Modernising UK homecare will boost neighbourhood health services and save money, says ABPI

The UK’s homecare service potentially saves the NHS £1.67 billion a year, and has the potential to save significantly more through shifting care from hospitals and into patients’ homes.

Homecare services, funded by manufacturers and supported by homecare providers and the NHS, allow patients to receive treatment in their own home, either by self-administering treatment or doing so with appropriate clinical support.

A study of homecare in Kent and Medway found that an average of 2.4 hospital bed days are saved per patient receiving homecare. In total, patients in the study receiving homecare spent 703 fewer days in hospital beds compared to those who did not - equating to a cost saving of £770,101.35. 

Extrapolated across the 640,000 people currently receiving clinical homecare across the UK, this equates to a total of 1,523,200 bed days saved – representing an annual potential saving of £1.67 billion to the NHS.

As the government rolls out neighbourhood health services in the NHS 10-Year Plan, a new report from the Association of the British Pharmaceutical Industry (ABPI), compiled by ZPB, shows that the groundwork for this transformation is already in place, but also warns that without action, the full potential of homecare is unlikely to be realised. 

The report, ‘Bringing healthcare home: A blueprint for collaborative clinical homecare’ found that there are inequalities in access to homecare and is often limited by outdated, paper-based processes. Limited funding for both the NHS and homecare providers is also a driving factor in reducing the homecare services available to patients.

Despite the clear patient and financial benefits of homecare, such services are often overlooked and misunderstood. Many believe that pharmaceutical companies profit from providing the services, when in reality, services are provided at no extra cost to the NHS. Estimates indicate companies currently invest at least £173 million per year into the delivery of homecare with approximately 20 percent of homecare funded by the NHS with 80 percent funded by pharmaceutical companies. 

David Watson, ABPI Executive Director, Patient Access, said: “Homecare provides a lifeline for those living with long-term and chronic conditions and is a real strength of the UK’s health system. Clinical homecare is a vital part of the shift from hospital to community-based services that the NHS Ten Year Plan sets out – but it will only work if we invest, modernise and collaborate to improve the systems already in place.”

David Webb, Chief Pharmaceutical Officer for England, said: “I welcome this collaborative report that highlights the range of benefits that homecare medicines services offers patients, the NHS and industry, when it’s delivered well”.

“As demand has grown at-pace, we are working with partners to modernise homecare from analogue to digital, maximise the available capacity and resources, and to ensure that where a patient lives does not determine their access to a homecare medicines service when this is the right clinical care for them”.

Chris Carver, treasurer of the National Clinical Homecare Association said: “Clinical homecare is the best kept secret in healthcare – this data sheds new light on the huge benefits it has for patients and how it alleviates the burden on the NHS. 

"Looking forward, we would like to see national policy that establishes a clear framework for standardisation and long-term planning, to improve the sustainability of homecare.

“Collaboration between the NHS, pharmaceutical companies and homecare providers is key to ensuring that access to homecare remains equitable for all.”

In a survey of NHS professionals, 71 per cent of respondents said they believe clinical homecare improves geographical access to care for patients. In another question, 57 per cent reported better health outcomes for their patients, and 56 per cent noted improved adherence to treatment [1]. 

The ABPI report warns of the risk of homecare services stagnating as a result of little to no investment.

Demand for homecare services is growing rapidly and can be met through the modernisation of digital systems, for example, electronic prescribing. The full report recommendations include:

• Greater collaboration is needed overall between the NHS, homecare providers and pharmaceutical companies to streamline processes and reach shared goals for the future of homecare services
• Centralised contracting: a centralised contracting framework could reduce admin burdens and ensure equitable access for patients
• Homecare design flexibility/innovation: allowing appropriate review and modification of individual patient services could drive efficiency and empower patients
• Digitisation of the NHS/provider interfaces: transitioning to digital solutions could streamline operations and delivery for all in line with the NHS 10s-Year Plan shift from analogue to digital
• Creating a more resilient and competitive homecare provider market: structural changes to incentivise providers could promote healthy competition and drive continual improvements to service quality