Review of homecare medicines service to launch in Scotland

A review of Scottish homecare medicines services is to be carried out, following concerns from charities that patients were running out of and facing delays in getting their medicines.

In response to a letter to MSP Rhoda Grant, seen and reported on by the British Society for Rheumatology (BSR) in March 2023, then health secretary, Humza Yousaf, said that Alison Strath, chief pharmaceutical officer for Scotland, would lead the review, due to start later in 2023.

The review follows a campaign by the BSR and five other bodies representing patients with inflammatory diseases, including the British Association of Dermatologists and the National Rheumatoid Arthritis Society, to raise public concerns around homecare medicines services.

Homecare medicines services deliver ongoing medicine supplies and, if necessary, associated care, initiated by the hospital prescriber, direct to the patient’s home via a homecare company.

In a parliamentary answer published on 13 March 2023, Yousaf said that the Scottish government “is aware of recent difficulties experienced by some homecare providers”.

“NHS National Procurement in partnership with health boards have worked closely with the homecare providers to improve service performance. All homecare providers are now demonstrating improved service levels,” he added.

The BSR first raised concerns in October 2022, calling for a parliamentary investigation into homecare medicines delivery services, following reports of patients experiencing delays in receiving medicines; patients running out of medicines; and patient’s calls or emails to homecare providers not being responded to.

In its campaign, the BSR also raised that there are staffing challenges in homecare services, with providers struggling to employ and retain nursing, pharmacy and technical clinical staff.

In a policy document published in November 2022, the BRS said that these issues were “increasing pressures on already stretched rheumatology teams and giving rise to patient safety concerns about long-term health damage, flares (relapse) and avoidable outpatient activity”.

A spokesperson for the Scottish government told The Pharmaceutical Journal on 13 April 2023 that, while the review of homecare medicines services in Scotland would go ahead, the timing and scope was still being considered.

Following news of the Scottish review, Ali Rivett, chief executive of the BSR, said: “Whilst this decision is an important first step for Scotland, we now call on [David Webb, chief pharmaceutical officer for England], to follow suit and for politicians in Westminster to step up and hold these services accountable, given how this issue is affecting so many of their constituents.”

In a written parliamentary answer on 11 April 2023, health minister Lord Nick Markham, said: “The National Homecare Medicines Committee, managed by and including representation from NHS England and the National Clinical Homecare Association, have met with the BSR to discuss [its] concerns about the safety and reliability of homecare medicines services, including delays in treatment.”

A spokesperson for the BSR told The Pharmaceutical Journal on 17 April 2023 that the Society had hosted a meeting between its president and David Webb to discuss concerns and what an NHS England review of homecare medicines services might focus on.

“It’s good news for patients and clinicians in Scotland that NHS Scotland has made the decision to review homecare medicines services and it’s a huge win for our members, who have been campaigning hard to raise awareness of the issues,” the spokesperson said.

“But rheumatologists across the UK are loud and clear that safety and reliability concerns exist across all four nations, with BSR members across the UK reporting dissatisfaction with homecare services.

NHS England was contacted for comment but did not respond in time for publication.