish Renal Registry (SRR)  have been producing regular reports regarding COVID-19 in patients on RRT in Scotland.

Thank you for highlighting your report and I look forward to reviewing your recommendations when they are published in December.

Yours sincerely

 Sharon Robertson Policy Manager


Welsh Government response

Dear Andrea,

Thank you for your letter of 9 November on behalf of the National Kidney Federation regarding home dialysis kits for kidney failure patients during the COVID-19 pandemic.

I hope I can assure you that we are committed to offering home dialysis to more patients in Wales. We already have higher rates than the UK average and are looking to build on this significantly.

We are also aware of the higher risks from COVID-19 for those receiving unit dialysis as compared to home therapy and this has been the subject of discussions at the Welsh Renal Clinical Network Board (WRCN). A ‘Pathways to Home’ strategic model is now being put in place to increase access to home dialysis and reduce unwarranted variation of uptake

within the health board localities.

This model has been evolving from a co-produced research study led by Dr Gareth Roberts, Consultant Nephrologist and Clinical Lead, WRCN. This research was designed to gain a fuller understanding as to why the majority of patients ‘opt’ for unit dialysis as a first choice and what service barriers need to be addressed to facilitate a ‘home first’ approach.

I hope this information is helpful.

Yours sincerely

Vaughan Gething AS/MS

Y Gweinidog Iechyd a Gwasanaethau Cymdeithasol

Minister for Health and Social Services