Commercial Medicines Unit (CMU) - Department of Health

September 2012 

Commercial Medicines Unit 

Procurement guidance 

For 

The provision of homecare delivery service of medicines to patients at 

home 

1 

Issue date: May 2011 

Review date: Sep 2012 

© Crown Copyright 2011

Contents Page 

1. Introduction 3 

2. National Homecare Medicines Committee (NHMC) 4 

3. Market overview 7 

4. Comparison of home delivery methods 11 

5. Data collection 14 

6. Homecare delivery service providers 17 

7. Stakeholders 20 

8. Therapy list 21 

9. Specification 


Core 26 

Deliver and Service 32 

Product Prescribing and dispensing 36 

Equipment and ancillaries 40 

Training and Education of staff and patients 43 

Nursing services 45 

10. Award Criteria 47 

11. CMU homecare medicines team 53 

Appendix 1 – Glossary of Terms 54 

Appendix 2 – Patient registration form 60 

Appendix 3 – Change management form 62 

Appendix 4 – Data template 79 

Appendix 5 – KPI’s 80 

Appendix 6 – Patient survey 81 

Appendix 7 – Complaints and adverse incidents 84 

Appendix 8 – Refrigeration 88 

2 


Introduction 

The Commercial Medicines Unit (CMU) in conjunction with the National Homecare Medicines Committee 

have produced the enclosed guidance and generic specifications to support service users, providers and 

most importantly patients in the procurement of a homecare delivery service of medications to patient‟s 

homes. 

The best practice guidance document gives you an insight into the market, homecare delivery service 

providers, stakeholders and key market information which is pertinent to the homecare delivery service of 

medicines. 

Specifications have been produced with wide consultation and are intended to be as generic and reflective 

as possible of the NHS needs, in order that they can be used as a template for a number of therapy areas. 

It is intended that to the latter part of 2010 the homecare team in conjunction with NHMC will develop 

therapy specific guidance to support other market areas such as; Total Parenteral Nutrition (TPN) and 

Cystic Fibrosis (CF) as it is felt these therapy areas may require specific guidance documents. 

Specification and guidance documentation cover: 

Core 

Deliver and Service 

Product Prescribing and Dispensing 

Equipment and Ancillaries 

Training and Education of staff and patients 

Nursing Services 

Patient Registration forms 

Change Management guidance 

Data template 

KPI‟s 

Patient questionnaire 

Complaints and adverse incident form 

Refrigeration 

Other key documentation held on the CMU homecare website cover: 

Audit procedures – as best practice regional QA and pharmacy procurement specialist should 

review the awarded suppliers audit reports prior to the final contract decision 

Award criteria 


3 


National Homecare Medicines Committee (NHMC) 

The NHMC was formed as a sub group of National Pharmaceutical Supply Group as it was recognised that 

this market was expanding and needed to be managed effectively in order to ensure patient safety and 

clinical effectiveness. 

The committee consists of representatives of stakeholder professions with experience in the area of 

homecare medicines delivery and service in primary care, secondary care, specialised commissioning and 

industry. CMU facilitates and manages this committee. 

Members of the NHMC, homecare delivery service providers, Secondary care trusts, Primary Care Trust, 

NPSG, Specialised Commissioning, Hubs and QA have been consulted during the production of this 

document. 

The guidance will be reviewed on a six monthly basis, next review date November 2010. 

Committee members (as at January 2012) 

Allan Karr (Chair) 

Pharmacy Business Manager, University College London Hospitals NHS Foundation Trust 

Tel: 0207 3809730 email: allan.karr@uclh.nhs.uk 

Jim Armstrong 

Specialist Procurement Pharmacist, South East Coast (NHS Commercial Solutions) 

Tel: 01634 83 8934 email: jim.armstrong@medway.nhs.uk 

Karen Bell 

Sourcing Specialist, Homecare, NHS Commercial Medicines Unit (CMU) 

Tel: 01928 794615 email: karen.bell@cmu.nhs.uk 

Lorraine Booth 

Regional Specialist Procurement Pharmacist North West England 

Tel : 0161 419 4465 mob : 07769 936506 email : lorraine.booth@stockport.nhs.uk 

Graham Brack 

Pharmaceutical Adviser, NHS Cornwall and Isles of Scilly PCT 

Tel : 07736 553710 email: Graham.Brack@ciospct.cornwall.nhs.uk 

Teresa Brannigan 

Contracts Officer, NHS Wales Shared Service Partnership, Procurement Services 

(NWSSPPS) 

Tel: 02920 315485 email: Teresa.brannigan2@wales.nhs.uk 

Michael Butterfield 

Specialist Pharmacy Technician: Homecare Medicines Management 

Leeds Teachings Hospitals NHS Trust 

Tel: 0113 3927020 email: Michael.Butterfield@leedsth.nhs.uk 


4 


Carol Clark 

Category Specialist, Homecare, NHS Commercial Medicines Unit (CMU) 

