The All-Party Parliamentary Kidney Group (APPKG) met on 16 June to review progress made since the publication of A Manifesto for Increasing Home Dialysis in England for the Benefit of Patients and the NHS. The meeting brought together NHS England, Regional Kidney Networks, clinicians, charities and patient representatives to discuss the progress made and the work still needed to improve access to home dialysis across England.

Home dialysis is increasingly recognised as an important part of delivering more care closer to home, improving patient experience and reducing pressure on hospital-based dialysis services. While progress is being made, home therapies still account for only 16.4% of kidney replacement therapy patients across the UK, remaining below the long-standing national ambition of 20%.

The APPKG heard updates from the DAYLife partnership, which is supporting renal units through mentoring programmes, quality improvement initiatives, workforce development and shared learning. Early results show increased staff confidence, increased support from senior teams and improvements in home dialysis uptake in participating centres.

The London Kidney Network also showcased its work to increase access to dialysis at home across the capital. Through a dedicated Dialysis at Home Strategic Forum, supporting renal units to develop local improvement plans focused on workforce development, patient education, shared decision-making and improving access pathways.

Professor Smeeta Sinha, National Clinical Director for Kidney Care, and Professor Mark Lambie, National Clinical Advisor for Dialysis, highlighted national work to better understand the significant variation in home dialysis uptake between centres. Research from the Inter-CEPt study suggests that supportive organisational culture, dedicated clinical leadership, quality improvement and adequate staffing are all important factors in increasing access to home therapies.

The meeting also heard from people with lived experience of dialysis, who highlighted the importance of having access to clear information, education and support when making decisions about treatment. Patients spoke about the benefits that home dialysis can offer, including greater flexibility, independence and the ability to fit treatment around family life, work and other commitments. They also emphasised the importance of peer support, shared care and ensuring that patients are routinely offered genuine choice about where and how they receive dialysis.

The APPKG progress report concludes that home dialysis is now firmly established as a national and regional priority. However, workforce capacity and training, commissioning arrangements and cultural change remain significant barriers to wider adoption. There was agreement that future priorities should include supporting publication and monitoring of the renal service specification, advocating for a national workforce and training plan, strengthening national incentives and accountability, and ensuring kidney disease remains a priority for Government and seeking a commitment to a national kidney strategy.

The National Kidney Federation welcomes the progress being made but believes sustained national leadership and implementation support will be essential to ensure all patients can access the dialysis option that is right for them.