Organising dialysis away from base: what you need to know

Being able to get away for a holiday or break is something many of us take for granted, but kidney failure and organising dialysis away from base (DAFB) can be complicated and difficult. We asked Laura Gleadell, Managing Director at Kidney Care UK Dialysis Freedom, to share her advice.

Kidney Care UK Dialysis Freedom is a free dialysis away from base (DAFB) planning and booking service for UK patients and UK units.

1. There is a difference between “holiday dialysis spots” and “swap spots”

“When booking DAFB, make sure you know the difference between a 'holiday dialysis slot' and what we call a 'swap slot'. The key distinction is that holiday dialysis slots are ‘booked’, and swap spots are ‘negotiated’.

Holiday dialysis slot Swap slot


Negotiated between units

Dialysis slot dedicated for DAFB

Someone else’s regular dialysis slot, not dedicated for DAFB

Easier to organise

Harder to organise

Generally, only available in popular holiday destinations

More availability in non-holiday destinations

Good for guaranteeing a DAFB slot

Good if you want to have DAFB somewhere that is not a common holiday location

Limited number of units that offer holiday dialysis slots

Can be hard to find, and more complicated to organise, as units may not have slots available on the dates you wish to go away

“A ‘holiday dialysis slot’ is probably what you think of when it comes to holiday dialysis. It is a guaranteed dialysis slot, in a unit, that is dedicated solely for holiday dialysis patients. This means that, if you book a holiday dialysis slot, you are guaranteed that slot providing you are medically approved. However, there are a limited number of units that have dedicated holiday dialysis slots, and they fill up fast.

“A ‘swap slot’ is a dialysis slot at a unit that is someone else’s regular dialysis slot. When that patient goes away – usually for DAFB themselves – their regular dialysis slot may become available to someone else. When this happens, if the unit are willing to have someone else fill the empty slot, they can 'swap in' a different patient for the period that the home patient is not dialysing at the unit. However, this does mean that the swap slot is not guaranteed, as if the home patient decides to remain at their regular unit, the slot will no longer be available. Swap slots aren’t usually cancelled, but it is something to consider.

“If you are looking to have DAFB at a swap slot, it is also worth noting that units may turn down a request for someone to receive ‘holiday dialysis’. Changing the language that you use, for example using the phrase ‘dialysis away from base’ rather than ‘holiday dialysis’, can help persuade a unit to negotiate a slot for you. Stating the reason why you are going away may also increase your chances of a negotiation with the unit. For example, if you are going away for a wedding, make this clear.

“At Dialysis Freedom, we tend to suggest ‘holiday dialysis slots’ over ‘swap slots’, as they are much easier to organise. However, if you wish to go away to a location where holiday dialysis slots are not an option, we will do everything we can to support you and help negotiate a swap slot.”

Example of how a swap slot works

2. Remember that you can join a waiting list if you can’t get a holiday dialysis slot immediately

“Units operating holiday dialysis slots tend to run on a first come, first served basis. However, many of these units will have waiting lists that you can join if you are unable to book your first choice of slots.

“At Dialysis Freedom, we run a waiting list for cancellations that is free to join if you contact us. As soon as we are made aware that spaces are opened, we contact the people on our waiting list and let them know. We have people who register a year in advance with a unit that runs holiday dialysis slots because they know that the unit only has two machines dedicated to holiday dialysis.

“While it may not be ideal – and there are other options, such as trying to organise a swap slot – joining a waiting list can be a great option if you are flexible about when you want to go away. My suggestion is to ring us at Dialysis Freedom, and we can either add you to our waiting list or support you in contacting the unit directly if they do not use our service.”

3. There are, unfortunately, areas in the UK where DAFB is almost impossible to organise

“There are whole regions in the UK where DAFB is not an option, whether that be through holiday dialysis swaps or swap slots. There are currently 45 units that actively accept holiday dialysis slot bookings, which is a minority of units across the UK, and there is no guarantee that you will be able to find a unit willing to cooperate with organising a swap slot. If someone contacts us about receiving DAFB in a region where holiday dialysis slots are unavailable, we will try help them organise a swap slot, but sometimes it is just not possible.

“The good news is that we have changed the way we request swap slots which has resulted more ‘yes’ responses to requests in 2024, and I think some units who are sending their own patients away for DAFB are realising that they need to start reciprocating and letting patients into their unit. But DAFB is a real issue for people living with kidney failure, and we have suggested people contact their local MPs and speak with their unit or Trust / Health Board if they are frustrated about DAFB and holiday dialysis.