Tel: 01282 850672 email: carol.clark@cmu.nhs.uk 

David Cook 

Specialist Procurement Pharmacist, North East England 

Tel: 07833294025 email: david.cook@nth.nhs.uk 

Judi Cross 

Pharmaceutical Advisor, South East Coast SCG 

Tel: 01622 713028 email: judi.cross@secscg.nhs.uk 

Phil Deady 

Pharmacy Procurement Manager, Leeds Teaching Hospitals NHS Trust 

Tel: 0113 3927012 email: Phil.Deady@leedsth.nhs.uk 

Margaret Dolan 

Pharmaceutical Adviser, National Procurement, NHS National Services Scotland 

Tel: 0131 275 6163 Mobile: 07717 468 776 email: margaret.dolan@nhs.net 

Alastair Gibson 

Director of Pharmacy, Blackpool Teaching Hospitals NHS Foundation Trust 

Tel: 01253 303790 email: alastair.gibson@bfwhospitals.nhs.uk 

Nick Haslem 

Commissioning Manager, South East Coast Specialised Commissioning Group 

Tel: 01622 713010 email: nick.haslem@secscg.nhs.uk 

Stephanie Hibbs 

Project Manager, London Procurement Programme 

Tel 07768006020 email : stephanie.hibbs@imperial.nhs.uk 

Mark Jackson 

Deputy Director, Quality Control North West 

Tel 0151 7948110 email Mark.jackson@lrippu.nhs.uk 

Jane Kelly 

Procurement Project Pharmacist, Leeds Teaching Hospitals NHS Trust 

Tel: 01133927036 email: Jane.kelly@leedsth.nhs.uk 

Michael Mc Beth 

Specialist Procurement Pharmacist Newcastle Upon Tyne Hospitals NHS Foundation Trust 

Tel : 0191 2825952 email: michael.mcbeth@nuth.nhs.uk 

Sarah Pacey 

Assistant Chief Pharmacist, Procurement, Therapeutics and Medicines Performance, 

Nottingham University Hospitals NHS Trust 

Tel: 0115 9627674 email: sarah.pacey@nuh.nhs.uk 


5 


Liz Payne 

Category Manager, Homecare, NHS Commercial Medicines Unit (CMU) 

Tel: 01926 857313 email: liz.payne@cmu.nhs.uk 

Dr Nick Payne 

Chairman, National Clinical Homecare Association (NCHA Limited) 

Tel : 07970 387992 email: nick.payne@clinicalhomecare.co.uk 

Cherryl Perry 

Customer Supply Chain Manager, Abbott Laboratories, representing ABPI 

Tel: 07950 162648 email: cherryl.perry@abbott.com 

Simon Perkins 

Category Specialist, Homecare, NHS Commercial Medicines Unit (CMU) 

Tel: 01928 794631 email: simon.perkins@cmu.nhs.uk 

Bernadette Porter 

Nurse Consultant,The National Hospital for Neurology & Neurosurgery, 

University College London Hospitals NHS Foundation Trust 

Tel: 0207 767 2083 email: bernie.porter@uclh.org 

David Stead 

Medicines Procurement Lead for South West, United Bristol Hospitals NHS Trust 

Tel: 07867 527491 email: david.stead@uhbristol.nhs.uk 

Dr.Richard Sturgess 

All Wales Technical and Computer Services Pharmacist 

Tel: 029 20 748128 email: richard.sturgess@wales.nhs.uk 

Liz Sutton 

Pharmacy Procurement Manager,Buckinghamshire Healthcare Trust 

Tel: 01296 315283 email: Liz.Sutton@buckshealthcare.nh.uk 

Kevan Wind 

Medicines Procurement Specialist Pharmacist, London and East of England 

Tel: 01702 385225, mobile 07534 958315 email: kevan.wind@southend.nhs.uk 


6 


Market overview 

A medicine homecare delivery service can be described as one that delivers ongoing medicine supplies and 

where necessary associated care, initiated by a hospital prescriber, direct to a patient‟s home with their 

consent. The purpose of the homecare delivery service is to improve patient care and choice for their 

clinical treatments. Patients that are typically on homecare are those with chronic diseases and stable 

treatment regimens that do not require acute care input. 

Currently, most homecare delivery service is initiated by hospital trusts, which normally administer 

medicines to patients within their own hospital environment. However, on some occasions the supply and 

administration of medicines is better provided directly to the patient in their own home. For example, there 

are many therapy areas which will cause patients logistic difficulties with the provision of heavy and large 

volumes containers which are required for their treatment e.g. dialysis solutions, total TPN, Enteral feeds. 

The use of such medicine homecare delivery services is expanding throughout the UK with an estimated 

120,000 plus patients now receive their medicines via the homecare route. The value of medicines being 

supplied by this route is estimated to be well in excess of £500 million. These figures are expected to 

increase substantially as clinical services follow the vision for building on the strengths of pharmacy, using 

that capacity and capability to deliver further improvements in pharmaceutical services over the coming 

years as part of an overall strategy to ensure safe, effective, fairer and more personalised patient care. ¹ 

It must be noted that at the beginning of any homecare medicines service whether it is initiated by a hospital 

trust or pct dialogue must be undertaken with the manufacturers of the medicine at the beginning of the 

process to ensure product visibility and agreement for distribution. 

