The Nursing Workforce Powering High-Tech Homecare

Victoria Walsh is HealthNet’s Nursing Director. She has extensive experience of working as a nurse and prescriber in both the NHS and homecare markets and within the oncology field. In this blog she explains why HealthNet is well placed to move into the High-Tech market.

“You enter a profession like nursing because you want to do the right thing by putting the patient first and provide high quality care, choice and empowerment to patients so they can live their lives. The reality is that in the NHS they can't see as many patients as they need to as quickly as they need to and that’s where we come in.

In order to get sustainability in the NHS you need to be able to offer additional services. Providing more complex services and therapies to patients will provide resilience in the system and allow for greater choice. The only way to get more capacity within the system is to introduce another credible homecare provider in that specific market. That is why we are now moving more into the High-Tech market. It is about reaching more patients equitably and aligning with strategic plans like Neighbourhood Health Services and the National Cancer Plan. These are the areas where the NHS is telling us they need help and where we can step in as a credible partner.

As well as Low-Tech and Mid-Tech Homecare Medicines Services, HealthNet already has experience of delivering some High-Tech therapies, for example we already provide enzyme replacement therapy, immunoglobulin therapy and other infused therapies for Multiple Sclerosis and Parkinson's Disease. We already have a repertoire of complicated therapies, some of which require you to be in a patient’s home for up to four hours, we are now just expanding that scope to cover a wider range of  High-Tech services including Systemic anti cancer therapies (SACT)

In preparation for this transition, HealthNet has invested heavily in a new nursing structure and new nursing roles and we now have around 200 nurses working for the organisation. We have created a number of strategic specialty roles and expanded our nurse management team and we now have nine regional managers and growing , each one linked to a specific therapy as our specialist in that field, including rheumatology, gastroenterology and cancer. In addition to that we have expanded our clinical training team so that it supports the specialist training of complex therapies. All our nurses are band six and above, which is the NHS equivalent, so they've already got a good baseline level of training and experience  and we are cross-training our nurses. We will soon have 80% of the workforce cross-trained in IV therapies and High-Tech medicines and we have also started to  recruit a specialist cancer team. All our nurses have experience of working in the clinical homecare space as well as the NHS.

We are educating NHS Trusts about our high levels of training to ensure we are seen by the Trust and its patients as a knowledgeable, credible partner and extension of the team rather than a private provider. Before we take on a service for the NHS, our nurses can go into the acute setting and work with their teams and colleagues to do the discharge planning and to demonstrate our  level of training and expertise The NHS wants reassurance from us that we are competent, credible and that risk is mitigated and managed as they would expect and that their patients are well looked after. They want the reassurance that the patients are going to be getting the same level of service in their home or a local clinic as they do at the Trust and that is what we are demonstrating.

I am proud to say that our Patients really do get a gold standard service with High-Tech Homecare because we are held to a higher account as a homecare provider and we have to abide by strict policy, protocols and contracts which means we take the time and are not rushed. If we are paid to spend one hour dedicated to a patient then that is what we do. We don’t have several other  patients to see in that hour, that time is solely dedicated to that one patient we are being paid to care for. We partner with Trusts to develop protocols together and ensure our practices directly reflect what the referring Centre requires and expects from us.

There will be many benefits for the patient, the first one being increased choice which will empower them when it comes to their treatment. They will also be seen quicker because often they're waiting to be seen and we can fill that gap. It is also more convenient for the patient and gives them more time to carry on with their daily lives. For example, if you have a patient impacted by cancer who actually feels quite well, we can just go and see them in their own home or they can come and see us under our clinic model. Their quality of life has improved. They also don’t get the potential infection risk that comes with going into a hospital if you're immuno-suppressed. 

There are benefits for the wider NHS too. Strategically, it costs thousands of pounds to have a patient go into hospital each day, whereas our service costs hundreds of pounds so there is a massive cost-saving for the NHS. It also improves accessibility, reduces waiting times and frees up resources to be used elsewhere.

HealthNet is a really agile company and we have a Board and CEO that absolutely gets the day to day operation and are very hands on. They understand the requirements of the NHS and what our patients need and are very accessible and supportive

The fact we are moving into the High-Tech market is good news for everyone. There are more than enough patients to care for and we should all be working together and collaborating to get the best outcome for the patient and ensure there is patient choice. It also mitigates the risk for the NHS, because they're not putting all their eggs in one basket. They get to choose. If there's a drug shortage or resource shortage at one particular company, then they can switch to another. It gives them resilience and a backup plan.”

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