Dialysis Care Outcomes — [Sir George Howarth in the Chair]

Part of the debate – in Westminster Hall at 3:46 pm on 19th May 2022.

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Photo of Gillian Keegan Gillian Keegan Minister of State (Department of Health and Social Care) 3:46 pm, 19th May 2022

The hon. Lady makes an important point. Hopefully the best shared practice includes that reimbursement should be paid very quickly. Clearly, the billing systems that are in place across the various providers will differ. It is important to state that best practice when it comes to reimbursement is to do it as quickly as possible.

We were talking about home hemodialysis support for children. That applies to about 20 children, as of February 2022, and it is currently at the discretion of individual providers. However, the renal service clinical reference group has begun an urgent review of the reimbursement process for children. Hopefully that will give some comfort to the hon. Member for Strangford.

If people with chronic kidney disease and their families need further information, there are a range of resources available on the excellent Kidney Care UK and National Kidney Federation websites, including information on treatment options, financial support and other support services to help people live well. NHS England will continue its work with those charities and others to engage their support in promoting awareness of reimbursement options available for those on home hemodialysis. In terms of wider ambitions, the renal services transformation programme is developing optimal pathways, tools and resources that will transform the delivery of renal services across England. That will support better healthcare outcomes for patients undergoing dialysis treatment, and provide integrated care systems with a whole-patient pathway approach to commissioning renal services.

The hon. Members for Rutherglen and Hamilton West and for Enfield North both mentioned the importance of providing suitable mental health support for dialysis patients. The Government acknowledge that this is very important. There can be a detrimental impact on an individual’s mental health when undergoing complex dialysis treatment. To address that, the national adult renal services transformation programme has identified psychosocial support in renal services as a key theme for improvement. Work is being taken forward with clinicians, patient representatives and other subject matter experts to identify best practices that can support patients’ psychosocial needs, as well as the steps that are needed to spread those best practices. Those suffering with renal issues can also access mental health support via self-referral to Improving Access to Psychological Therapies, which the Government have invested £110 million in to expand access.

As the hon. Member for Strangford is aware, health policy is a devolved matter, and I understand that there are different arrangements for Northern Ireland, although commissioners and trusts remain equally committed to excellent care and better outcomes. The transformation programme has established a multi-agency programme board with representation from key stakeholders, including regional commissioners, patient charities and relevant national bodies, to ensure that a full range of views are considered. It has also established five expert-led multi-disciplinary clinical workstreams, including work- streams on improving access, identifying best practice and developing solutions in chronic kidney disease. All transformation programme workstreams intend to make key deliverables available by April 2023. That will include documentation outlining best practice, a data dashboard outlining key metrics to support better decision making, and support for the review of the renal service specification led by NHS England’s renal clinical reference group.

I was asked earlier what the Government are doing to fund research into kidney conditions and their treatment. We are committed to supporting research and funding it through the National Institute for Health and Care Research. For the financial years 2016-17 to 2020-21, the NIHR spent £113.2 million on kidney research. That research includes kidney disease, but also explored why people with kidney disease are at an increased risk of death and disability following a heart attack, the relationship between covid-19 and kidney disease and whether aspirin reduces the risk of major vascular events in patients. There is a full research programme ongoing.

Once again, I extend my continued gratitude to all charities working to support improved outcomes for people with chronic kidney disease. We are very happy to continue to work with them; we all have the same objective.

Finally, I thank the hon. Member for Strangford for securing the debate and giving me the opportunity to promote the vital schemes that are available to support patients with chronic kidney disease, to make sure people know what is coming next and are aware of the financial support available to them, and to outline the strong programme of work we are undertaking across the country to transform these services. I urge all patients receiving dialysis at home to speak to their provider so that they receive the full NHS support they are entitled to through their care.