Independent Review of Medicines Homecare in Scotland: review report and recommendations

Review purpose, structure, design and approach

Purpose

The purpose of the Independent Review of Medicines Homecare was to evaluate approaches to the supply of secondary care-initiated medicines and associated care to patients in the community in Scotland. The Review commenced in August 2023 and aimed to ensure timely access to critical medicines and enhance patient experience.

Structure

Professor Alison Strath, Chief Pharmaceutical Officer, Scottish Government appointed Benjamin Hannan, Executive Director of Pharmacy and Medicines, NHS Fife as Independent Review Lead.

The Review Lead established and chaired a Review Project Board, comprised of Jason Cormack (Report Co-author), Donna O’Rourke (Project Manager), and Dr Frances Notman, (Research and Analytics Lead). The Review Project Board conducted all day-to-day activities associated with the Review and attended the Review Reference Group.

The Review Lead also established and chaired a Review Reference Group. The purpose of the Reference Group was to provide expert advice from a range of perspectives to the Review and to support the Review Lead to form recommendations for the future of medicines homecare in Scotland. This multi-disciplinary and multi-agency group reflected the skills and expertise required to appropriately represent stakeholder groups from the medicines homecare community (Appendix 1 and Appendix 2).

Design

This qualitative Review is about people’s experiences of homecare whether they use homecare services, care for someone who uses them, commission, deliver or work in them. To make this happen, an engagement programme was conducted which focused on three activities:

• Call for Evidence – From September to October 2023, individuals and organisations could submit their views to the Review (Appendix 3 and Appendix 4)
• Targeted stakeholder engagement discussions – From November and December 2023 targeted engagement sessions were hosted between the Review Lead and individual stakeholders to further explore specific feedback they had provided in their evidence submission, clarify existing points and allow for in-depth exploration of themes.
• A public engagement exercise – From December 2023 to March 2024 the Health and Social Care Alliance Scotland (The ALLIANCE) [1] undertook a public engagement exercise using a patient survey and follow-up targeted engagement to understand patient experiences of medicines homecare services.

Stakeholder analysis

A stakeholder analysis exercise was undertaken to identify and outline key stakeholders across the medicines’ homecare pathway. Stakeholders identified included individual healthcare professionals, patient group representatives, voluntary health and social care organisations, contractor representatives, NHS boards, homecare providers, pharmaceutical companies, pharmaceutical, medical, and nursing regulatory and professional bodies, and representative groups.

Review recommendations were informed by findings and conclusions drawn from the call for evidence survey, stakeholder engagement activities and patient voice workstream. The Review Lead was responsible for decision-making in relation to the Review Report and recommendations, and considered all information and findings where there were any areas of stakeholder discord.