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Learn about the gold standard for homecare

By Carol McCall, PhD, MRPharmS, and Ray Fitzpatrick, PhD, FRPharmS, FFRPS

Pharmacists should take the time to familiarise themselves with new professional standards for homecare services, published by the Royal Pharmaceutical Society. This is because pharmacy has been designated the healthcare profession responsible for ensuring that this rapidly expanding area of healthcare is delivered appropriately. The RPS homecare standards recognise that homecare is a key component of specialist-led healthcare provision in England and set the gold standard for how these services should be managed.

Homecare services have expanded considerably in recent years: over 200,000 patients in the UK are now receiving these services and homecare medicines account for £1.5bn of the £4bn spent on medicines by NHS hospitals each year. Three quarters of the clinical commissioning groups in England now consider the provision of “out-of-hospital” care to be of high strategic importance; therefore, up to 60% of hospital medicines could soon be delivered via homecare services.

“Homecare medicines: towards a vision for the future”, a Department of Health review conducted by Mark Hackett, was commissioned in response to this seemingly uncontrollable expansion of the homecare market. The 2011 report clearly puts pharmacy in the driving seat by ensuring that chief pharmacists are appointed as responsible officers for homecare services provided by their organisations.

The RPS standards embody the principles that arose from the Hackett review and subsequent implementation workgroup discussions. They provide best practice guidance on strategic planning and policy development, and address areas such as the design of services, commissioning, implementation and how to manage individual homecare patients. Although the standards build on and complement the RPS professional standards for hospital pharmacy services, homecare provision introduces additional and specific challenges that must not be underestimated and will require additional resources for hospital pharmacies to ensure full compliance.

The standards promote patient-centred care and patient safety through the implementation of robust risk control measures. Another key theme is integrated care — ensuring clinical responsibility is clearly defined within service specifications. The standards also say that homecare services should be efficient and effective and should comply with good financial practices that ensure value for money. (The commercial side of homecare services is to be addressed by a separate DH workstream into the implementation of the Hackett review.)     

So, many of you will be asking “what now”. We are currently working to produce a “homecare handbook” on how to implement the homecare standards that will include specific examples of best practice — so more help is on the way. In the meantime, we recommend that all hospital pharmacists, even those who are not currently involved with homecare, read these standards. Although they may look complex at first glance, they should provide a supportive framework for improving existing services or for designing new ones. 

Carol McCall and Ray Fitzpatrick are co-chairmen of the Homecare Standards Workgroup.

 

Citation: Clinical Pharmacist DOI: 10.1211/CP.2013.11129547

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