Consenting patients started on HPN in 9 UK centres will be randomised to receive telemedicine follow up or not. Randomisation will be after consent, and will be restricted by centre. Patients not receiving Telemedicine will receive standard care and follow  up according to his/her centres usual protocol, with telephone links with the NNS weekly for the first month, fortnightly for the next month, once monthly for the next four months, and at least once every 3 months for the remainder of the study.  Questionnaire data collection will be by telephone by a trial coordinator not involved with the patients care and will be carried out two days after discharge home and then one, three, six, and twelve months from discharge. The time period between cathetor insertion and discharge home will be noted and the patients records of time in hospital (as in- or out-patient) will be collected. Those receiving Telemedicine support will be assessed identically but will have telemedicine links with the NNS weekly for the first month, fortnightly for the next month, once monthly for the next four months, and at least once every three months for the remainder of the year. At the end of the first year all patients in the trial will be offered Telemedicine links, and data will be collected for a maximum of two years for each patient.