To kidney disease patients spending long hours on dialysis, a hospital is like their second home.

But a new programme in Bradford will see many patients swapping sitting at machines in a hospital ward for the comfort of their living rooms.

More than 235 people currently receive long-term dialysis at Bradford Teaching Hospitals Foundation Trust, but the introduction of the Trust’s first home haemodialysis programme could increase the proportion of patients who undergo dialysis within their own homes.

Since being diagnosed with polycystic kidneys 14 years ago, travelling to hospital for dialysis has become part of Julie Clarke’s regular routine.

When she was initially diagnosed with the condition, she worked it around her job. Becoming self-employed has given the 46-year-old greater flexibility to fit her treatment around work.

It was while having regular treatment at the Skipton satellite dialysis unit that Julie was encouraged to do some self-care. This prompted her to ask whether she could administer her own treatment at home.

With the support of the nurses – who she says she can’t praise highly enough – Julie was given the go-ahead, and is currently the only patient using home dialysis. She is paving the way for other patients to have their treatment at home.

Currently, 60 patients on dialysis are waiting for a kidney transplant. Bradford’s renal unit currently dialyses 170 patients at the main unit in St Luke’s Hospital and 31 receive treatment at the satellite unit in Skipton. There is also a four-stationed acute unit at Bradford Royal Infirmary, primarily treating inpatients requiring kidney replacement therapy.

Although Julie is currently the only patient on home dialysis, there are plans to increase the number of patients benefiting from this facility this year.

“Home haemodialysis has put me back in control of my treatment and my health, my aim now is to move to overnight home haemo, which would mean that I can have my working week back and that would seriously give me my life back. It would also mean improving my health further, as the treatment is much more gentle,” says Julie.

“I now live a much better life than before and would recommend this to anyone who wants more control and freedom in their life.”

Dr Russell Roberts, the renal consultant who led the project, says: “This new service, which we are bringing into people’s homes, will see patients across the district benefiting from a more flexible dialysis arrangement that better suits their needs.

“The National Institute for Clinical Excellence guidance says units should offer all possible models of treatment, and home haemodialysis is another step along the way to improving our service to patients.

“The standard in-centre regime currently sees patients dialysing for four hours, three times a week but there is increasing evidence that a significant number of patients will do better on different regimes; some for long gentle dialysis overnight, while others may benefit from doing shorter dialysis sessions five or more times a week. This new home-based service means patients can adapt the dialysis to the schedule that best suits and is most flexible for their lifestyle.”

Home haemodialysis sister Jayne Oldroyd will co-ordinate the support and advice available to home haemodialysis patients.and also train potential new patients before they go home.

Technical support is also provided for the modifcations to patients’ homes. Patients will visit a review clinic every three to four months and receive home visits from staff when required. They also have the re-assurance of a number for the renal team offering 24/7 telephone advice.

Dr Roberts also talks about the ‘buttonhole technique’ – a new technique piloted by Dr John Stoves and sister Sheila Hull from the Skipton satellite dialysis unit, for inserting needles into patients’ veins.

“This technique is considered more suitable for home patients so that they can ‘needle’ themselves more easily compared to conventional techniques and formed an important step along the road to the home haemodialysis programme,” says Dr Roberts.

He says as the home haemodialysis service expands, it is hoped it will ease some of the pressure on the main hospital dialysis unit at St Luke’s.

“Home haemodialysis is a very exciting development as it has been an aspiration for a very long time. It is great to see our first patient dialysing herself and reporting that she feels so much better. She is not only genuinely physically better, but there is a huge psychological benefit as well,” says Dr Roberts.