05 February 2024
Following the government’s response to the House of Lords inquiry Homecare Medicines Services: An opportunity lost; eight patient charities and clinical membership bodies, led by BSR, have published a joint statement saying that “Significant work [still] needed to assure patients and clinicians of the future safety of homecare medicines services”.
Speaking about the publication of the joint letter our CEO Sarah Campbell said:
“Following the government’s response to the Lord’s report, the voice of patients and clinicians is united: significant work is still needed to assure us that homecare services will be safe and reliable in the future.”
She continued;
“The government has accepted recommendations which were hard fought for by BSR and our partners and will make homecare services more transparent and more accountable, in particular by agreeing to name a senior NHS England (NHSE) official as responsible for the system nationally.
However, provisions to review the regulatory system and publish the scale of harm to patients have both been delayed and important measures to help clinicians struggling on the ground have been watered down or not adopted in full.
She concluded;
“Both NHSE and the Department for Health and Social Care (DHSC) still have a long way to go to demonstrate that they understand the scale of the problem and are serious in putting them right.”
The House of Lord’s Public Services Committee launched its inquiry into homecare medicines after 12-months of campaigning by BSR and others highlighting worrying instances of harm to people using homecare services and high levels of disruption experienced by NHS clinicians. These experiences were validated by a series of hard-hitting media reports, including a 6-month investigation by the Guardian newspaper into Sciensus, the largest deliverer of homecare medicines services in the UK.
The organisations to sign the joint statement include patient and clinical groups from across five medical speciality areas and represent hundreds of thousands of NHS service users and staff. The group consists of British Society for Rheumatology (BSR), Crohn’s and Colitis UK (CCUK), National Rheumatoid Arthritis Society (NRAS), British Association of Dermatologists (BAD), National Axial Spondyloarthritis Society (NASS), British Society of Gastroenterology (BSG), Cystic Fibrosis Trust (CFT), The Haemophilia Society and Versus Arthritis (VA).
Following the government’s response to the inquiry, there will now be a debate in the House of the Lords and NHSE has pledged to lead the next stage of actions following a ‘desktop review’ was carried out in the autumn of 2023. NHS Scotland (NHSS) has already launched a public review of homecare services which is already underway.
You can read the full joint statement by patient and clinical groups below;
Significant work is needed to assure patients and clinicians of the future safety of homecare medicines services following the government’s response to the Lord’s inquiry Homecare Medicines Services: An opportunity lost; it is our view that more work is needed to assure patients and clinicians of the safety and reliability of future homecare medicines services.
In its response to the inquiry, the government has accepted some positive recommendations that will improve accountability and transparency in the sector, including the naming of a senior NHS England (NHSE) officer who will assume national responsibility for homecare, as well as the regular publication of homecare KPI data which will open companies up to public scrutiny for the first time. Together, these changes will remove the cloud of secrecy around service performance and will finally enable a recourse to patients and clinicians when things go wrong.
They have also accepted that to resolve issues relating to delayed patient initiation and ongoing care, there needs to be a more urgent focus on shifting to e-prescribing in the homecare setting. This is an essential change that has the potential to vastly improve the safety and efficiency of the sector. We are, however, deeply disappointed that the government has rejected the committee’s call for a single digital interface to manage this shift, without which the positives of e-prescribing will not be realised. As this is such an important priority for clinicians, we are asking NHSE and the Department for Health and Social Care (DHSC) to think again about this recommendation.
Despite these positive improvements, it must be stated that the government has refused the opportunity to pursue more holistic reform of the sector, through their rejection of recommendation 14, which calls for a full-scale independent government-funded review. It is our opinion that this decision represents a missed opportunity to reset homecare from the foundation up and make it fit for a future with ever-larger numbers of patients.
In their response, the government has also set several medium-term deadlines to address crucial issues highlighted in the inquiry, including the need to reform the regulatory arrangements and the publication of data detailing the extent of harm to patients. Both areas are critical to understanding the severity of suffering caused by disruption in the sector, as well as how these harms were so substantively missed by the regulatory bodies responsible for protecting the public. We urge NHSE and DHSC to pursue these recommendations in the urgent manner set out by the committee, given that the unacceptable performance of homecare services continues to lead to harm and distress across the country.
Throughout our 18-month long campaign on this issue the levels of despair, frustration, and helplessness amongst patients and clinicians have become plain, as well as the very real instances of harm that have been so powerfully highlighted in media reports. The role of homecare medicines services is to make life easier, not harder for those who are reliant upon them, and the Lord’s inquiry has shown that is currently not the case.
Although this government response confirms some positive progress will be made, it is our view that significant work remains to demonstrate to patients and clinicians that those running and profiting from this system understand how badly things are going wrong, that they’re listening to service users, and that genuine service improvement is an urgent and critical priority.
This joint statement is supported by the following bodies which represent the patients and clinicians using homecare medicines services.
British Society for Rheumatology (BSR)
Crohn’s and Colitis UK (CCUK)
National Rheumatoid Arthritis Society (NRAS)
British Association of Dermatologists (BAD)
National Axial Spondyloarthritis Society (NASS)
British Society of Gastroenterology (BSG)
Cystic Fibrosis Trust (CFT)
The Haemophilia Society
Versus Arthritis (VA)