Homecare delivery service can be further sub-divided into low-tech or high tech. Other definitions are also 

possible. 

(a) High Tech Homecare 

This will include all: 

Intravenous therapy 

Other injectable therapy where significant support is required e.g. consumables, storage, 

monitoring, preparation and administration. 

Any oral therapy that requires significant support such as blood level monitoring or special storage 

requirements 

1. Department of Health, publications – Pharmacy in England: building on strengths – delivery the future 


7 


(b) Low-tech homecare 

This will include all: 

Oral medication and external preparations that require no other support than standard concordance 

monitoring from the homecare delivery service provider. 

Injectable therapy that is not intravenous and requires little support other than concordance monitoring. 

What are the benefits of homecare? 

There are many benefits in using homecare, key among which is that for many patients it would be 

necessary to make visits to hospital solely to receive periodic treatment or prescriptions. Homecare delivery 

services avoids this need, thereby also freeing both patient and hospital time. Homecare can also release 

hospital beds and return patients to their homes earlier. An example of this would be cystic fibrosis 

homecare services: not only does homecare decrease hospital visits but also decreases the chances of 

cross-infection in this vulnerable patient group. 

Where appropriate homecare services can be commissioned with nursing support to ensure seamless 

delivery of care without creating any burden to community services. Where patients are receiving a range of 

home medicines, homecare may offer the opportunity of providing all medications through a single provider. 

Homecare offers the opportunity of providing high quality, cost effective and accessible care to specific 

patient groups. 

Medicines homecare delivery services will vary according to the degree of intervention 

The types of medicine delivery services provided by a homecare delivery service provider can include the 

delivery process, pharmaceutical dispensing, and sterile preparation of injectable medicines in a ready to 

use form, phlebotomy services and nurse or patient administration of injectables. 

This potentially high level of medical and clinical care will require highly trained staff. The staff are currently 

either employed by the provider trust or perhaps more commonly by a commercial homecare delivery 

service providers. A considerable amount of attention should be given to ensure that all clinical governance 

arrangements are formally agreed and adhered to. 

It is worth clarifying that Shared Care is different from homecare. In shared care prescribing responsibility 

passes to the GP in agreement with the Consultant and Primary Care Trust (PCT). In the case of medicine 

homecare the responsibility for the clinical care remains with the hospital prescriber. 

How do homecare delivery services work? 

Typically, homecare arrangements began informally with acute trusts arranging a service for discharged 

patients, with reimbursement of costs by the PCT. Control was often minimal, but the risk to the PCT was 

low and the number of patients small. It is clear however that more formal arrangements are necessary. In 

many areas these have now been developed and robust processes with dedicated teams afford much more 

control and governance, but some trusts may not have yet instituted this level of control. 


8 


Effective clinical governance is fundamental to homecare delivery services due to the shared nature of the 

service with acute trusts retaining clinical responsibility, care usually being delivered through an 

independent contractor and in some case a third party being involved where services are directly funded by 

PCTs. In addition, each prescription causes generation of an order, delivery note and invoice which must be 

reconciled, and the timely issuing of prescriptions has to be managed. 

The use of homecare delivery services introduces an additional dimension into the care of patients. It 

exposes a wide range of issues including communication regarding treatment outcomes, therapeutic intent 

and adverse reactions. There requires to be absolute clarity regarding what information can be provided 

and by whom. Clear communication channels regarding concordance and adverse incidents with the 

responsible consultant will need to be put in place. 

Homecare delivery services are most effectively provided when purchased through joint working 

arrangements between acute trusts and PCTs. It is also recommended that pharmacy procurement 

specialists are involved to harness expertise of collaborative contracting and tender exercises. 

What is the role of PCT's in homecare? 

The day to day management should be retained by the organisation that has clinical responsibility of the 

patient, usually the acute trust. Acute trusts and PCTs should work in conjunction in agreeing and 

establishing service criteria and also ensuring appropriate contractual and governance arrangements for 

homecare delivery services. Joint working is recommended in: 

VAT 

agreed that a homecare delivery service is a suitable route for the provision of a specific clinical 

service. 

ensuring that the tendering process is appropriately conducted preferably with those with 

experience in homecare delivery service contracting, and a formal contract and/or Service Level 

Agreement is in place. 

ensuring that the service provided by the appointed homecare delivery service provider is 

monitored regularly and thoroughly. 

ensuring there is an appropriate, efficient and adequately resourced process to verify the 

administration of the prescriptions, purchase orders, delivery notes and invoices. 

The points below are a summary of discussions with HM Revenue & Customs (HMRC) and are an overview 

only. The NHMC takes no responsibility for any inaccuracies and NHS trusts are advised to secure their 

own advice with regard to particular arrangements. 

VAT liability of homecare delivered medicines and associated services. 


9 



o Medicines dispensed to individuals for their personal use, dispensed by a registered 

pharmacist against a prescription issued by a registered doctor or nurse for administration 

in their own home (or residential home) are zero-rated. 

o Pharmacy dispensing services provided by a registered pharmacist are exempt from VAT 

o Delivery services are subject to VAT at the standard rate 

o Where two or more of the above elements form part of a composite supply, the 

predominant element will determine the VAT liability of the whole. 

