Dialysis Away From Base (DAFB) Frequently Asked Questions.
Q: Who is this guidance for?
A: This guidance relates to patients living in England only (or registered with an English GP), who are on some form of dialysis treatment. ‘Base’ refers to the place where a patient normally has their dialysis treatment.
Q: Is it easy to organise to have DAFB?
A: Whilst it does take some planning for DAFB to take place, the renal team will be able to help you with organising DAFB and there are some useful websites and telephone numbers at the end of this paper that will help. It is best to give as much notice as possible before you plan to go away. This is usually a minimum of 4 weeks for within the UK and 3 months if outside of the UK. Due to the risk of passport issuing delays, it is also advisable to make sure that you have all the relevant travel documents needed for travelling abroad in plenty of time before arranging visits to other countries.
Q: Will I have to pay for my DAFB?
A: No, not in an NHS unit in the UK, nor in those private units with which the NHS has made an agreement to pay, but you will of course have to pay for your travel and accommodation costs. If the unit is private you will need to check that they have an agreement with the NHS, that the NHS will pay.
For outside of the UK the rules on whether you have to pay are different depending on where you dialyse.
The European Health Insurance Card (EHIC) card allows you to access state-provided healthcare in all European Economic Area (EEA) countries. The EHIC is available free of charge at the following web site https://www.ehic.org.uk/Internet/startApplication.do or phone 0300 3301350.
However, please be aware, that in some countries, for example, France and Switzerland there may be a percentage payment system. It is therefore important to check this before you confirm the booking for your stay. The following website will have up to date information
available. http://www.nhs.uk/nhsengland/healthcareabroad/plannedtreatment/pages/introduc tion.aspx
This will mean that you will need to pay a proportion of the cost of the provision of holiday haemodialysis.
If the renal unit you will be using within the EEA is not a state-provided renal unit you will need to pay for the dialysis treatment sessions yourself. However if this is the case, you will need to apply before you go away for a partial or full refund from the Cross Border team of NHS England at firstname.lastname@example.org under a European directive known as Article 56. You can expect to be refunded up to the cost of what the National
(NHS) pays for dialysis but you will only receive this refund after you have been away. Applying before will help you to understand the amount to be refunded, and it is likely that the amount will not cover the cost of the holiday dialysis. This will mean that you will need to pay the excess costs as the cost of the dialysis will probably be more than what the NHS pays for dialysis. You will need to forward the original receipts and proof of payment when you come back in order to receive the refund.
There are a number of other countries with which the UK has a reciprocal healthcare agreement. Please check the following website link for the countries. Treatment must be arranged in advance, at a state dialysis centre. In most cases, this will either be free or at a reduced cost to the patient. You will need to check before you confirm your booking if there are any additional charges foryou. http://www.nhs.uk/nhsengland/healthcareabroad/countryguide/noneeacountries/pages /non-eeacountries.aspx.
For haemodialysis outside of the EEA or a country with a reciprocal healthcare agreement you will be expected to pay for full cost of the treatment. DAFB outside of EEA or reciprocal countries may not be regulated by a country's health policy, and you will need to make checks about the quality of the service. Before you book your dialysis you need to check for example, the type of dialysis service provided, the number of doctor and nursing staff, machines, back up machines provided, and the experience of the renal team in providing dialysis. For some destinations it may be wise to take some of the consumables used in dialysis with you, this needs to be agreed with your usual renal unit.
Q: Will I get my usual transport to and from dialysis?
A: You will need to check that there is transport available at the unit that you are planning to use for the times that you will be dialysing there. If you meet the eligibility criteria for having transport provided to and from dialysis sessions at your home unit, you may be able to receive this transport free of charge but this is in England only. Your renal team can help with finding out about what the transport arrangements are before you book your DAFB.