National Clinical Homecare Association Welcomes the Department of Health’s Sponsored Review of NHS Homecare Medicines

By National Clinical Homecare Association, PRNE
Thursday, December 1, 2011

LONDON, December 2, 2011 -

The National Clinical Homecare Association (”NCHA”,, the industry body representing companies providing clinical homecare services to patients of the NHS, welcomes today’s publication of the Department of Health’s Sponsored Review “Homecare Medicines - Towards a Vision for the Future”.

In 2010, the NHS Chief Pharmacist commissioned Mark Hackett, Chief Executive of Southampton University Hospitals NHS Trust, to chair a review of homecare medicine supply in the UK. The review’s objective was to set out a greater understanding of the UK’s clinical homecare market, explore similar models of care within the EU, examine any links to other service provision under the Pharmaceutical Service Regulations and to develop solutions that support the NHS Quality, Innovation, Productivity and Prevention (”QIPP”) agenda programme.

Dr Nick Payne, Chairman of the NCHA, said: We welcome the publication of the review by Mark Hackett and its demonstration of the valuable role that clinical homecare plays in both improving outcomes for patients and saving money for the NHS.

“More than 150,000 patients are currently treated at home instead of in hospital by our members. The clinical services provided are highly rated by patients and cover a wide, and increasing, range of therapy areas. Patients treated at home are often very poorly and would otherwise need to be treated in hospital, so clinical homecare can help to relieve capacity pressures on bed-spaces within the NHS. Treatment at home is not suitable for every patient but is overwhelmingly preferred by patients when clinicians support the decision to treat them at home rather than in hospital. It is widely proven that treating appropriate patients in the community can deliver better outcomes at lower cost than in hospital. Consequently, clinical homecare as provided by NCHA members brings a triple benefit: patient preference, better outcomes and cost-savings for the NHS.

“The review recognises the important role of clinical homecare in supporting patients and, as a result, that the NHS will need to adapt appropriately to support the large and growing number of patients who will not only prefer to be treated at home but also benefit from high quality clinical homecare as provided by NCHA members instead of in hospital. The NCHA commends Mark Hackett and the members of the steering committee for their work. We believe that this report endorses the approach that we have taken to aim for the highest standards of patient care. We look forward to working with the NHS to further improve existing arrangements and to introduce new approaches that will exploit the full potential of clinical homecare to improve the treatment of patients and to save costs for the taxpayer.”

The NCHA’s response to the “Homecare Medicines - Towards a Vision for the Future” report

Contractual improvements

The NCHA would welcome any opportunity to standardise and improve contractual arrangements with the NHS relating to the provision of clinical homecare. One of the main problems facing the industry at present is inconsistent arrangements with different parts of the NHS.


The NCHA is committed to greater transparency and again would welcome the introduction of more transparent and open tendering for contracts. Clinical homecare in general has been shown to reduce treatment costs and improve outcomes, and more transparent and open tendering would be expected to increase competition and further reduce costs.

Governance and accreditation

The NCHA welcomes all proposals designed to improve corporate governance and looks forward to entering into a debate with the appropriate authorities within the NHS and Department of Health to set relevant standards. However the NCHA wishes to point out that clinical homecare is already a highly regulated industry. Although there are currently no industry-specific regulations, clinical homecare is covered by a wide range of regulation, inspection and audit by such bodies as the Care Quality Commission, the Medicines and Healthcare Products Regulatory Agency and the General Pharmaceutical Council and is also subject to supervision by pharmaceutical company suppliers and by the NHS. All member companies of the NCHA adhere to quality marks (such as ISO 9001) and as a trade body the NCHA is committed to raise and define standards.

Collaboration with the NHS

It is our ambition to work with the different parts of the NHS to develop common approaches and common standards for clinical homecare throughout the NHS, replacing the current situation where standards and expectations vary from one Trust to another and to remove any inequity and lack of access for certain patients who would otherwise benefit from clinical homecare services. In our view, this collaboration would help to maximize the quality of service for patients, rather than the current situation where clinical homecare is primarily regarded as a means of achieving cost-savings.

