20 November 2023
As organisations representing both patients and clinicians, who rely upon and work with homecare medicines services, we are encouraged by the direction set out in the House of Lords Public Services Committee report, Homecare Medicines Services: An opportunity lost.
Bringing care closer to home for patients and reducing the burden on overstretched and under-resourced NHS clinicians is the central benefit of homecare medicines services. However, as the House of Lords Public Services Committee has correctly concluded, the potential benefits of the system are not being realised due to the disjointed, opaque, and unaccountable system which has evolved to deliver these services. The committee has vindicated the voice of patients and clinicians stating they were “persuaded by the weight of evidence from service users that there are real and serious problems in the sector.”
Addressing these problems in its report the committee has set out a series of crucial recommendations for immediate implementation, including for;
- There is to be a full-scale Government-sponsored independent review of the overly complex homecare system.
- The NHS is to designate a named individual to be appointed and appropriately supported to lead and take responsibility for homecare medicines services.
- NHS England to identify how many patients have become unwell or have been harmed because of a failure in homecare services.
- A review of the regulatory regime for homecare medicines services [where a] lead regulator should be identified with the skill and the expertise to take action against providers that are under-performing.
- NHS England to develop and implement a uniform set of performance metrics for the homecare industry and for these to be consistently published in a standardized form.
- Improvement of patient recourse and complaints systems through the initiation of a thematic review of homecare by the Care Quality Commission (CQC)
- Government to take responsibility of the response by making a ministerial statement on the [report’s] findings and proposed actions for NHS England's work on homecare.
Collectively we believe it is imperative that these recommendations are adopted in full and actioned immediately by the NHS, the regulators, and the Department for Health and Social Care so that patients and clinicians can have confidence that much-needed reform is going to take place.
We also call for the longer-term recommendations addressing e-prescribing, IT interoperability, and support for NHS homecare teams to be taken forward in full. This will support Trusts in the management and procurement of homecare contracts and reduce the burden on clinical teams interacting with homecare services during the systems review.
We would like to thank the House of Lords Public Services Committee for their excellent work on this inquiry and we are optimistic that, if taken forward in full, the recommendations set out provide an excellent foundation for long-term improvements in the sector.
Sarah Campbell, CEO, British Society for Rheumatology
Professor Andrew Veitch, President, British Society of Gastroenterology
Dr Christian Selinger – Chair IBD section, British Society of Gastroenterology
Sarah Sleet – CEO, Crohn’s & Colitis UK
Professor Mabs Chowdhury, President, British Association of Dermatologists
Clare Jacklin, CEO, National Rheumatoid Arthritis Society
Dr Dale Webb, CEO, National Axial Spondyloarthritis Society