Clinical societies and patient charities working across inflammatory disease specialities have come together to raise public concern around the safety and reliability of Homecare Medicines Services across the UK.  

The British Society for Rheumatology (BSR), British Society of Gastroenterology (BSG), British Association of Dermatologists(BAD), National Rheumatoid Arthritis Society (NRAS), National Axial Spondyloarthritis Society (NASS), and Crohn’s & Colitis UK (CCUK) have all supported the statement. The statement follows concerns raised about the standards within Homecare Medicines Services by patients and clinical staff both living and working across the relevant disease areas. 

The full statement reads;  

“We, the undersigned, are coming together to publicly raise our concerns about the current and historic reliability of Homecare Medicines Services across the United Kingdom. This widespread unreliability is distressing and endangering patients and needs to be resolved.”  

“Our members, patients, and supporters have reported issues that range from lengthy waits for patients to commence treatment, an unreliable system for managing prescribing, delays in care reprovision, and a culture of poor customer service by Homecare providers. These issues have left both patients and NHS staff frustrated when things go wrong, and put patients at risk of unnecessary pain, suffering, and a diminished quality of life.” 

“We understand that performance management processes are in place between the NHS and some individual Homecare providers, however, given the cyclical nature of underperformance within the sector we do not have the confidence that these mechanisms are sufficient to put services on a long-term, sustainable footing, or to guarantee excellent outcomes for patients and the health service.” 

“Enabling more patients to get their treatments at home remains a key ambition for the NHS, however, the last major review of the Homecare sector was carried out over a decade ago.”  

“With significant ongoing issues in the sector, we believe the time is right for thorough scrutiny of Homecare Medicines Services. We call on governments across the four nations, the NHS, and parliamentarians to work with us to ensure this can take place in a timely and effective manner.” 

 Signatories; 

Ali Rivett  – CEO, British Society for Rheumatology

Dr Christian Selinger – Chair IBD section, British Society of Gastroenterology  

Sarah Sleet – CEO, Crohn’s and Colitis UK 

Dr Mabs Chowdhury, President, British Association of Dermatologists 

Clare Jacklin, CEO, National Rheumatoid Arthritis Society 

Dale Webb, CEO, National Axial Spondyloarthritis Society

Commenting on the joint statement Head of External Affairs for BSR Jack Buck said; “BSR has been leading the calls for holistic scrutiny of the Homecare sector since September 2022 and we are pleased to be joined in these calls by partner organisations from the dermatology and gastroenterology sectors.”  

“Clinicians and patients across the inflammatory disease area are dissatisfied with the way in which Homecare Medicine Services are currently operating, and it’s time for the NHS, government across the four nations, and parliamentarians to carry out a thorough investigation.”  

He continued, “Whilst BSR agrees treating patients at home is the right ambition for the NHS, we’re also clear that these services must be on a sustainable footing, deliver the best possible care for patients, and ease pressure on our hard-pressed NHS staff. It is BSR’s view that these expectations are not sustainably and reliably met by the Homecare industry, which is why it is essential for an investigation by the relevant bodies to take place.”  

Notes for editors. 

About British Society for Rheumatology (BSR) 

BSR is the UK’s leading specialist medical society for rheumatology professionals. We support our members to help deliver the best care for their patients, in order to improve the lives of children, young people, and adults with rheumatic and musculoskeletal disease.  Our members represent the entire profession – from those at the beginning of their career to the most senior consultants, researchers, academics and health professionals in the multi-disciplinary team. Together, they form a powerful voice for paediatric, adolescent and adult rheumatology in the UK. 

What are homecare medicines services? 

A homecare medicines service delivers ongoing medicine supplies and, where necessary, associated care, initiated by the hospital prescriber, direct to the patient’s home with their consent. In England homecare medicines services are typically funded by the product manufacturer, the NHS or provided to private patients.   

• Manufacturer pharma funded homecare services (also known as pharma schemes): A private sector provider(s) is commissioned by the marketing authorisation holder of a drug (manufacturer) to provide a homecare service to patients. For the majority of services, the NHS is liable only for the cost of the medicine and the service, and consumable product costs, are funded by the pharma company.  The model of manufacturer funded homecare services forms most of all homecare services provided by NHS trusts, by both in patient volume and expenditure. Where Pharma schemes are in place the Homecare contract is held by individual NHS trusts (or relevant bodies in devolved nations) and individual patients have no choice on who supplies them.  
• NHS funded homecare services: they operate on a traditional outsourced service model whereby both product and service costs are payable by the clinical referring centre. 

Approximately 500,000 people in England receive homecare medicines services. Clinical Homecare accounts for £2.1bn or 30% of the NHS secondary care medicines budget. It is estimated that this would rise to 60% if extended to all medicines known to be suitable for homecare. 

What has BSR done to raise concerns about Homecare Medicines Services to date? 

• BSR launched a public campaign calling for a parliamentary led inquiry in to falling standards in Homecare Services in September 2022. Through this campaign we have engaged directly with Parliamentarians in England and Scotland and had 20 written Parliamentary Questions (PQs) submitted to government in Westminster and 5 written PQs submitted to government in Scotland about the issue. Our concerns have also been raised by the Scottish Society for Rheumatology in the most recent Cross-Party Group meeting on Arthritis and Musculoskeletal conditions in the Scottish Parliament.  
• In addition to our public campaign BSR has led an energetic stakeholder engagement campaign to raise awareness of our concerns, this has included meeting with; 

• The National Homecare Medicines Committee (NHMC), the NHS body which monitors performance management of Homecare contracts in England, and with NHS Scotland.  
• The National Clinical Homecare Association (NCHA), the trade body which represents Homecare Providers across the United Kingdom 
• Individual Homecare companies, including Sciensus (formerly Healthcare at Home) the single largest provider of Homecare Services in the UK. 

• The Regulators for the sector in England and Scotland, the Care Quality Commission (CQC) and Care Inspectorate (CI) respectively.  
• We are also due to have meetings with the Chief Pharmaceutical Officer of NHS England and the General Pharmaceutical Council (GPhC) in the coming weeks.  
• We have also briefed a number of Parliamentarians across political parties in both the House of Lords and the House of Commons.  

If you have any media enquiries in relation to this release, please contact; 

Jack Buck – Head of External Affairs, British Society for Rheumatology, at;  

Jbuck@rheumatology.org.uk