HHD PATIENTS RE-IMBURSEMENT

[mrspick]

I am really interested in re-imbursement for HHD patients. The guide lines have not been up dated since 1974 yes thats a long time ago. What do hospitals pay for electricity and water, lighting and heating? do they pay up front or in arrears, paid into a bank account or by cheque straight to patient, lots of questions there any one want to comment?

[Advocacy_NP]

Hello mrspick. This is a topic area which the NKF are currently undertaking research into as practice varies across the UK as to what payments patients receive and how they are paid.

Some patients report receiving a flat rate solely for the energy the dialysis machine use and no other payment for heating or lighting. While other patients get payments for all costs associated. Furthermore, some homes will be on water metres while others are not so this is another cost to be taken into consideration.

In terms of payments some receive cheques while some receive a direct payment (BACS) to their bank account. Variability appears common place and has been reported to the NKF who will be looking for a more consistent and transparent approach.

As we find out more we will report back through the NKF website/Kidney Life and to the network of Kidney Patient Associations (KPA's) across the UK. In the meantime we welcome views from patients on home dialysis and what their experiences have been.

[mikeb]

We receive payment from Leicester HA for electricity and water only based on average usage/week for our NxStage machine. As we use our conservatory for dialysis sessions we do need supplemental heating (electric fan heater) during winter months and cool summer days but don't receive any compensation for this

Payment is by cheque.on a quarterly basis in arrears.

[mrspick in reply to mikeb]

Thanks Mike any one else around the Country like to comment?

[sky27]

we only receive a flat payment for electricity for the machine and in arrears, nothing for lighting or heating. we are paid by cheque.

[mrspick in reply to sky27]

Don't want to know where you are located sky27 but which hospital trust do you come under?

[sky27]

north bristol

[NKFADVOCACYKC in reply to sky27]

I will take this up with the Home Therapies nurse in Bristol again. I only met with him last week and this was one of the specific questions I asked. I understood - clearly wrongly - that the quarterly cheque went towards heating costs as well.

[sky27 in reply to NKFADVOCACYKC]

hi that will be very interesting to see what they say,when i have asked i have been told it is only for electricty for the machines ie the Dialysis machine and the softner and ro, we do how ever get £20 in january to help with postage and telephone calls,of course bloods have to be sent first class

[NKFADVOCACYKC in reply to sky27]

I will keep you posted as soon as I have a reply.

[NKFADVOCACYKC in reply to sky27]

why can't the bloods be dropped off at your GP surgery - they would have a courier collecting bloods etc to take to the lab on a daily basis (prob twice daily actually). Would this be a difficulty for you?

[sky27 in reply to NKFADVOCACYKC]

Hi this is beacuse we live 40 miles from the hospital although the local hospital is only 5mins away

[NKFADVOCACYKC in reply to sky27]

that still should be possible - local hospitals would have bloods to be delivered to the main site.

[sky27 in reply to NKFADVOCACYKC]

Hi the reason for not being able to do this locally is that I diayalise outside the county, this is beacuse when I started HHD it was not available in this area, it still is not at this moment.

Ofcourse it would be so much easier to drop them off at our local lab and have the results on Renal Patient VIew, which both the GP and the unit could look at. and this would save the cost of postage.

[DavidJW in reply to NKFADVOCACYKC]

I take my bloods to KGH as although they could be taken in from my GP's village surgery I am advised that the time could be quite a few hours during which they would be bounced about in a van and that that could cause deteriation of the blood samples

Similarly I take my transplnt bloods in to KGH and they courier them to LGH

KGH is for me only a 15min / 6 mile drive away so no real problem for me

[NKFADVOCACYKC in reply to sky27]

I have had a very prompt response - you are absolutely correct - Bristol does not allow for heating costs. This needs to be addressed, and a national standard applied. Home HD does not, I believe, come into the tariff.

[sky27 in reply to NKFADVOCACYKC]

Hi iam glad that you had such a quick response,

I am not complaining about this it was my choice to Dialyse at home

[mrspick]

Thought as much have heard this before from this part of the Country.

