Home Care Flashcards
How did the Hackett report define homecare medicines supply?
“A homecare medicine delivery and service can be described as being one that delivers ongoing medicine supplies and, where necessary, associated care, initiated by the hospital prescriber, direct to the patient’s home with their consent. The purpose of homecare medicine is to improve patient care and choice of their clinical treatment.”
Give some examples of the patient groups considered in the 1995 paper on homecare medicines supply.
- Cystic fibrosis patients receiving nebulised and IV antibiotics.
- Home TPN patients.
- Thalassaemia patients receiving IV deferoxamine infusions.
Which two organisations/entities drive the change towards more medicines being available as part of homecare medicines supply?
This change was driven by both the NHS and pharmaceutical companies.
What was the major downside of an increase in homecare medicines supply?
Unfortunately, by bypassing pharmacy departments and hospital governance systems, the regulation was missing. This proved problematic and led to a number of questions being asked, especially when it came to a loss of care monitoring impacting the clinical effectiveness of the drug.
What are the three levels of technology in homecare medicine supply?
Low, medium, and high technology.
Define low technology services in homecare medicines supply.
These services include licensed treatments such as oral medications for chronic illnesses. These are kept at room temperature. Examples include:
• Antiretrovirals for HIV.
• Treatments for Hep C.
Define medium technology services in homecare medicines supply.
For medium technology services, clinical support or testing may be required, as well as patient training. Self-administration of these medications may be achieved with the help of ancillaries and refrigerators may need to be supplied.
An example of medium technology services is pre-filled SC monoclonal antibody syringes for rheumatology.
Define high technology in homecare medicines supply.
These are more complex therapies which may include intravenous infusions. Self-administration may be possible with advanced technique however it may also require the help of a healthcare professional (nurse).
Examples of this include:
• Home IV antibiotics with or without clinical monitoring.
• Home TPN.
Explain the tax loophole in homecare medicines supply.
As a result of homecare companies using registered pharmaceutical premises, Trusts could save VAT on expensive therapies by outsourcing the supply. Some of the savings could be used to invest in improved care. HMRC recognised the tax loophole – providing hospitals could prove they were reinvesting the money, they allowed it to carry on.
What problems did the 2011 report into homecare medicines supply outline within the market?
- Market problems.
- Governance, in NHS trusts and the wider market.
- Collaboration across organisations, particularly between NHS trusts.
- Patient involvement.
