Updated 17/10/11; for more details read the change notice on the kidney audit download page

The second major survey into kidney patient transport across England, Wales and Northern Ireland shows that while most patients are happy with the service they receive, there has been no marked improvement since the first survey's results were published two years ago.

Of the 19,000 patients who have to travel to and from dialysis units for life-saving treatment three times a week, around one in four of those who rely on hospital arranged transport have to wait more than 30 minutes to be picked up to go for treatment.

Once picked up, nearly a third of patients using hospital arranged transport have a journey time of more than 30 minutes.Meanwhile, around one in three has to wait more than 30 minutes following treatment before they are collected to be taken home, according to the 2010 survey from the National Kidney Care Audit.

These times exceed the UK Renal Association guidelines that the wait for collection to or from the unit or the travel time to the dialysis unit should not exceed 30 minutes¹.

The results show little change from the 2008 survey, which found that while most patients were happy with the service they received and had good access to transport, a significant cohort received an unacceptable level of service.

Commissioned by the Healthcare Quality Improvement Partnership and carried out by The NHS Information Centre, the 2010 survey received responses from around two thirds (approximately 12,400) of all haemodialysis patients and from 95 per cent of all dialysis units.

Key findings include:

• 78 per cent of patients either claim back the cost of their journey or do not pay at all, compared to 83 per cent in 2008
• 76 per cent of patients using hospital arranged transport waited 30 minutes or less to be picked up on their way to dialysis, compared to 75 per cent in 2008
• 68 per cent of all patients had a travelling time of 30 minutes or less to get to their dialysis unit, compared to 65 per cent in 2008
• 75 per cent of all patients waited 30 minutes or less at the unit for dialysis to commence, compared to 73 per cent in 2008
• 66 per cent of patients using hospital arranged transport waited 30 minutes or less to be picked up for the return journey after dialysis, compared to 63 per cent in 2008
• 88 per cent of all patients said the transport they used (regardless of what type of transport it was) either met their needs all the time or most of the time, compared to 61 per cent in 2008.

Dr Donal O'Donoghue, National Clinical Director for Kidney Care said:

“No other medical condition requires such frequent travel back and forth for treatment - for months and years on end - like haemodialysis does. Patients have to make six journeys every week - Christmas and holidays included. Transport is therefore a significant component of the patient's experience and it is no wonder that it is frequently cited as the part that most needs improving. As this patient survey shows, complaints are common. Difficulties in identifying who is responsible and who can improve the service are almost universal.

“I would like to thank the thousands of patients and the staff who took part in this survey. By providing details of their experience of this aspect of care, they have highlighted an important issue for the kidney community in improving patient experience. I look forward to seeing this on the agenda of every kidney care network, on seeing ownership of the issue and working together to see what improvements we can make for patients.”

From 8 June the national summary can be viewed at www.ic.nhs.uk/nkcareports with Unit Level reports to follow.

ENDS

Notes to editors

1. Renal Association, Clinical Practice Guidelines – Haemodialysis (5th Edition, 2009) http://www.renal.org/Clinical/GuidelinesSection/Haemodialysis.aspx#s1

2. The NHS Information Centre is England's authoritative, independent source of health and social care information. It works with more than 300 health and social care providers nationwide to provide the facts and figures that help the NHS and social services run effectively. Its role is to collect data, analyse it and convert it into useful information which helps providers improve their services and supports academics, researchers, regulators and policymakers in their work. The NHS Information Centre also produces a wide range of statistical publications each year across a number of areas including: primary care, health and lifestyles, screening, hospital care, population and geography, social care and workforce and pay statistics.

3. The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP hosts the contract to manage and develop the National Clinical Audit and Patient Outcomes Programme (NCAPOP). Their purpose is to engage clinicians across England and Wales in systematic evaluation of their clinical practice against standards and to support and encourage improvement in the quality of treatment and care. The programme comprises more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions, including kidney care.

4. Renal Replacement Therapy (RRT) takes the form either of dialysis or kidney transplantation. Not all patients are suitable for a kidney transplant (either because they are not physically well enough, there is no suitable donor kidney, or patient choice). These patients have dialysis. Dialysis takes the form either of peritoneal dialysis (PD) or haemodialysis (HD). PD is usually home based, and is not the subject of this report. HD can be performed at home, but far more often takes place in a dialysis unit.

5. Unit level reports will be available to download from services/national-clinical-auditsupport- programme-ncasp/kidney-care following the publication of the report 6. For media enquiries and interview requests please call 0845 257 6990 or contact mediaenquiries@ic.nhs.uk