Holiday haemodialysis
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1 Holiday haemodialysis Information for patients from the Renal Department This booklet aims to give patients a brief overview of the arrangements necessary for haemodialysis treatment whilst away from home. Holiday dialysis (also known as dialysis away from base) can be organised by yourself or via Dialysis Freedom for UK holidays and supported by your holiday coordinator, who will also help arrange your dialysis abroad. Can I use haemodialysis units worldwide? There are many haemodialysis centres throughout the world that provide holiday dialysis. Dialysis in the UK You should be able to have dialysis at any NHS unit in the UK, providing there are spaces available. Private (non NHS) units are also available in the UK, but please check they have an agreement with the NHS before you book your holiday. If the private units do not have an NHS agreement then the full cost for dialysis will be charged to you with no reimbursement available. Please check on the NHS Choices website (see Useful information). The Kent Kidney Patients Association own two six berth, static caravans in the Coombe Haven caravan park in Hastings. These are free for dialysis patients and very popular. As it is run by a charity you may wish to consider making a small contribution to the charity after your holiday. For haemodialysis patients the dialysis would need to be undertaken in either the NHS unit in Bexhill or the private dialysis unit in Eastbourne (contracted to NHS). Dialysis Freedom will contact the units to establish if there are spaces available for you. Europe - within the European Economic Area (EEA) some facilities currently offer free dialysis. Either you or your holiday coordinator must check that the unit accepts the European Health Insurance Card (EHIC) before you book, and that it covers the full cost of your treatment as this will entitle you to free dialysis. If the unit does not accept the EHIC you will be charged for the dialysis and any additional costs, such as administration and blood tests.
2 The EHIC is not an alternative to travel insurance. Patients are asked to discuss their insurance requirements with their insurance company and make sure their policy covers pre-existing conditions which includes haemodialysis. Holidays outside of the EEA If you wish to travel to a non EEA country, you or your holiday coordinator will need to check whether or not the country has a bilateral healthcare agreement with the UK (found on the NHS choices website). If they do not have a bilateral healthcare agreement, you will be liable for the entire cost of the treatments in that country. If you are travelling to Australia, treatment must be arranged in advance at a state facility and costs will be met by the Australian Medicare system. Please go to for further information. Can I claim a refund for the fees charged for my dialysis? Europe - if the unit chosen does not take the EHIC, then they are a privately run unit and an application is necessary to NHS England before travel to reclaim the fees charged for dialysis. The regulations and advice regarding this are on the NHS Choices website. If an application for funding for dialysis is not made before you go on holiday it is not possible to make a claim upon your return, as haemodialysis is classed as pre approval only. The EAA/S2 form you will need can be downloaded from the website below, or please ask your holiday coordinator for a copy. There is a checklist at the back of this form as you have to also show a recent utility bill plus a bank statement as they require evidence you are a resident of England. All queries should be made via to the cross border team of NHS England nhscb.europeanhealthcare@nhs.net Refunds will only be up to the NHS tariff, which means that if the overseas unit is more expensive than the UK cost for haemodialysis, then you will have to make up the difference. The application process should not take more than 20 days. A reference number will be allocated to you by the European healthcare cross border team and should be used for all future correspondence Article56.aspx Some countries, such as France or Switzerland may ask for a contribution towards the costs of dialysis. This is often referred to as a co-payment. You or your holiday coordinator should check if a co-payment is required as you will be liable for this additional cost. It is always worth checking if there is a nearby unit which is fully covered by EHIC. Cruises - if the ports visited are EEA countries then reimbursement will be paid up to tariff by East Kent Hospitals and you will have to pay any additional costs. Approval is necessary before travel. Your holiday coordinator will discuss this with you and an application to the renal operations manager will be needed before you book your holiday. If the cruise is outside of the EEA, full cost will be charged to you for each dialysis treatment, with no reimbursement. An application for reimbursement and confirmation of what countries provide what treatments are found on the NHS Choices website
