NHS Central East Integrated Care Board will continue to work with NHS England and the Cambridge University Hospitals NHS Foundation Trust, as the renal dialysis service provider at Hinchingbrooke Hospital, to ensure that there are fit for purpose facilities to meet expected levels of demand. The current service location will remain at Hinchingbrooke Hospital whilst this work is undertaken.

No specific provisions have been made, but trusts may provide renal services as part of their clinical models of care, depending on their assessment of local needs, and levels of service provision at individual sites.

The updated service specification will be published in due course. It will support ongoing action to increase home dialysis provision in line with the Renal Services Transformation Programme ambition for at least 20% of patients to be treated at home, including through strengthened early patient education, standardised pre-dialysis pathways, and multidisciplinary care models that enable shared decision-making.

The specification will include defined metrics for commissioned providers, including the proportion of dialysis patients receiving home-based therapies, supporting formal assessment against the ambition of achieving at least 20% uptake.

This is complemented by improvements to operational processes, including home assessments and installation pathways, to ensure patients can access home therapies in a timely and consistent way.

The updated service specification will be published in due course. It will support ongoing action to increase home dialysis provision in line with the Renal Services Transformation Programme ambition for at least 20% of patients to be treated at home, including through strengthened early patient education, standardised pre-dialysis pathways, and multidisciplinary care models that enable shared decision-making.

The specification will include defined metrics for commissioned providers, including the proportion of dialysis patients receiving home-based therapies, supporting formal assessment against the ambition of achieving at least 20% uptake.

This is complemented by improvements to operational processes, including home assessments and installation pathways, to ensure patients can access home therapies in a timely and consistent way.

We welcome the National Kidney Federation’s 2025 manifesto which is closely aligned to NHS England’s existing national priorities to expand home dialysis, reduce inequalities, and improve patient choice.

NHS England is supporting this through renal networks by improving transparency via unit‑level dashboards, standardising pre‑dialysis education so home therapies are routinely offered, embedding home dialysis in local commissioning plans with integrated care boards, and reviewing renal tariffs to better support clinically appropriate home‑based care.

NHS England is currently working to update the Renal Service Specification which aims to support increased home dialysis provision in line with the Renal Services Transformation Programme ambition for at least 20% of patients to be treated at home.

Delivery will be supported through accountability and reporting via renal networks and National Health Service commissioners.

NHS England is taking action through the Renal Services Transformation Programme and renal networks to increase home dialysis uptake by strengthening early patient education and shared decision‑making through standardised pre‑dialysis pathways, supporting multidisciplinary care models, and working with providers on workforce capacity and training. This is complemented by improvements to operational processes, including home assessments and installation pathways, to ensure patients can access home therapies in a timely and consistent way.

Progress is being made towards the ambition through NHS England’s Renal Services Transformation Programme and renal networks, which promote a “home‑first” approach and routine offering of home therapies.

Some regions have improved, with renal networks and regional specialised commissioners using UK Renal Registry data and regional dashboards to benchmark uptake, track progress, and target support in other areas. Increasing home dialysis uptake remains a core national priority.

We recognise the regional variation in home dialysis uptake, as identified through UK Renal Registry data, reflecting differences in workforce, infrastructure, and local practice.

To address this, renal networks are using data dashboards to benchmark variation, supporting some centres to implement improvement plans, standardising pathways such as pre‑dialysis education and home set‑up processes, and sharing best practice from high‑performing “home‑first” models to improve equity of access.

NHS England recognises that tariff arrangements can influence the delivery of home dialysis.

Subject to resource availability, NHS England aims to review renal replacement therapy tariffs in 2026/27. The review will cover in-centre dialysis, home dialysis, and transplantation, with the aim of ensuring that funding reflects clinical best practice and supports greater uptake of home dialysis where clinically appropriate.

NHS England also plans to calculate future prices using 2023/24 cost and activity data. Prices for 2027/28 will be the first to use post-COVID data, allowing changes in clinical activity and reported costs to be reflected.

The latest UK Renal Registry report in 2025 shows that the uptake of home dialysis has increased, with continued progress in expanding home therapies, which account for around 15–20% of dialysis patients. A copy of the report is attached.

NHS England, renal networks, providers and patient organisations are working together to continue to increase access to home-based therapies.

The specification is being worked on by NHS England in line with its national service specification methods process. Stakeholder testing was recently undertaken. The timing of full publication has yet to be decided upon as the feedback from stakeholders is being considered, alongside any changes required. NHS England will set out the expected date of publication as soon as this is available.

NHS England is increasing access to home-based therapies through the Renal Services Transformation Toolkit (2023), which aims for at least 20% of patients to be treated at home. The specification will support the 20% ambition.

NHS England is delivering a comprehensive programme to improve the diagnosis, treatment, and outcomes of people with kidney disease, through its renal services transformation programme. This includes a specification for renal services which sets out the scope for the work of the renal clinical networks commissioned across England, with further information available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2024/05/PRN231110-renal-clinical-network-specification-2023-.pdf

The goals of the specification include reducing variation across the renal care pathway by developing, agreeing, and implementing standardised pathways of care, including dialysis and home therapy services for adult and paediatric services. The eight regional kidney networks in England, working with providers, are implementing this toolkit with a clear focus on improving early diagnosis, slowing disease progression, and reducing the number of patients reaching advanced stages of kidney disease. This work is supported nationally by the Renal Clinical Reference Group.

NHS England is also supporting the Department and key kidney organisations to identify further opportunities to enhance prevention, diagnosis, treatment, and long‑term outcomes for people living with kidney disease, including improved access to home dialysis.

