Universal self-travel reimbursement scheme for incentre haemodialysis patients: My Dialysis Treatment Travels

In August 2021, NHS England published a review of non-emergency patient transport services (NEPTS), introducing a new national framework to ensure services are responsive, fair, and sustainable. One recommendation was to implement a universal self-travel reimbursement offer for haemodialysis (HD) patients. The North West (NW) Regional Ambulance & NHS 111 Commissioning team partnered with the North West Kidney Network (NWKN) and successfully applied to become a pathfinder group, receiving funding for the project.

The project aimed to introduce a reimbursement scheme across the North West (NW) for journeys to and from in-centre haemodialysis (ICHD). This scheme would allow patients to drive themselves, have family or friends take them, or use public transport. In August 2024, NHS England published the national incentre reimbursement framework, endorsed by the NHSE Medical Director.

The project team included two members from the NW Regional Ambulance & NHS 111 Commissioning Team and three members from the NWKN, including two people living with kidney problems. Baseline data was collected on the number of NEPTS trips to each HD centre in the NW in 2023. Haemodialysis units were then identified as pilot sites. A network patient survey was launched, and the results were analysed and disseminated. The project name was chosen by patients living with kidney problems and logo created by Lydia Sinnott a work placed student, interested in NHS services with a particular interest in genetics. 

Stakeholders from across all four ICBs were formed. Pilot site teams were enlisted and engaged with the project team, which formed part of the National Reimbursement Offer team. The team explored functioning reimbursement models and repayment mechanisms in other ICB areas in England. Financial modelling for the national incentre reimbursement framework was completed and presented to the project's ICB transport reimbursement leads. PDSA cycles were completed at each stage of the project.

Pilot sites commenced three months of the ICHD self-travel reimbursement model and payment mechanism. Feedback from pilot site teams indicated that the setup of the reimbursement mechanism was simple and familiar.

The patient survey received responses from 282 NW ICHD patients (13%) across 11 NW dialysis units. Knowledge of the reimbursement offer was low at 8%, while 62% of patients were interested in accessing reimbursement. Four percent were unsure, and 34% declined access.

Survey Comments Submitted Number
Negative 142
Positive 123
Neutral  69
No Comment  24
Grand Total 358

Prolonged waiting times featured in 49% of negative comments. The pilot site setup has been completed, with patients enrolled onto the reimbursement scheme. The overall results will be fully realised by June 2025, with a comparison from baseline to post-project data. Patient satisfaction will be measured through pre- and post-scheme questionnaires.

The project aims have been achieved, with 68 patients testing the reimbursement model. A resource and patient information pack was produced to enable the universal rollout of reimbursement for any ICB. NHS England has expressed interest in sharing the reimbursement model and resource pack nationally. The project concludes in 31st March 2025, and more results will be available then. A project closure report will be completed in March 2025, will evaluate the impact of the project and its potential for replication in other areas nationally.

Patient Survey Questions

  • Home Haemodialysis Centre
  • Age  
  • Gender
  • Ethnicity
  • How long have you been receiving your Haemodialysis treatment in the hospital setting? (in-centre) 
  • How do you travel TO your in-centre haemodialysis treatment?
  • How do you travel FROM your in-centre haemodialysis treatment?
  • Have you been informed of, or are you aware of any reimbursement for independent travel to your in-centre haemodialysis? (for example NHS Low Income Scheme)
  • If Yes, are you currently eligible and claiming reimbursement for this independent travel?
  • Have you ever claimed reimbursement for independent travel to or from your in-centre haemodialysis treatments?
  • Please rate your current travel means based on how satisfied you are with travel to and from your in-centre Haemodialysis session?
  • Please give a reason from why you gave this satisfied or unsatisfied rating to question 11? (previous question)
  • If a reimbursement scheme for independent travel to and from your haemodialysis treatments (driving yourself, travel via friends and family, public transport or private taxi hire) was implemented would you wish to access this?
  • What would be your preferred choice of transport to and from your in-centre haemodialysis treatment?
  • Does your dialysis unit have free onsite parking? 
  • Are there any barriers that could prevent you from arranging your own independent travel to and from your in-centre haemodialysis treatments?
  • If Yes, what do you feel these barriers are?
  • If the reimbursement scheme was implemented within your Dialysis Unit. Other than financial benefit how would independent travel reimbursement benefit you?
  • Has or does patient transport services travel impact on your in-centre haemodialysis experience in a- Positive way, Negative way, Does not impact on my treatment experience?
  • Thank you so much for your time in completing this survey.
  • Please do add in any additional information you wish to share below