3 British Kidney Patient Association (BKPA) funding application - there are opportunities for dialysis patients to apply for funding for holidays via the BKPA. Please speak to our renal welfare officer about this - an information sheet about BKPA funding is available from your holiday coordinator. If you use the company Dialysis Freedom to coordinate your overseas holiday and the holiday is cancelled, you will be liable for the cost of the cancellation. Please clarify this with Dialysis freedom when booking. Please do not book your holiday until you are happy the dialysis has been arranged, and you understand who is paying for the dialysis. It is your responsibility to check the funding arrangements before booking your holiday. Do I need to keep my receipts? If the dialysis unit was in a private European unit or on a cruise please refer to the reference number you were given on your application. Please be aware that full payment for your dialysis will be expected whilst away and all receipts should therefore be kept with proof of attendance to the European cross border team. Please speak to your holiday coordinator if you need to confirm contact details. Will my place on the transplant list be affected by my holiday? Whilst away on holiday overseas, if you are on the transplant list you will be temporarily suspended due to the time it takes to travel back to the UK. This should be reinstated upon your return unless there is concern over your health. The staff in the dialysis unit will assess and discuss with your consultant if they have any concerns. What will happen before I travel? There are certain swabs and blood tests needed before you can dialyse in another renal unit. The holiday dialysis facilities will contact your holiday coordinator with the health screening checklist. Your consultant may need to discuss the risk involved with you if you plan to visit any high risk countries. Your consultant will need to assess and make sure you are well enough to travel. Holiday units also ask for confirmation of this in writing. Some units request you bring with you certain medications specific for dialysis. If this is the case you will also require a customs letter listing these items. It is not necessary to take dialysers, blood lines, or needles unless advised by our department. You will need to obtain confirmation of payment of dialysis if the unit is not NHS or does not accept the EHIC card. This is your responsibility and you may incur unexpected costs if this is not confirmed before you travel. How much notice do I need to give you before I go on holiday? To make sure that all renal units comply with the highest standards of infection control, there are certain procedures and blood tests required before you can go to another renal unit. You will need to give as much notice as possible to your holiday coordinator - we request at least four weeks notice for UK holidays and 12 weeks for overseas holidays.
4 What happens when I return to the UK? There are strict infection control guidelines for all patients returning back into East Kent Hospitals. Your holiday coordinator will discuss this with you. Screening with blood tests and swabs will be necessary. Isolation of your dialysis in a side room may also be necessary as a temporary measure until all results are available. Will I be able to return to my usual dialysis slot? Holiday dialysis is usually unlimited, but if you are away for longer than six weeks we might be unable to keep your routine slot for when you return. Upon return you will be allocated to a unit as close to your home as possible until a slot at your permanent unit becomes available. Useful websites Kent Kidney Patients Association Holiday Insurance or EHIC card Useful information National Kidney Federation - for an introduction to holidays for kidney patients Web: British Kidney Patient Association - for information about holiday grants Web: Global Dialysis - for information about dialysis holidays abroad Web: Dialysis Freedom (booking charge applies for overseas) - for information about dialysis in the UK Web: Telephone: NHS Choices Web: European Cross Border Team Telephone: nhscb.europeanhealthcare@nhs.net List of units and contact numbers Canterbury Telephone: Dover Telephone: Margate Telephone: Medway Telephone: or Maidstone Telephone: Ashford Telephone: Please discuss with your holiday coordinator any questions or concerns you may have.
5 Confirmation that this leaflet has been given to the patient and explained in full. Staff name: Staff signature: Patient name: Patient signature: Date: This leaflet has been produced with and for patients If you would like this information in another language, audio, Braille, Easy Read, or large print please ask a member of staff. Any complaints, comments, concerns, or compliments please speak to your doctor or nurse, or contact the Patient Advice and Liaison Service (PALS) on or , or ekh-tr.pals@nhs.net Further patient leaflets are available via the East Kent Hospitals web site patientinformation Information produced by the Renal Department Date: May 2017 (version 3) Review date: September 2019 Web 362
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