Homecare delivery service providers will seek advice from their local HMRC office who will advise 

on the VAT status of the proposed services 

The homecare delivery service provider is responsible for collecting the VAT where applicable. If 

the homecare delivery service provider fails to charge the customer VAT and later finds that its 

interpretation was incorrect, the HMRC will pursue the homecare delivery service provider for 

payment of the under declared VAT. It may be that, the homecare delivery service provider 

will approach its customer seeking further payment, whether or not the customer should make 

further payment is a commercial matter between the two parties and the HMRC would not involve 

itself in that issue. 

Medicines used while an individual is receiving care or medical or surgical treatment in a hospital or 

nursing home - whether as an in-patient, resident, day-patient or outpatient - cannot be zero rated. 

The VAT (Drugs, Medicines, and Aids for the Handicapped) Order 1997/2744 which came into effect on 1 

January 1998 is outlined in Business Brief 29/97 www.newsrelease-archive.netlcoi/depts/GCE/coi5955d.ok 

Comparison of Homecare Delivery methods 

The method of delivery chosen should involve a local risk assessment and give due consideration to the 

convenience for the patient. The final decision on the delivery route chosen should be documented in the 

service level agreement and also include the consent by each individual patient. 

The most frequent delivery method used by homecare delivery service provider is the use of dedicated vans 

and suitably trained drivers. The vans must be able to demonstrate validated cold chain where this is 

required and in all cases show that temperature control is within an acceptable range for the storage of 

medicines. All packages should be tamper evident. It is expected that on making the delivery the driver will 

put away stock, remove waste packaging, rotate stock and where appropriate monitor fridge temperatures. 

The homecare delivery service provider must inform the patient as soon as possible if for any reason 

delivery cannot be made. If it is necessary to arrange delivery through third part couriers then they should 

adhere to the usual agreed procedures. 

For certain services or emergency deliveries the use of national parcel carriers or Royal Mail is used. Where 

such postal services are used, either via the Royal Mail or other carriers, it is advisable to check with the 

10 


homecare delivery service provider on any restrictions that apply. The Post Office has useful information on 

its website (www.postoffice.co.uk). Consideration should also be given to any advice from the Royal 

Pharmaceutical Society. 

All items must be securely wrapped to prevent loss or damage to the contents and also to avoid harm to 

recipients or postal employees. Any item should be contained in a strong inner container and enclosed in 

an outer packaging. This should ensure that any spillage is contained within the outer packaging. For 

liquids, it is recommended that any tins or bottles should be sealed with tape, wrapped in polythene, sealed 

again and surrounded with an absorbent material to soak up any leakage. Although medicines could be sent 

by ordinary post when needed, Royal Mail recommends using their 'Special Delivery' service to guarantee 

next day delivery and obtain the recipient's signature. It is the supplying pharmacists‟ responsibility to 

ensure that the patient receives their medication. 

In the case of the Royal Mail medicines for medical purposes may be posted provided these are supplied 

lawfully. This is however subject to their prior written approval, (which may be subject to conditions, 

including the type of medicines that may be sent, how, when, by whom and to whom), and subject to such 

items being sent in suitable tamper-proof packaging and only being sent by Royal Mail's Special Delivery or 

Recorded Delivery services. Although the Royal Mail may request full details of any medicines being 

posted, registered pharmacies are not normally required to provide this information. 

The following restrictions for posting medicines apply. 

The only type of Controlled Drugs permitted are those classified as Schedule 4 e.g. 

Benzodiazepines. All other types of CDs are prohibited. Guidance may be sought from the Home 

Office 0207 035 4848 or visit www.homeoffice.gov.uk 

Items requiring refrigeration are prohibited unless specialist containers are used which have been 

validated to demonstrate suitable temperature control. 

Any medicine that uses an aerosol where the volume exceeds 50ml is prohibited. 

Any aerosols that use flammable or toxic gases as propellants are also prohibited. 

COMPARISON OF DELIVERY METHODS 

SERVICE TYPE STRENGTHS WEAKNESSES 

Postal ( including special 

delivery 


Lowest cost option for small 

number of deliveries. 

Track & Trace capability. 

Insurance cover for loss of 

product and delivery failure. 

Post office pick-up point if 

patient is not at home. 

Dedicated van and driver Deliveries consistently by 

the same driver. 

11 

Loss incidence higher than 

with dedicated van. 

No facility to check stock 

within patients‟ homes. 

No certainty regarding 

delivery time (but before 

9am service available) 

Certain categories of 

medicines prohibited. 

Unable to send items 

requiring refrigeration. 

Highest cost option. 

Backup needed for when 


Data collection 


Ability to conduct stock 

checks in patients‟ homes. 

May offer a secure key 

holding service for access 

when the patient is out. 

Lower losses than post or 

courier. 

Flexibility – facility to 

redirect van for urgent 

needs. 

Weekend deliveries. 

12 

the vehicle is off the road 

and during holidays. 

Driver needs suitable 

training 

Police check of driver 

required 

CMU has not captured homecare delivery service information on either the BTT or Pharmex applications. 

