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

Organisations linked to the recommendations of this Review report

Homecare services involve the multi-disciplinary healthcare team and wider healthcare workforce. There are a range of organisations who are involved in medicines homecare, and more broadly the supply of secondary-care initiated medicines – this section may support readers’ understanding of the recommendations which follow, and the organisations likely to be involved in the developments. This list is not intended to be exhaustive; it is designed to support understanding.

The Association of the British Pharmaceutical Industry (ABPI) is the trade association for over 120 drug manufacturers in the UK. ABPI Scotland represents the interests of member organisations to stakeholders in Scotland as a devolved nation. This ensures that organisations including the Scottish Government and NHS Scotland are kept informed about issues affecting the UK pharmaceutical industry.

Community Pharmacy Scotland (CPS) is a professional body which represents community pharmacy owners and their teams throughout Scotland. They function as the voice of these vital healthcare professionals as they deliver pharmaceutical care services to the people of Scotland on behalf of NHS Scotland and in line with national and local priorities. Community pharmacy owners are independent contractors whose businesses make up a diverse network of primary care providers.

Homecare providers – There are currently eight homecare providers operating in Scotland and delivering a range of medicines homecare services.

Marketing Authorisation Holder (MAH) – Organisations that have the authorisation to market a medicine in the UK.

The National Homecare Medicines Committee (NHMC) is a national body with a focus to promote, develop and improve homecare services across the UK specifically around administrative and governance processes for medicine homecare services. The committee includes representatives from the NHS, supplier and pharmaceutical manufacturer associations and regulators.

NHS National Services Scotland (NSS) National Procurement is responsible for procurement of services via established NHS tender process and the negotiation and management of Service Level Agreements. National Procurement is also responsible for agreeing contracts and Service Level Agreements (SLAs) between NHS boards and homecare providers.

NHS Scotland territorial boards - There are 14 territorial NHS boards in Scotland, each responsible for the provision of healthcare services in their respective geographical areas. There is a significant population variation between the largest (NHS Greater Glasgow and Clyde serves a population of around 1.3 million people [15]) and the smallest (NHS Orkney serves a population of around 22,000 people. [16]) There is also significant variation on demography, including urban/rural and measures of deprivation. These factors have a bearing on the demand for, and service provided within, medicines homecare.

Public Health Scotland (PHS) is responsible for the production of intelligence on healthcare services in Scotland. In the context of medicines homecare, PHS provides data and information to NHS Scotland on volume and spend on medicines, at both aggregate and patient level. There is a significant importance to “Community Health Index (CHI) capture” in delivery of this data. (CHI is the unique patient identifier used in NHS Scotland). By ensuring an elevated level of CHI capture, more granular and clinically useful data can be produced. In Scotland, the ability to deliver this is based on the prescribing system used. Homecare prescribing, in its current form, has a high rate, as do other systems such as GP practice systems, and Hospital Electronic Prescribing and Medicines Administration (HEPMA) systems. However, there are a range of process within Boards which could apply to medicines homecare prescribing, depending on the model selected, which would not currently deliver this benefit.

The Royal Pharmaceutical Society (RPS) is a GB-wide body which represents the interests of Pharmacy professionals and provides a range of standards and guidance. This extends to identifying and communicating guidance on best practice for pharmacy professionals in medicines homecare, including how pharmacy should steer the work of other clinical groups as the foremost experts in medicines.

Scottish Government has policy responsibility for the delivery of healthcare in Scotland. The Chief Pharmaceutical Officer has oversight of all medicines policy in Scotland, including medicines homecare. Although healthcare is a devolved matter, there are a number of components of medicines policy which are reserved to the UK Government, including licencing (through the Medicines and Healthcare Products Regulatory Agency (MHRA)). As noted below, there is a UK-wide body which oversees aspects of medicines homecare strategy.