What does quality look like when it comes to homecare services?

The market for homecare services has grown substantially over the past decade. Some £1.5bn is now spent by the NHS on homecare medicines each year. But these services come with clinical and financial risks and, until recently, there has been no recognised framework available to describe what a good homecare service should encompass.

In September, the Royal Pharmaceutical Society published a set of professional standards for homecare services in England. The overarching developmental standards (illustrated in the Figure) have been designed to support teams that commission and deliver homecare services and to ensure their continual improvement. It is also hoped that the standards will help in shaping pharmacy roles to deliver quality homecare to patients.

The development of the standards has been led by the Homecare Standards Workgroup, overseen by the Department of Health Homecare Strategy Board, and hosted and published by the RPS. The work came out of a 2011 report, commissioned by the DH, which made recommendations for the improvement of financial and clinical governance arrangements for organisations supplying medicines to patients via homecare services.

So how is homecare described in the standards? Homecare delivery services provide ongoing medicine supplies and, where necessary, associated care, initiated by the hospital prescriber, direct to patients’ homes with their consent. The purpose of the homecare medicine service is to improve patient care and choice of treatment, the RPS document says.

According to the standards, there should be one pharmacist in each organisation who is responsible for all homecare services related to medicines. Yet the standards recognise that homecare involves the whole pharmacy team, as well as the wider pharmacy workforce.

“Ultimately these standards will help patients experience a consistent quality of homecare services, irrespective of homecare provider, that will protect them from incidents of avoidable harm and help them to get the best outcomes from their medicines,” the standards document states.

The framework is modelled on the RPS professional standards for hospital pharmacy services. In line with the hospital resource, the homecare standards are divided into three domains:

• The patient experience
• Implementation and delivery of safe and effective homecare services
• Governance of homecare services

It is expected that the standards will support ongoing work across homecare services and enable the continual improvement of the sector. Additional support materials are being produced to help organisations implement the standards.

Speaking at the launch of the standards at this year’s RPS Conference, Catherine Duggan, RPS director of professional development and support, said that work lies ahead to encourage adoption of the standards and make sure that they apply to Wales and Scotland as much as to England. “We’ve done a lot of work on this for the hospital standards, and that’s why they have been so successful.”

This and other sets of RPS standards can be found at www.rpharms.com/support-resources/professional-standards.asp.