The introductions of homecare services to CMU lead to a requirement for new business processes and 

applications. The strategic objectives for the collection are:- 

Understand value of homecare market to inform national procurement strategy. 

Unbundle service and delivery costs from pharmaceutical costs. 

Identify where savings can be made. 

Quantify volumes, usage and spend for contracting purposes. 

Benchmark prices in order to drive best practice. 

Identify patient numbers for homecare by trust, therapy, product and service. 

Manage risk in homecare market and ensure appropriate level of competition. 

Measure trends in growth of the homecare market. 

Provide a central resource of data for the NHS on homecare spend. 

Ensure that CMU is able to respond to Department of Health request for information on NHS 

Homecare spends. 

Enable the DH to make informed policy decisions on homecare services 

Avoid any duplication of effort on homecare processes within NHS organisations. 

Collection of data will be consistent with NHS data and coding standards. 

The “to be” strategic vision from the government and the NHS is to have a more “joined up”, “do 

Once and Share”, “Auto-identification and data capture (AIDC)” health service². CMU is a leading 

body of this change and is committed to supporting the standards needed to make this change 

happen. 


2. Coding for Success – Simple technology for safer patient care, Healthcare Quality Directorate, Department of Health 

CMU data collection project objectives 

1. Collect homecare medicine usage and spend data from homecare delivery service providers. 

2. Collect homecare service data from homecare delivery service providers. 

3. Collect homecare medicine usage and spend data backdated to the beginning of 2008. 

4. Ensure that the data collection process does not allow duplication of transaction (spend and usage) 

reporting. 

5. Where NHS data standards do not exist, document a consistent data specification to support the 

exchange of medicine and service information between DH MPIG, CMU, NHS trusts and purchasing 

groups (for example, hubs) and suppliers. 

6. Provide homecare delivery service providers with the capability to provide and access homecare data 

direct to/from CMU. 

7. Provide trusts with the capability to access homecare data direct from CMU. 

8. Facilitate more accurate and timely (near real time) homecare reporting capability. 

9. Remove homecare delivery service provider reporting medicine usage and spend to individual trusts. 

Replace with a collective report submitted to CMU. 

10. Collect key performance indicators (KPI‟s) on homecare delivery service providers to use to make 

informed contract adjudication decisions (against award criteria weightings). Appendix 5 


13 



CMU Data collection fields 

14 


TRUST WORLD 

MEDICINE 

DATA NOT 

CAPTURED 

Trust - Pharmacist 

1. 

Secondary 

Care Trust 

medicinal spend and usage 

DATA CAPTURED 

PCA 

(Only FP10) 

3. 

Primary 

Care Trust 

Hospital 

Prescription 

Pharmacy Trust 

Procurement Systems 

medicinal spend and usage 

DATA CAPTURED 

2. 

NHS 

Prescription 

Services 

Secondary Trust 

Clinician 

OPD Script 

Purchase 

Order 

FP10 

Prescription 

(to PCA) 

Framework 

Agreements 

Secondary Care Trust 

provides 

medicinal product 

spend and usage 

Invoice and 

reports 

Purchase Quantity 

£ Purchase Price 

£ Service Price 

£ Payment 

NHS CMU World 

Email Usage 

NHS CMU 

Web 

SUPPLIER WORLD 

Homecare Provider 

(Supplier) 

© Crown Copyright 2011 May 2011 

PPRS 

Usage 

NEW - Homecare Data Collection Project 

15 

PPRS 

Reports 

Data Analyst 

Delivery 

Note 

Homecare Service 

delivers to Patient 

ERM CIMS 

Load Transaction Files 

Homecare service purchases 

Medicinal Product 

£ Purchase Price 

Patient 

Pharmex 

Supplier email service 

spend and usage figures 

Trust may have a 

contract price 

Phate 

Other 

Reports 

£ Contract Price 

Phacter 

(planned) 

Category Specialist 

IBT Benefits 

Load Transaction Files 

£ Medicinal Product Baseline Price 

(weighted average purchase price paid by trust over the latest 

four months) 

BTT 

Pharmaceutical 

Manufacturer 

(Supplier) 

Homecare delivery services Overview - Thick vertical dotted line illustrates new Homecare delivery service provider information flow to CMU

Homecare delivery service providers 

The market is growing and new entrants are emerging both SME and multinationals. In the UK the major suppliers are:- 

These suppliers are currently providing, or have shown an interest in supplying, a home delivery service 

This IS NOT an approved list, these suppliers have not been vetted by CMU or the National Homecare Medicines Committee (NHMC) 

Homecare Service 

Providers Address 1 Address 2 Town County 

Air Products 

Baxter Healthcare Limited 

T/A Willow Healthcare 

Services 

2 Millennium 

Gate 

Unit 1 North 

Orbital 

Commercial 

Park 

Westmere 

Drive Crewe Cheshire 

Napsbury 

Lane St Albans Herts. 

