Belgian dialysis centres struggle to offer varied care due to staff shortages

Many kidney dialysis centres in Belgium are unable to provide a wide range of treatments for patients because of ongoing staff shortages, according to an audit by the Hospital Audit Unit shared by the National Institute for Health and Disability Insurance (Riziv) on Tuesday.

Three out of four centres say they lack enough nursing staff, which limits the options available to kidney patients. The audit found that while four in five centres offer different types of dialysis, many have no clear care plan or standard procedure to assess patients’ quality of life or long-term outlook.

The Riziv had reformed dialysis reimbursement in 2016 to encourage more personalised treatment and better access to home-based care. However, little progress has been made. The number of patients using home peritoneal dialysis has barely changed, and one in six centres still does not offer the option at all.

The shortage of nurses also makes it harder to support patients at home. “Providing and supervising dialysis at home is labour-intensive and financially challenging for both patients and care providers,” the Riziv explained.

To address the problems, the audit includes about 30 recommendations. Riziv suggests that all dialysis centres should be required to offer at least two main types of treatment (haemodialysis and peritoneal dialysis) and to ensure patients receive full information about their options. Centres should also employ at least one specially trained nurse, a nephrologist, a dietitian and a patient counsellor, and work more closely with family doctors.

^{Illustration picture shows nursing staff checking a kidney dialysis machine at the intensive care unit of the Imelda hospital in Bonheiden © BELGA PHOTO DIRK WAEM}