Substandard dialysis did not kill patients, says trust

A decision to provide substandard dialysis treatment due to “exceptional” capacity pressure was not responsible for high mortality discovered among the service’s patients, a trust has claimed.

HSJ has discovered internal reports from East Kent Hospitals University Foundation Trust that acknowledge it saw “increased mortality” after it began putting “significant numbers” of patients on two-weekly treatments rather than the standard three. The increased death rate was particularly seen among sicker patients.

Twice-weekly dialysis is often used in low and middle-income countries where resources are limited. In the UK it has become more common but is usually used in a limited way as patients step up to three sessions, and with close monitoring.

But the East Kent documents, released to HSJ under the Freedom of Information Act, show it discovered that a “significant number of patients” had been put on twice-weekly dialysis “long term”, in one case for more than a year, “due to capacity issues”. 

A renal deep dive report, considered by a trust committee, questioned whether the service did enough to assess “dialysis adequacy” and to review the risks and benefits of the changes.

The trust had not been measuring patients’ residual kidney function, and there was variability in how often they were reviewed by consultants.

It has also emerged that NHS England launched a review of the service in 2024 over concerns about its “quality, safety and sustainability”. It was found to be an outlier for deaths within a year of patients starting dialysis or transplantation, in data UK Renal Registry data covering 2018-22. At the time, it was struggling to dialyse all the patients who needed it, with some having to go outside the county.

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Source: HSJ, 2 June 2026