Bupa Home Healthcare 

Unit 4 Scimitar 

Park Roydon Road 

Eastgate 

Way, Manor 

Harlow Essex 

Calea UK Limited Cestrian Court Park Runcorn Cheshire 

Careology Ltd 

Central Homecare Ltd 

CHEMISTREE 

HOMECARE 

Evolution Homecare 

Services Ltd 

Flexible Homecare 

Services 

Unit 2-4 

Fenchurch 

Court 

Bobby Fryer 

Close Oxford 

Selbourne 

House Mill Lane Alton Hampshire 

Unit 7 Curo 

Park Park Street Frogmore St Albans 

Post 

Code Contact Position e-mail 

CW1 

6AP 

AL1 

1XB 

Mo 

Rahman 

Steve Lane 

CM19 

5GU Alton Austin 

WA7 

1NT 

OX4 

6ZN 

GU34 

2QJ 

AL2 

2DD 

16 

Telephone 

number 

Contracts 

Manager BUCKLEIP@airproducts.com 0800 389 0202 

Business Manager 

Head of Homecare 

(Baxter) 

Commercial 

Manager 

Christina Senior Product 

Willis 

Manager 

Dominic 

Moreland 

(MD) 

or Natasha 

Arif Manging Director 

Gaurang Head of Homecare 

Majmudar Development 

Gitika 

Kalra/Sam 

Bhudheo/Le 

sley Parrott 

Head of Homecare 

Business 

Development 

Manager/Director 

of 

Homecare/Senior 

Homecare 

supervisor 

mohammed_a_rahman@baxte 

r.com 

steve_lane@baxter.com 

aaustin@bupahomehealthcare. 

com 

01727 849721 

01635 206273 

01279 456789 / 

456946 

Christina.willis@caleaonline.com 

01928 533742 

dmoreland@careology.co.uk 

narif@careology.co.uk 

01865 770510 

- switchboard 

or direct 01865 

334925 

gaurang.majmudar@cen 

tralhomecare.co.uk 01420 540535 

Homecare@chemistree.co.uk 

Sam.b@chemistree.co.uk 

Gitika.k@chemistree.co.uk 

Lesley.p@chemistree.co.uk 01727 877954 

Mobile 

Member of the 

National 

Clinical 

Homecare 

Number Website 

www.airpr 

Comments Association 

07834 

oducts.co. Oxygen and 

259590 

07825 

374917 

uk 

Medicines 

07717 

www.willo Low & High 

542261 whs.co.uk Tech. 

Low & High 

Yes 

www.bupa Tech 

07971 

homehealt complex and 

499518 hcare.com continuing care Yes 

0779530812 

4 

07748 

936914 

07879 

488000 

07545 

243796 

www.calea 

.co.uk High Tech 

High Tech - 

Clotting 

Factors / 

Yes 

www.careo Genetics / 

logy.co.uk 

www.centr 

Chemotherapy Yes 

alhomecar Low & High 

e.co.uk Tech Yes 

www.chem 

istree.co.u 

k 

Low and High 

tech - incl CF, 

all IV 

Technology 239 Ampthill 

MK42 Paul 

Contracts & Sales paul.probert@evolutionhomeca 

07713 

www.evolu 

tionhomec 

House 

Road Bedford Bedfordshire 9QG Probert Support Manager re.co.uk 01234 223673 306564 are.co.uk 

52 French 

No 

Westbury Laurence 

OX44 Julian 

jgooddy@eyecare- 

Website 

House 

Way Chalgrove Oxford 

7YF Gooddy Managing Director services.com 01865 400384 

(checked High Tech 


Low and High 

tech Yes

Healthcare at Home Ltd 

Lloyds Pharmacy - sister 

company of Evolution 

Fifth Avenue 

Centrum 100 

Technology 

House 

Mawdsleys (Mawdsley - 

Brooks & Co. Ltd) Number Three 

Burton upon 

Trent 

Staffordsh 

ire 

239 Ampthill 

Road Bedford Bedfordshire 

South 

Langworthy 

Road 

Medco Health Solutions 

(UK) Bewer House Caswell Road 

Nutricia Limited 

Pharma Service Division 

& Applied Dispensing (a 

division of Healthcare at 

Home) 

Newmarket 

Avenue 

Polar Speed Unit 8 

White Horse 

Business 

Park 

Chartmoor 

Road 

PO Box Salford, 

18 

Manchester 

Brackmills 

Industrial 

Estate Northampton 

Trowbridg 

e Wiltshire 

Leighton 

Buzzard Bedfordshire 

DE14 

2WS Mark Smith 

MK42 

9QG 

M50 

2PW 

NN4 

7BZ 

BA14 

0XQ 

Trevor 

Jones 

Kelly 

Jacques 

Alison 

Davis 

Dave 

Hobdey 

LU7 

4WG John Evans 

Group Commercial 

Director Mark.Smith@hah.co.uk 0870 600 1540 

UK Contracts 

Manager 

Hospital contracts 

Manager 

Director- Business 

Development 


17 

trevor.jones@evolutionhomeca 

re.co.uk 01234 223600 

Kelly.jacques@mawdsleys.co. 

uk 0161 742 3360 

alison.davis@medcohealth.co. 