The NCHA welcomes all initiatives to improve collaboration with the NHS and we look forward to entering into a debate with the NHS and commissioners. In particular we endorse the need to standardise systems and arrangements throughout the NHS. This would improve efficiency and reduce costs while allowing us to focus on our primary objective: delivering an optimal service for patients. Furthermore, we would welcome the introduction of systems that evaluate the costs of the whole healthcare system. As far as procurement is concerned, all of our members are committed to transparency and welcome the introduction of improvements to their contractual arrangements with the NHS.

Both as a trade association and as individual companies we would be delighted to debate and agree clear, consistent and relevant performance indicators with the NHS and to set the highest standards for governance and operational management. We are committed to transparency and would be happy to cooperate with the NHS in discussing how best to separate the provision of clinical homecare services from the supply of medicines in order to highlight the value for money that our service brings to the NHS.

The NCHA welcomes any initiatives that would improve the relationship between the NHS and providers and help to standardise operating practices. In particular the NCHA welcomes the suggestion to second personnel from the NHS to homecare providers as this would help to improve the understanding within the NHS of the contribution that clinical homecare can make to patient care. It will also highlight the practical issues concerned with treating patients in their homes rather than within an NHS facility. Finally the NCHA is committed to the highest standards in terms of transparency surrounding its members’ financial arrangements with the NHS.

The NCHA also welcomes the proposals on cost savings. We have an important role to play in improving treatment outcomes as well as reducing costs. We would be pleased to enter into arrangements whereby cost savings are shared between the NHS and the homecare provider. However, in view of the not inconsiderable difficulties in assigning costs and values we would recommend that this should commence with a pilot study.

Working with patients

The NCHA also believes that the proposals to increase the involvement of patients and their representatives in the treatment process make eminent sense. The NCHA has always emphasised the importance of patients as paramount and we would be happy to cooperate with the NHS and patient groups in framing appropriate safeguards and involvement in the setting of contractual arrangements.

About the NCHA

Established in 2006, the National Clinical Homecare Association (NCHA) is an industry body representing companies providing clinical homecare services to patients of the NHS, along with charitable and independent sectors within the UK. With well over 150,000 patients currently receiving clinical homecare services in the UK, the importance of an industry body should not be underestimated. Possessing over 150 years’ collective experience, the NCHA is perfectly positioned to provide an invaluable service to commissioners, clinicians and patients alike. Furthermore, by only offering membership to companies that meet the stringent criteria of the Association, patients, and staff working with patients, can rest assured that member companies’ activities have achieved a core set of minimum standards in terms of the provision of clinical homecare.

Currently the following organisations are members of the NCHA:

Bupa Home Healthcare
Calea UK Limited
Central Homecare Ltd
Eurobay Pharma
Evolution Homecare Services
Healthcare at Home Ltd
Medco Health Solutions (UK) Ltd


About Clinical Homecare

Clinical homecare is the treatment of patients in their homes, involving drug therapies and often regular and frequent nursing contact, differing significantly from other homecare approaches (e.g domiciliary care).  Clinical homecare offers improved convenience and privacy for the patient and has won high satisfaction ratings from both patients and carers. It has been shown not only to bring improved compliance and better outcomes but also to achieve significant cost-savings (an analysis by Dr Foster Intelligence has shown that wider adoption of home services could save the NHS - and therefore the taxpayer - over a billion pounds each year). It also frees up valuable hospital resources for the NHS. Treatments for a large range of clinical conditions are now routinely delivered in the home setting of the patient. Therapy areas and conditions for which services are now provided at home include:

Dermatology (Psoriasis)
Chronic Kidney Disease
Assisted Conception
Growth disorders
Virology (HIV)
Hepatology (Hepatitis)
Infection management
Oncology (Oral & IV therapies)
Cardio-Thoracic Medicine (e.g. COPD, Cystic Fibrosis, Pulmonary Arterial Hypertension)
Neurology (e.g. Multiple Sclerosis, Parkinson ’s disease, Schizophrenia)
Parenteral nutrition

For further information, please contact:

Dr Nick Payne, Chairman
Tel: +44(0)7970-387992

Peter Laing/Emma Thompson/Claire Dickinson
Tel: +44(0)207-920-2330


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