Prior to the COVID pandemic, Baxter delivery drivers would often deliver the pallet load of medical supplies to the room where the patient’s dialysis equipment was located. Due to COVID-19 safety concerns in March 2020, the HSE / Health Protection Surveillance Centre (HPSC) advised that delivery of prescriptions and medical material should not cross the patient’s threshold and should only be delivered to the patient’s doorstep.

Based on this advice, the National Renal Office (NRO) issued a “home dialysis delivery protocol during COVID-19”. When Baxter Healthcare changed delivery company in October, they discovered some patients had continued to receive ‘across the doorstep’ deliveries. This had occurred in certain individual circumstances where patients were unable to manage doorstep deliveries.

Once Baxter informed the NRO of these deviations the NRO asked the HSE/HPSC for advice. The NRO received new guidance from the HPSC, which laid out the conditions upon which, ‘across the doorstep’ deliveries may be facilitated. It acknowledged that ‘across the doorstep’ deliveries pose additional risks to patients and advised that these should be minimised, particularly the duration of contact between the patient and the driver.

The new October 2020 protocol can be used as a guide for clinicians to use in consultation with their patients in relation to their home dialysis supply deliveries. The final decision regarding implementation is a matter for the individual patient and their own clinician. Make sure that both your consultant and renal nurse are aware of any decisions made.

In general, dialysis patients are deemed to be ‘extremely vulnerable patients’, and are therefore advised that they should check with all visitors that they do not have symptoms of COVID-19, before they allow them to enter their house. They should also ask them to clean their hands (soap and water or hand sanitiser) and to wear a face covering. The length of time the driver is in the patient’s house should ideally be less than 15 minutes. Patients should avoid being in the same room as the driver and ensure room windows are open as far as possible.

The HPSC general guidance can be found at the www.hpsc.ie website and the circular is called ‘COVID-19 Guidance for Older People and Others at Risk of Severe Disease on Reducing Risk of COVID-19 Infection’.

In conclusion, we in the IKA encourage patients to discuss arranging ‘across the doorstep’ deliveries with
their local healthcare team if they believe ‘across the doorstep’ deliveries are in their best interests. If you experience any problems, please let your healthcare team know and if the matter is not resolved contact us at Donor House.