Logo: NHS East of England Collaborative Procurement Hub

What are Homecare Medicines Services?

A homecare medicine delivery service can be described as being a service that delivers ongoing medicine supplies and, where necessary, associated care, initiated by the hospital prescriber, direct to the patient’s home with their consent. The purpose of the homecare medicines service is to improve patient care and choice of their clinical treatment. [1]

Homecare services are provided to over 200,000 patients in the UK representing £1.5 billion of the £4 billion spent on hospital medicines. The sector has grown rapidly and continues to develop and expand to meet patient demands and NHS cost containment targets [1]. In the East of England (EoE); annual spend for oral chemotherapy, HIV and Hepatitis homecare services alone is in excess of £12 million with total annual expenditure in the EoE over £100 million.

[1] Royal Pharmaceutical Society – Professional Standards for Homecare Services in England.

Types of Homecare Medicines Services

Homecare medicines services can be categorised in a number of ways, below are two examples:

Funding Routes

Funding for a homecare medicines service can ultimately fall to two entities, the NHS or a product manufacturer (Pharma).

Pharma Funded Homecare Medicines Services

 What are Pharma Funded Homecare Services?

Pharma funded homecare services (also known as pharma schemes) are homecare medicines services for which one or more homecare providers are commissioned by a manufacturer of a drug (pharma company) to provide a homecare service to NHS or private patients.

For the majority of pharma funded homecare services, the NHS is liable only for the cost of the drug / product with the service costs funded by the pharma company. This is a key factor driving the use of these services within the NHS compared to NHS funded homecare services. Pharma funded homecare services form the majority, by both patient volume and expenditure, of all homecare services provided by NHS trusts across the country.

Manufacturers often establish pharma funded homecare schemes with the aim of improving the patient experience, product accessibility and availability of accurate usage data. Data collected from homecare providers delivering a pharma funded homecare service is more detailed (Eg. patient demographics, indication and incidents) that that available through the usual pharmacy wholesale supply chain.

To find out more about how the EoECPH supports trusts to implement and manage pharma funded homecare services please see the “Contracting of Homecare Medicines Services” page.

What Pharma Funded Homecare Services are Available?

The East of England NHS Collaborative Procurement Hub (EoECPH) maintains a list of available pharma funded homecare services for use by local trusts. This data is provided by each of the homecare providers and is updated on a regular (at least quarterly) basis to ensure accuracy.

You can find this list under the "Related Files" heading to the right of the screen.

Not accurate? If you have information to update or correct the content of this list please contact joe.bassett@eoecph.nsh.uk

NHS Funded Homecare Medicines Services

NHS funded homecare services are simply those which the NHS procures from the open homecare services market whereby both product and service costs are payable by the local trust or commissioner.

Services are procured at national, regional and local level. The commercial Medicines Unit is responsible for national procurement of homecare services. Regional procurement hubs or lead trusts procure on behalf of multiple NHS trusts within a geographical region. Bespoke local contracting occurs where there is a specific and unique requirement for a particular trust not covered by national or regional framework agreements.

To find out more about how NHS funded services are procured in the East of England please see the “Contracting of Homecare Medicines Services” page.

Service Complexity

Homecare medicines services can also be categorised by their relative complexity as defined within the RPS Professional Standards for Homecare Services.

Low tech homecare service

Activities include

  • self-administration of oral therapy or medicinal products for external use only excluding oral oncology
  • products are licensed medicines or uncomplicated medical devices
  • product storage conditions are 15-25 C and/or 2 -8 C suitable for storage in the patient’s own fridge
  • self-administration of medicines is usually in accordance with the Summary of Product Characteristics, occasional off-label use
  • homecare team members are expected to identify and report obvious misuse of medicines and noncompliance
     

Mid tech homecare service

Activities include

  • products that are unlicensed medicines
  • therapy that requires significant clinical support or diagnostic testing such as blood level monitoring as part of the homecare service e.g. oral oncology
  • patient training and competency assessment relating to self-administration
  • self-administration needing basic aseptic technique and standard ancillaries e.g. pre filled syringes
  • medications with special storage requirements
  • provision of refrigeration equipment
  • compliance and/or concordance programmes including specified interventions
     

High tech homecare service

Activities include

  • intravenous infusion
  • self-administration needing advanced aseptic technique and / or portable equipment / specialist ancillaries
  • products that are compounded aseptic medicines
  • administration by healthcare professional
  • clinical decisions taken within approved clinical protocol with escalation of out-of-limit findings to the clinically responsible person
     

Complex homecare service

Activities include

  • provision of bespoke homecare solutions for individual patients not covered by national standards
  • permanent or semi-permanent adaptation of the home environment required as part of the service
  • permanent or semi-permanent installation of equipment in the home
  • clinical responsibility delegated to a third party
  • clinical trials including homecare services

 


Site Maintenance

Have you found a broken link, outdated/incorrect information, missing file? Do you have a suggestion for improvement of the site?

Please contact joe.bassett@eoecph.nhs.uk

[Information on these pages is representative of the EoECPH homecare team only]