NHS England is delivering a comprehensive programme to improve the diagnosis, treatment, and outcomes of people with kidney disease, through its renal services transformation programme. This includes a specification for renal services which sets out the scope for the work of the renal clinical networks commissioned across England, with further information available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2024/05/PRN231110-renal-clinical-network-specification-2023-.pdf

The goals of the specification include reducing variation across the renal care pathway by developing, agreeing, and implementing standardised pathways of care, including dialysis and home therapy services for adult and paediatric services. The eight regional kidney networks in England, working with providers, are implementing this toolkit with a clear focus on improving early diagnosis, slowing disease progression, and reducing the number of patients reaching advanced stages of kidney disease. This work is supported nationally by the Renal Clinical Reference Group.

NHS England is also supporting the Department and key kidney organisations to identify further opportunities to enhance prevention, diagnosis, treatment, and long‑term outcomes for people living with kidney disease, including improved access to home dialysis.

Non-Emergency Patient Transport Schemes (NEPTS) often provide funded transport where a medical condition means that a patient would struggle to safely attend their treatment independently.  NEPTS can be provided by ambulance trusts or other providers depending on local arrangements.

In May 2022, NHS England set out eligibility criteria, which includes disability criteria, available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2022/05/B1244-nepts-eligibility-criteria.pdf

NHS England has worked closely with a range of kidney patient groups, renal professionals, integrated care boards (ICBs), and other stakeholders to develop a dialysis transport support framework which has been made directly available to ICBs. The 2022 updates to the eligibility criteria included where patients are travelling to or returning from in-centre haemodialysis, in which case specialist transport, non-specialist transport, or upfront/reimbursement costs for private travel will be made available.

NEPTS in England is an operational matter for the National Health Service, and how the NEPTS guidance is implemented at a local level is determined by ICBs and their partners, including local ambulance trusts. There are no current plans to update the eligibility criteria further.

NHS England is delivering a comprehensive programme to improve the diagnosis, treatment, and outcomes of people with kidney disease, through its renal services transformation programme. This includes a specification for renal services which sets out the scope for the work of the renal clinical networks commissioned across England. The specification is available at the following link:

https://www.england.nhs.uk/wp-content/uploads/2024/05/PRN231110-renal-clinical-network-specification-2023-.pdf

The goals of the specification include reducing variation across the renal care pathway by developing, agreeing and implementing standardised pathways of care, including dialysis and home therapy services for adult and paediatric services. The eight regional kidney networks in England, working with providers, will review service delivery across network against need and identify gaps and variation in services, gaps in overall provision, quality, geographical distribution, and deliver improvements to network services to address these issues.

NHS England is delivering a comprehensive programme to improve the diagnosis, treatment, and outcomes of people with kidney disease. In 2023, NHS England published a renal services transformation (RSTP) toolkit to support earlier identification of chronic kidney disease and more joined up services. The RSTP sets out that services, working in partnership with integrated care boards, should undertake capacity planning and activity monitoring to ensure service capacity matches demand requirements.

These changes are intended to make it easier to deliver improvements along the whole patient pathway including earlier diagnosis and treatment, that can potentially prevent or delay the need for dialysis and transplant further downstream in the pathway.

NHS England is also investing in home dialysis for children, supported by a robust network of nurses and clinicians who can move that care from hospital to home. This approach is working, with rates of home dialysis ranging from 64 % to 76% across the 10 National Health Service paediatric dialysis centres.

This data is not available in the requested format. Best Practice Tariffs are regularly updated to ensure they incentivise National Health Service providers to move from usual care to best practice, by creating a price differential between agreed best practice and usual care.

The national average patient cost for home-based renal dialysis for the last three years was £280 in 2023/24, £231 in 2022/23, and £213 in 2021/22. The national average patient cost for hospital-based renal dialysis for the last three years was £223 in 2023/24, £220 in 2022/23, and £192 in 2021/22.

There are no plans to undertake an assessment of the potential merits of standardising reimbursement for all types of home dialysis, or to reduce variance in payments. Commissioned renal providers in England have a contractual obligation to reimburse the additional utility costs for patients who receive home haemodialysis therapy, as stipulated within the national Haemodialysis to treat established renal failure performed in a patients home service specification and the Paediatric medicine renal service specification, and reimbursement costs are managed directly between providers and patients. Currently, information about patients seeking reimbursement costs is not collected centrally. Further information on the Haemodialysis to treat established renal failure performed in a patients home service specification and the Paediatric medicine renal service specification is available, respectively, at the following two links:

https://www.england.nhs.uk/wp-content/uploads/2018/08/Haemodialysis-to-treat-established-renal-failure-in-the-home.pdf

https://www.england.nhs.uk/long-read/nhs-standard-contract-for-paediatric-medicine-renal/#:~:text=The%20aim%20of%20the%20service,progression%20of%20disease%20where%20possible

Increasing access to home therapies is a priority for NHS England and this is reflected in its inclusion in the Renal Transformation Toolkit that was published in 2023, which recommends that 20% of all patients on kidney replacement treatment should receive treatment at home.

Commissioned renal clinical networks across England have included improving access to home therapies in their work plans as per the recommendations within the toolkit. The NHS England national team supports renal clinical networks with the implementation of home dialysis transformation.

The renal clinical networks and the renal services clinical reference group are providing input into the Department’s 10-Year Health Plan development process. As part of this, it is highlighted that increasing home dialysis provision will reduce in-centre dialysis demand and this will shift care from a hospital to a community setting. Renal clinical networks are working towards increasing home dialysis rates in line with the Renal Service Transformation Programme Toolkit’s recommendations.