“You can see every dialysis unit in the UK on our “Find a dialysis centre” map on the Dialysis Freedom website but remember that not all of those units listed offer holiday dialysis slots. We recommend that you enter your destination details into the map and once you have selected your preferred unit, complete the request form and we will respond with information about whether that unit offers DAFB or where the next available area would be.”

People on dialysis have to live their lives alongside chronic kidney disease. Not being able to book dialysis at a unit elsewhere in the country can mean missing out on things most people take for granted – visiting grandchildren, being part of family celebrations, or simply taking a short break away from home. Current DAFB is a postcode lottery and people are finding they simply cannot travel to certain locations because of availability of dialysis sessions. Policies also vary across the UK, with some people in Scotland facing limits on how many trips they can take per year. This is simply not good enough. We want to see everyone living with kidney disease across the UK supported to plan and access DAFB. Please do let us know if your unit does not allow you to travel as much as you would like by emailing us on [email protected].
Samantha Sharp, Senior Policy Officer at Kidney Care UK

4. Booking well in advance means things are less likely to go wrong at the last minute

“While everyone should be able to go on holiday at short notice, the reality is that I would advise booking DAFB with as much notice as possible, ideally months before you go away.

“The first reason to book in advance is because many holiday dialysis slots get booked up. Units that offer holiday dialysis have a finite number of spaces available and popular holiday destinations with units that run holiday dialysis slots, such as Cornwall and Devon, get to full capacity quickly.

“The second reason to book well in advance is to ensure that both your home unit, and the holiday unit, have enough notice period to organise everything. People come to us asking for dialysis ‘this month’, and they simply don’t realise that it isn’t just about making the booking, it is about the preparation that needs to be done to facilitate DAFB – for example, how quickly you can get medical paperwork signed by your unit, or how long will it take the holiday unit to review your blood tests. If there are issues or hold-ups, this process can take a while, and the last thing you want is to be stressing in the days prior to going away.”

5. Being flexible with dates, and locations, can help

“This might seem obvious, but the more flexible you can be about dates you go away, and the location you go to, the more likely you are to be able to find a unit to dialyse in. If you can be flexible on the dates, you're more likely to find a holiday dialysis slot, or swap slot. If you are able to be flexible about location, there will be an even greater choice about where and when you go away. Of course, if you require DAFB for planned events such as a graduation, it can be difficult to be flexible, and this is why we always suggest booking as far in advance as possible.”

6. Going private won’t guarantee you a holiday dialysis spot

“Some people contact us at Dialysis Freedom with the presumption that because they can afford to pay, that they can go private and pay for a holiday dialysis slot. Unfortunately, while it is true that most holiday dialysis slots are privately run, they still covered under NHS which means that there once they are full, they are full, regardless of whether you are willing to pay extra.

“There are a few units in London that offer DAFB privately, but that is it. So, even if you are able to afford to go private, do not assume that you will easily be able to find somewhere to dialyse.”

Travel tips from the Dialysis Freedom team (Kate, Nicki, Melissa, Suzy and Laura)

  • Check with your home unit when starting to plan to see if they require you to give them any notice period or requirements before arranging DAFB.
  • The amount of holiday dialysis you can take per year will be limited – speak with your healthcare team for more information.
  • It can take time to make DAFB arrangements, and unfortunately bookings are not instant.
  • If you are open to different destinations or areas, contact us first at Dialysis Freedom to find out which units actively offer DAFB.
  • Make sure dialysis slots are available before booking a holiday.
  • Remember that dialysis is also free for UK Patients at non-NHS units, not just in NHS hospitals.
  • Remember that you can access DAFB both in the UK and worldwide.

More information about travelling with CKD

  • Dialysis Away from Base (DAFB)

    Holidays and respite breaks can help to reduce stress and improve mental wellbeing. However, if you need dialysis, there are certain things to consider when organising a holiday, or any kind of travelling away from home.

  • Travelling in the UK on dialysis – top tips

    Top tips for UK travel while on dialysis to help make your holiday or trip run as smoothly as possible.

  • Your complete guide to travelling abroad as a kidney patient

    Find out about travelling abroad as a kidney patient: what to consider, planning your trip, dialysis abroad, what to think about if you’re a transplant patient, and more sources of advice and support.