uk 01604 241120 

07772 

712216 

07788 

416093 

Contracts 

Manager david.hobdey@nutricia.com 01225 711586 none 

Director - 

Pharmaceutical 

Services john@polarspeed.com 01525 217666 

0785090151 

4 

07970 

578364 

03/06/08) 

www.hah.c 

o.uk 

www.evolu 

tionhomec 

are.co.uk 

www.maw 

dsleys.co. 

uk 

www.medc 

ohealth.co. 

uk 

uk.nutricia. 

com 

www.polar 

speed.com 

Low and High 

Tech - 

Integrated 

Homecare 

Services Yes 

High tech; HIV 

/ CF 

Low-tech 

therapeutic 

category 

initially 

Low tech-high 

tec Yes 

High Tech 

Feeding; 

Enteral Feeds, 

Specialised 

Feeds 

Chill Chain (act 

as distributors 

for Careology

Drug Suppliers Offering Homecare 

These suppliers are drug companies who offer homecare using an in-house provider 

Fresenius Medical Care (UK) 

Gambro Lundia AB (UK & 

Ireland 

Merz Pharma UK Ltd 

Nunn Brook 

Sutton in 

Road Huthwaite 

Ermine 

Ashfield Nottinghamshire 

Lundia Business 

House 

260 

Park Huntington Cambridgeshire 

Centennial Elstree Hill 

Park 

South Elstree Hertfordshire 

NG17 

2HU 

PE29 

6XX 

WD6 

3SR 

Kathryn 

Miller 

David 

Lyons 

Pharmacy2 

Home 

Contracts Coordinator 

HND Business 

Development 

office 

Head of 

Medical 

Information 


18 

ukcontracts@fmcag.com 

david.lyons@gambro.co 

m 

pharmacy2Home@merz 

.com 

01623 

445149 www.fmc-ag.com 

01480 

444000 

0208 

236 

3583 

07870 

624706 www.gambro.co.uk 

www.merzpharma. 

co.uk 

Hi Tech; 

Peritoneal 

Dialysis and 

Haemodialysis 

Hi Tech; 

Haemodialysis 

on supply for 

patients on 

Denzapine

Homecare stakeholder map 

HRG4 

(PbR) 

Clinicians 

PMSG 

NPSG 

MHRA 

NHS QA 

BCAG 

NICE 

Specialist 

Commissioner 

NHMC 

PCT 

Wider environment 

Business influencers 

Operational 

Secretary 

of State 

Secondary 

Care Trust 


JCWG 

NHS CMU 

NHS 

19 

Homecare 

Provider 

CPHs 

ABPI 

PPD 

Pharmacists 

HM Treasury 

Pharmacy 

Manufacturers 

NCHA 

DOH MPIG 

OFT 

DOH PPRS

© Crown Copyright 2011 

May 2011 

List of products and therapies 

The tables below lists therapy areas and conditions which are currently treated through homecare and examples of 

the drugs involved. 

The list of medicines (table 1) are catalogued as they first appear in the BNF and the list is in BNF order. They 

have not been duplicated where they have more than one indication e.g. Methotrexate first appears under 

Cytotoxic Drugs and is not repeated under Rheumatology. 

Table (2) is an alphabetical list of products that have been distributed to patients homes by brand name. 

These are not exhaustive lists. Please contact carol.clark@CMU.nhs.uk if you are aware of any other 

products which are being supplied via homecare. 

Table (1) Therapy areas and conditions which are currently treated through homecare 