[pgt67]

i have had major issues with this at my hospital as the advocacy officers know. I am not asking for the earth but some reasonable reimbursement with the costs associated with heating/lighting the dialysis room through winter - last winter it got down to minus 10/12 and guidelines (some 30 years old) state the machine should be kept in a room above 5 degrees when not in use and 21 degrees when used.

It is my choice to dialyse at home but if i am saving them around £10,000 a year surely it isn't too much to ask for is it??

a reply from Donal O'donoghue in August 2011

Thank you for your email of 11 July about funding for costs associated

with home dialysis. I am sorry for the delay in replying.

The 1974 Guidance is still current and requires the NHS, where there is no

separate heating supply for the dialysis room, to estimate and pay for the

average energy consumption for the type of room. The room needs to be kept

permanently above 4 degrees C when the dialysis machine is not in use and

21 degrees C when you are using the machine. As you say, power supplies

are increasing in price and I would expect the NHS to take account of that

in determining the amount of the payment you receive. The costs of

maintaining the room temperature should be paid in addition to the costs of

running the dialysis machine. It is not possible to determine these costs

nationally as they are dependent on local factors such as room size and

type of heating system etc.

We will be considering whether any of the 1974 guidance needs to be updated

in due course, but in the meantime it still applies and I suggest that you

draw it to the attention of your local unit.

Yours sincerely,

Dr. Donal

anyone want a copy of the guidelines just send me a PM and i will forward it to you!

[SPARKY1 in reply to pgt67]

Dear Dr Donal, please could you send me a copy of the current guidelines for HHD reimbursement costs. My email is <deleted by moderator>. Thank you.

[Hidden in reply to SPARKY1]

Please don't post e-mail addresses on these pages, as they are visible to the world and could be harvested for sending spam.

pgt67 asked you to send a Personal Message for a copy of the guidelines. Please use that option to get in touch.

[ChrisS]

For the record Royal Derby Hospital paid me £72 per quarter , direct to bank for my Nocturnal 5 times a week Dialysis. , We are not on a water meter so they did not have to pay for additional consumption ( But did check that out ). The room I use is part of the house and was already heated .

My nurse visited me once every 4 weeks to audit progress , take my daily results away and take my blood samples to the hospital lab , ensuring timely and quality delivery of results to RPV.

A fair deal I felt , and nocturnal dialysis was brilliant for keeping me in good condition .

[Leagibb4]

We are paid £41 per month to cover electric & water costs. This is a backs payment made automatically to our bank account. My husband is on hhd 5 times a week. However our last 2 quarterly eon bills (for elec & gas) have been £420 and £470! They use to be about £180 over previous winters so we are calculating that we are at a minimum of £150 worse off at a minimum.

In addition to the payment from the nhs our council tax band has also been reduced saving us £20 per month because our home is being used for medical purposes. Hope you all know that you are entitled to this.

I would be interested to know if anyone has had support from electricity companies on the subject of hhd.

[Leagibb4]

By they way - this is in Lancashire

[Goldeneye]

Hospitals give you an allowance for water and electricity. The water company put you on a special tariff and if you are in East Sussex another water company takes your waste away so you have to notify them that you are on a special tariff from your water company otherwise you will be paying for a lot for waste water as each 2 hour session uses 33 gallons of water. It is paid 3 monthly in arrears by my trust ,other trusts may be different but you are only allowed payment for 5 x2 hour sessions regardless if you decide to do it 5 or 6 times a week

[Hidden]

We send a copy of the quarterly Bill to the hospital finance department and they pay the billpayer via BAC's transfer. Sometimes need chasing up in writing to remind them...

[niknocks]

Not sure if any of you have done so but its worth ringing your suppliers and let them know that your home is also used for medical purpose's. I know welsh water cap the water bill for anyone who has medical need and some electric company's have special tariffs etc. There are also grants that are available to make sure that your home stays warm like cavity insulation etc

[Rozieb]

I know thus is an older thread but still valid. Is anyone in the Yorkshire area know about payments?

I may have to start dialysis soon and am looking at hhd.