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Home delivery company still not up to scratch

Healthcare at Home has made "some progress" but it still needs to deal with outstanding complaints and ensure it documents any risks to patients caused by late medicines delivery, the GPhC says

Healthcare at Home needs to create contingency plans to ensure it can deal with extra patients and complaints, GPhC says

A medicines home delivery company must undertake a "considerable amount of work" to address unresolved complaints about missed deliveries, the General Pharmaceutical Council (GPhC) has said. 


Healthcare at Home, which cares for more than 150,000 people across the UK, was reprimanded by the GPhC in April after an inspection found it was "insufficiently prepared" to deal with an increased number of patients. This had resulted in patients being left "confused and uncertain" about why their complaints about late and failed medicines deliveries were not being dealt with.


The company was ordered to remedy the situation by ensuring it had the capacity to deal with extra patients and complaints, but a further inspection three months later found that it needed to make "further progress" to create contingency plans, the GPhC said on Monday (September 1).


Although Healthcare at Home had made "some progress" in implementing the GPhC's recommendations, it still needed to eliminate the backlog of complaints and ensure the risks to patients caused by the late delivery of medicines were "recorded, monitored and acted on", the regulator said.


In its initial inspection in April, the GPhC found that Healthcare at Home was unprepared to deal with the "significant changes" of taking responsibility for an increased number of patients and transferring medicine distribution arrangements to another provider. The company's customer service team had been "overwhelmed" by complaints about late deliveries, some of which were left unresolved, it said.


The GPhC noted that, since its first inspection, the number of complaints had "stabilised" and there were more staff available to answer telephone calls from patients who had not received their medicines on time. The company had issued more guidance to staff to ensure they followed the correct processes and more data was being collected to assess risks, the GPhC said.


But the company still needed to ensure that any changes to its arrangements for delivering medicines to patients and its capacity to take on more patients or services was assessed "much more robustly", the regulator said. It recommended the company ensure patients could receive up-to-date information on their deliveries and that it create adequate contingency plans to maintain its service at times of increased workload.


The GPhC expected the company to implement the recommendations "swiftly" and would conduct a further inspection in two months to assess Healthcare at Home's progress, it added.





What do you think of the GPhC's verdict on Healthcare at Home?

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14 Comments

Tariq Atchia, Pharmacy Area manager/ Operations Manager

Clinical homecare is actually hugely regulated, far more than community pharmacy. Most clinical homecare providers hold MHRA wholesale licences, therefore they do have GDP level quality management systems and the provisions in the contracts that they hold with NHS trusts require them to monitor the quality of the service provided against KPIs set by the trusts.

It's exactly because of the amount of regulation and the costs involved that the service is pretty low margin. Healthcare at Home is an independent provider, as is Bupa Home Healthcare and Alcura. Together with Evolution Homecare, these are the four biggest providers in the UK. Clinical homecare saves the NHS money a huge amount of money; the services that they provide to patients keep people on long term therapy out of hospital, reduce the risk of healthcare acquired infections and improve outcomes by improving adherence.

Rajive Patel, Community pharmacist

Oh come on. Everyone know GDP is no way near as quality driven as GMP. I would concede that recently steps are being taken to implement GDP regulations more tightly. That said, there is no pre-requiste to have an accredited QMS in place. Are any of the providers you listed, ISO accredited? If they were, why were the system failures not identified internally through audit and placed on CAPA, until the problems were closed out?

Also, I like the last part of your statement "improve outcomes by improving adherence" - well, perhaps that would have some weight, if the problem identified by the GPhC of late or missed deliveries did not occur. Frankly, there is no excuse for late or failed deliveries. Failures like this have a direct impact on therapy outcomes and must resolved, otherwise the market players should quite rightly exit the market. Weak margins, as you mention, have not place in discussions about service quality

Tariq Atchia, Pharmacy Area manager/ Operations Manager

Seems you know as much about GDP as you do about clinical homecare Rajive!

Rajive Patel, Community pharmacist

By the way, here's a good piece in the Guardian about your "highly regulated" sector:

http://www.theguardian.com/society/2014/jun/03/nhs-patients-medicine-del...

This type of negative publicity brings the profession into disrepute

Rajive Patel, Community pharmacist

Lol. Oh well, you obviously missed the essence of my posts. If you try and defend a broken system, which obviously the GPhC has quite rightly highlighted, then that's your opinion. Perhaps if you feel so passionate about "GDP" and "Clinical Home-care" and "hugely regulated" market, then you should speak to the visiting inspector in this case, to put the record straight.

Good luck buddy!

MESUT OZIL,

Rundy sounds a tad envious.

Rajive Patel, Community pharmacist

Hey Phudi, what happened did they let you back in ;) Hopefully, they kept hold of your passport.

Marc Borson, Community pharmacist

we have one home care company (healthcare at home) that delivers patients medication to our pharmacy because they are not in, we can refuse but we end up losing a patient. hospital can save money by just sending a prescription to to a pharmacy and pharmacy could charge them a dispensing fee like we do the NHS. we are a better option as are conveniently located and can do several deliveries same day if needed. Anyone out there interested in setting up a network to facilitates this?

Rajive Patel, Community pharmacist

This is the same company, owned by Alliance Healthcare, that has "cosy" deals with manufacturers such as Pfizer to "control" their stock by delivering directly to the patients.

CCG's should be made aware of this arrangement and also the issues raised in the GPhC report and act to contain this issue.

On the other side, from reports I have been reading on several trust review sites, Pharmacy2u are having the same problem. Increased workloads, from aggressive marketing, leads to increased business which is poorly managed, in terms of handling capacity, by senior management. I think the GPhC should approve marketing strategies, beforehand, that may see a surge in business and hence evaluate the companies contingencies in dealing with the overloaded workflow, which may lead to negative patient experiences, such as late or missing deliveries.

Disillusioned Pharmacist, Community pharmacist

I thought Pharmacy2u had gone out of business?

Steve A, Administration & Support

I think you're thinking of Alcura, who are part of Alliance Boots; Healthcare @ Home are an independent homecare company.

Also - NHS Trusts negotiate directly with pharma co's with regard to homecare stocks, so the solus deals in pharmacy don't apply; the homecare companies are just service providers.

Really? Wow, Superintendent Pharmacist

Healthcare at home are hardly independent, they are owned by BUPA!

Stephen Bochet, Work for health provider

Incorrect, BUPA owns "BUPA Home Healthcare" not Healthcare at Home.

Rajive Patel, Community pharmacist

Agreed. My apologies. However, the essence of my post still stands. Home care companies, whoever they may be, need to have stringent controls to ensure quality and performance metrics are not compromised by aggressive scaling up of operations.

It may be easy for the companies in this niche segment to win contracts, but the service needs to be tested. Perhaps a mandatory ISO 9001:2008 accreditation should be a per-requesite. Otherwise the GPhC should have a system of continual monitoring. Surely if these companies had a quality management system, then their CAPA's should have picked up on the short comings and pushed for a system redesign to ensure quality indicators and metrics are met.

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