Scottish in-centre dialysis transport: change and improvements urgently required

An in-centre dialysis transport service which is responsive, fair and sustainable shouldn’t be too much to ask for. Yet a new Kidney Care UK report published today highlights that in Scotland people face an unreliable, inefficient transport service, long travel and waiting times to and from in-centre dialysis and a lack of suitable vehicles and drivers.

In addition, the majority of patients in our survey who take a private car to and/or from in-centre dialysis are not reimbursed at all for their travel costs and are left to foot the bill themselves, with 69% of those left to pay these high costs worried about how they can afford them.

I feel that I should be reimbursed for all of my travel costs to the dialysis unit instead of feeling penalised for being ill.

No national framework

Unlike England, there is no national framework in Scotland to ensure services are consistently responsive, fair and sustainable and that universal support for people accessing kidney units for dialysis is offered.

Postcode lottery

Inconsistencies exist across Scotland with 6 of the 14 health boards telling us that access to all modes of in-centre dialysis transport they provide is needs assessed and 6 others telling us that all the modes of transport they offer, except Scottish Ambulance Service transport, are open to everyone travelling to and from in-centre dialysis.

Healthcare professionals concerned

Almost two thirds of kidney healthcare professionals respondents told us they have concerns about the transport arrangements that their hospital or renal satellite unit have in place for patients travelling to and from in-centre dialysis.

Transport should accommodate the patient and not the other way about. If patients are late in due to transport then they should be able to complete treatment and still have transport home.

Our recommendations for change

Kidney Care UK recommends that national guidelines should be set for Scotland and are ready to act as partners with the Scottish Government towards this.

We also recommend that a universal commitment is made by all Scottish health boards, to support and implement a fair, efficient, sustainable, reliable and person-centred transport service. They must also ensure that the needs and preferences of people on in-centre dialysis are listened to and considered.

Kidney Care UK believe that no one should be financially penalised for having to travel to receive life-saving treatment.

Means-tested reimbursement for an already impoverished patient group, whose long term life expectancy is impacted, is inherently unfair.

With the introduction of national guidelines there will also be the need to regularly review their implementation and effectiveness. This will lead to better services by increasing transparency, incentivising patient-focused provision and enabling greater learning and accountability within and between health boards and other dialysis transport service providers.

Download the Kidney Care UK In-centre Dialysis Transport in Scotland report

Campaigning for improvements in patient transport

Kidney Care UK previously highlighted the experience of patients travelling to and from in-centre dialysis and why it is vital these services are improved in the Finding a way together dialysis transport report .

Following on from this, the charity worked with Healthwatch England and Age UK on There and Back which helped to inform NHS England’s national review of non-emergency transport, leading to England’s national framework.