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What are Homecare Medicines?

The Royal Pharmaceutical Society (RPS) defines homecare medicine services as:

'A service that delivers ongoing medicine supplies and, where necessary, associated care, initiated by the hospital prescriber, direct to the patient's home with their consent'¹

 

The use of homecare medicine services does not reduce or alter the NHS duty of care to patients. The prescribing trust and the patients' clinical team will retain responsibility for the clinical aspects of the patients treatment. The purpose of homecare medicine services is to provide patients with more choice over their care, however not all services or patients will be suitable for homecare. Patients must be assessed and provided with relevant information regarding the service so they can make an informed choice when opting for the homecare package.

 

Types of Homecare Medicine Services

Homecare services can be divided into low tech, mid tech or high tech based on the complexity of the service. Elements of complex homecare may be provided alongside low, mid or high tech homecare services.

 

Low Tech Homecare Services¹

Activities include:

  • Self-administration of oral therapy or medicinal products for external use only excluding oral oncology
  • Products are licensed medicines or uncomplicated medical devices
  • Product storage conditions are 15-25°C and/or 2-8°C suitable for storage in the patient's own fridge
  • Self-administration of medicines is usually in accordance with the Summary of Product Characteristics with occassional off-label use²
  • Homecare team members are expected to identify and report obvious misuse of medicines and non-compliance

 

Mid Tech Homecare Services¹

Activities include:

  • Unlicensed medicines³
  • Therapy that requires significant clinical support or diagnostic testing such as blood level monitoring as part of the homecare service e.g. oral oncology
  • Patient training and competency assessment relating to self-administration
  • Self-administration needing basic aseptic technique and standard ancillaries e.g. pre-filled syringes
  • Medications with special storage requirements
  • Provision of refrigeration equipment
  • Compliance and/or concordance programmes including specified interventions

 

High Tech Homecare Services¹

Activities include:

  • Intravenous infusion
  • Self-administration needing advanced aseptic technique and/or portable equipment/specialist ancillaries
  • Products that are compounded aseptic medicines
  • Administration by healthcare professional
  • Clinical decision taken within approved clinical protocol with escalation of out-of-limit findings to the clinically responsible person

 

Complex Homecare Services¹

Activities include:

  • Provision of bespoke homecare solutions for individual patients not covered by national standards
  • Permanent or semi-permanent adaption of the home environment required as part of the service
  • Permanent or semi-permanent installation of equipment in the home
  • Clinical decisions taken within approved clinical protocol with escalation of out-of-limit findings to the clinically responsible person

 

Next page: Contracting Homecare Medicine Services

 

 

References:

¹ RPS Professional Standards for Homecare Services in England

² Off-label use: where a licensed medicinal product is prescribed, dispensed or administered not in accordance with the Summary of Product Characteristics

³ Unlicensed medicine: A medicinal product that does not hold a valid license for supply to the UK market

 

 

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