Community members and dialysis patients consulted for the review spoke positively about nurse–supported dialysis in communities. This is currently offered through WDNWPT. It is perceived to be stable, safe and reliable by patients and community members. Treatment at Kintore, for example, had enabled patients to be home and with families for periods of time. This had positive flow–on effects to the whole community especially when senior cultural and community figures returned. The clearest evidence of Aboriginal community support for this model is through the requests of three other non–Pintupi communities to WDNWPT for respite dialysis services in their communities.
Currently this is a respite model only. Patients do not remain in their communities permanently. Respite care does not impact the overall numbers of patients needing dialysis services in Alice Springs. Nurse–supported respite dialysis in communities also has the potential to evolve into permanent mini–satellite care, as is being implemented in the Kimberley. Other important considerations for nurse–supported respite dialysis raised to the Study Team include:
- The possible negative impact of nurse–supported dialysis on the uptake of (unsupported) self–care therapies.
- The likelihood of an increase in patients opting to take up dialysis (offered in their own community) who would have otherwise chosen not to take up treatment at all.
- The acute shortage of staff accommodation in remote communities.