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Could Clinical Homecare be the NHS’s secret weapon?

The NHS remains under tremendous strain, with long waiting lists and backlogs in almost all areas. Without intervention the situation is unlikely to improve. But how can real change be achieved?

Currently 31 million people in the UK are estimated to be living with at least one long term health condition. And with a growing ageing population, this number is projected to increase. In fact, the Health Foundation estimates that the number of people living with major illness will increase by 2.5 million by 2040. It is unclear how the NHS will navigate this increased demand.

However, a solution might be right under our noses.

What is Clinical Homecare?

Clinical Homecare encompasses a range of services such as patients receiving consultant led care in community settings. Giving patients the choice to have their treatment at home, these services include dispensing and delivery of medicine to the patients home whilst also administering treatment or training patients or carers on how to safely store their medication and self administer.

There are three tried and tested Clinical Homecare pathways: medication dispensing and delivery, medication delivery with self-administration (including the training to do this), and medication delivery with clinical support for treatment at home.

Treatment for many conditions can be delivered in this way –respiratory, musculoskeletal, cardiovascular, cancer, some rare and orphan conditions and some blood disorders are just a few examples. Its adaptability and widespread reach make it versatile, fitting individual needs seamlessly.

Clinical Homecare currently provides treatment for around 600,000 people in the UK, yet the service remains underutilised – partly due to a lack of awareness and a lack of understanding around the opportunities.

In light of this, the National Clinical Homecare Association (NCHA), the trade body for companies providing Clinical Homecare services, has commissioned an independent report which brings fresh insight on the industry. This Best Kept Secret report has been steered by a panel of experts from the NHS and beyond. It uses detailed economic modelling which reveals the benefits to the NHS and patients, as well as looking at the wider impact on society.

Benefits to NHS

Clinical Homecare alleviates pressure on traditional services by bringing care to patients’ homes. The Best Kept Secret report demonstrates the operational savings this creates for the NHS and the broader health economy. The report quantifies direct savings like reduced Did Not Attend rates and decreased demand on NHS staff , as well as other benefits such as lower infection rates and improved medication adherence. Together, these factors contribute to a current annual value of £264m to the UK’s health economy. In light of budget cuts, industrial action and inflation rates, this saving is significant, and expanding these services could further amplify these benefits.

The report shows that Clinical Homecare services provide the equivalent of additional day-case elective capacity for 15 NHS Trusts annually. The benefits can particularly be felt in the reduced footfall in hospital pharmacies, and savings on NHS nurse time.

Medication wastage costs the NHS £375m annually. Clinical Homecare creates savings and increased efficiency by minimising prescription waste caused by transit damage or early cancellation, as well as by responding to disruptions to the pharmaceutical supply chain to ensure that patients receive their medication promptly. Collaborating with the NHS’s National Homecare Medicines Committee, Clinical Homecare providers take a national view on medication distribution and, if necessary, rationing to maintain patient access during supply shortages.

Clinical Homecare providers keep a formal record of the amount of medicines the patient has in their home, to help ensure that they do not run out of supplies. This benefits both the patient and the NHS –patients are more likely to complete their treatment correctly, and less NHS resource is needed to treat patients who are not adhering to their treatment plan. Patient adherence is also supported, as medication delivery to a patient’s home removes the need for patients to collect their medication from a pharmacy.

Clinical Homecare also supports good medication management, including smoothing the transition when switching medications and providing patients with necessary training for new treatments. This helps to minimise the time, cost and waste associated with switching medication.

Woman working as nurse with computer and documents in cabinet, checking files for examination appointment. Medical assistant looking at screen for patient information and checkup visit

Benefits to Patients

With healthcare becoming increasingly consumer-centric, the option of receiving care at home that meets their needs is important for patients. An objective survey was conducted with 804 patients for the Best Kept Secret report to explore the impact Clinical Homecare has on the lives of patients.

Half of these patients had received Clinical Homecare in the last year, and the other half had received treatment for the same condition via an NHS GP, pharmacy or hospital. Results showed a notably higher proportion of those receiving Clinical Homecare reported a positive impact on their health (79% vs 36%),recovery (72% vs 41%), relationships (64% vs 27%), ability to work(58% vs 26%) and ability to get on with life (75% vs 39%). Many Clinical Homecare patients have long-term conditions that require frequent visits to the hospital to receive their treatment. This can be time consuming and costly for patients, and in some cases can make it difficult for them to remain in work or education – negatively impacting their opportunities in later life.

By providing repeat medicines and treatment at home, Clinical Homecare saves an average of 1.3 hours in travel time per appointment and reduces barriers to access for patients who live faraway from hospitals offering their treatment.

Clinical Homecare’s flexibility around patient schedules, can help patients to remain in employment while promoting patient independence, with reduced reliance on family members or caregivers to take them to appointments. Where possible, patients are also taught how to self-administer their medication, allowing them to actively participate in their own care.

Happy young female nurse provide care medical service help support smiling mature woman at homecare medical visit, lady carer doctor give empathy encourage retired patient sit on sofa at home hospital

Benefits to Wider Society

The Best Kept Secret report also highlights the benefits that Clinical Homecare has on wider society.

One example is the environmental impact. On average, NHS patients travel 16 miles to hospital. However, Clinical Homecare providers reduce this to just 6.9 miles per patient delivery through consolidating many patient’s medication deliveries into a single, optimised delivery route. This cuts carbon emissions by 22,000 metric tonnes annually, aligning with the NHS’s Carbon Footprint Plus target.

Another example is how Clinical Homecare enhances pharmacovigilance, achieved through the patient education, timely intervention, monitoring and robust reporting mechanisms. Delivering medication at home provides specialist clinical trainers with the opportunity to dedicate time to educate patients about medication administration, potential side effects, and reporting unusual symptoms. Regular nurse visits enable close monitoring, facilitating prompt identification and intervention for adverse effects or complications. Providers efficiently report adverse drug reactions to manufacturers, ensuring timely actions, identification of rare but important side effects and enhanced monitoring for new medicines.

“In a challenging and rapidly changing healthcare landscape, Clinical Homecare might be the solution.”

Where We Go From Here

The Best Kept Secret report’s economic modelling and patient survey has shown that Clinical Homecare can deliver a number of benefits. Healthcare that is tailored and responsive to individual needs is something that all patients should have access to, however many patients who could benefit from Clinical Homecare are not currently being offered it as an option.

If we are to realise the full potential of Clinical Homecare, collaboration is key. Clinical Homecare companies, pharmaceutical manufacturers, and the NHS need to come together to jointly plan and implement these improvements.

In a challenging and rapidly changing healthcare landscape, Clinical Homecare might be the solution.

To read Best Kept Secret: The Value of Clinical Homecare to the NHS, Patients and Society, click here.

Chris Carver

Deputy Chief Executive