BNF 

Section 

2.1.2 

2.5.1 

2.11 

3.1.1.1 

3.4.3 

3.6 

3.7 

4.2.1 

4.9.1 

Therapy area Medicine Specific medicine 

Cardiology 

Congestive heart failure 

Vasodilator antihypertensives 

Antifibrinolytics 

Respiratory 

Selective beta2 agonists 

Allergic asthma 

Oxygen 

Mucolytics 

CNS 

Antipsychotic drugs 

Parkinsons disease 

Milrinone 

Iloprost 

Epoprostenol 

Bosentan 

Sildenafil 

Sitaxentan 

Blood Factors 

V11, V11a, V111, 

IX 

Terbutaline 

Omalizumab 

Oxygen 

Dornase Alfa 

20 

Primacor 

Ventavis 

Flolan 

Tracleer 

Revatio 

Thelin 

Advate, Benefix, Haemate 

P. Helixate NexGen, 

Kogenate, Novoseven, 

ReFacto, 

Bricanyl 

Xolair 

Pulmozyme 

Clozaril 

Denzapine 

Zaponex 

APO-Go

BNF 

Section 

5.1.4 

5.1.7 

5.1.9 

5.3.1 

5.3.3 

8.2.4 

8.2.4 

5.3.5 



Infections 

Cystic fibrosis 

Antitubercolosis 

HIV 

Viral Hepatitis 

Hepatitis C 

May 2011 

Tobramycin 

Colomycin 

Imipenem & 

Cilastatin 

Amikacin 

Capreomycin 

Rifabutin 

Pyrazinamide 

Rifampacin & 

isoniazid 

combinations 

Antivirals and related 

medicines 

Entecavir 

Interferon 

Pegylated Interferon 

Ribavirin 

21 

Tobi 

Colistin 

Primaxin 

Amikin 

Capstat 

Mycobutin 

Rifater, Rifinah 

Baraclude 

Intron A, Roferon A, 

Viraferon 

Pegintron, 

ViraferonPeg 

Copegus, Rebetol

BNF 

Section 

6.5.1 

6.5.1 

6.6.1 

8.2.4 

8.1 

8.2 

8.3.4 



Endocrine 

Infertility 

Bone metabolism & 

Growth hormone 

Bone metabolism & 

Growth hormone 

Multiple sclerosis 

Malignant disease 

Cytotoxic drugs 

Immunosuppressants 

Hormone antagonists 

May 2011 

Chorionic 

Gonadotrophin 

Choriogonadotropin 

Alfa 

Follitropin Alfa 

Follitropin Beta 

Human Menopausal 

Gonadotrophins 

Lutropin Alfa 

Somatropin 

Teriparatide 

Interferon Beta 1a 

Interferon beta 1b 

Glatiramer 

Natalizumab 

Capecitabine 

Gemcitabine 

Methotrexate 

Erlotinib 

Imatinib 

Topotecan 

Trastuzumab 

Bortezomib 

Bevacizumab 

Mycophenolate 

Ciclosporin 

Sirolimus 

Tacrolimus 

Lanreotide 

Octreotide 

22 

Choragon, Pregnyl 

Ovitrelle 

Gonal-F 

Puregon 

Menogon,Menopur 

Luveris 

Saizen 

Zomacton 

Genotrope, Humatrope, 

Norditropin, Nutropin Aq., 

Saizen, Zomacton 

Forsteo 

Avonex, Rebif 

Betaferon, 

Copaxone 

Tysabri 

Xeloda 

Gemzar 

Tarceva 

Glivec 

Hycamtin 

Herceptin 

Velcade 

Avastin 

Cellcept, Myfortic 

Neoral, Sandimmune 

Rapamune 

Prograf, Advagraf 

Somatuline LA and 

Autogel 

Sandostatin and LAR

BNF 

Section 

9.1.3 

9.1.3 

9.3 

9.8.1 

9.8.1 

9.8.1 

9.8.1 



Nutrition and Blood 

Anaemia 

Thalassaemia 

Parenteral nutrition 

Gauchers disease 

Fabrys disease 

MPS VI 

MPS II 

May 2011 

Darbopoetin 

Epoetin Alfa 

Epoetin Beta 

Desferrioxamine 

Desferasirox 

Deferipirone 

TPN 

Imiglucerase 

Miglustat 

Agalsidase beta 

Agalsidase alfa 

Galsufase 

Idursulfase 

Musculoskeletal 

10.1.3 Rheumatic Disease Adalimumab 

Etanercept 

Infliximab 

Methotrexate 

Rituximab 

23 

Aranesp 

Eprex, Retocrit 

NeoRecormon 

Desferal 

Exjade 

Ferriprox 

Cerezyme 

Zavesca 

Fabrazyme 

Replagal 

Nagalzyme 

Elaprase 

Humira 

Enbrel 

Remicade 

Metoject 

Mabthera 

13.5.3 

Skin 

Psoriasis 

Metabolic Disorders 

Efalizumab Raptiva 

9.8.1 Mucopolysaccharidosis Aldurazyme 

Laronidase 

Pompe‟s Disease 

Vaccines and antisera 

14.5 (IV Immunoglobulin) 

Alglucosidase 

Alfa 

SC 

IV 

Myozyme 

Subcuvia 

Subgam 

Vivaglobin 

Flebogamma 

Gammagard 

Octagam 

Sandoglobulin 

Vigam

Table (2) Alphabetical list of products that have been distributed to patients homes by brand name. 

1 APO-Go 36 Gonal-F 71 Raptiva 

2 Advagraf 37 Haemate P 72 Rebetol 

3 Advate 38 Helixate 73 Rebif 

4 Amikin 39 Herceptin 74 ReFacto 

5 Aranesp 40 Humatrope 75 Remicade 

6 Avastin 41 Humira 76 Replagel 

7 Avonex 42 Hycamtin 77 Retocrit 

8 Baraclude 43 Intron A 78 Revatio 

9 Benefix 44 Kogenate 79 Rifater 

10 Betaferon 45 Laronidase 80 Rifinah 

11 Bricanyl 46 Luveris 81 Roferon A 

12 Capstat 47 Mabthera 82 Saizen 

13 Cellcept 48 Menogon 83 Sandimmune 

14 Cerezyme 49 Menopur 84 Sandoglobulin 

15 Clozaril 50 Metoject 85 Sandostatin and LAR 

16 Colistin 51 Mycobutin 86 Somatuline LA and autogel 

17 Copaxone 52 Myfortic 87 Subcuvia 

18 Copegus 53 Myozyme 88 Subgam 

19 Choragon 54 Nagalzyme 89 Tarceva 

20 Denzapine 55 Neoral 90 Thelin 

21 Desferal 56 MeoRecormon 91 Tobi 

22 Dynepro 57 NexGen 92 Tracleer 

23 Elaprase 58 Norditropin 93 Tysabri 

24 Enbrel 59 Novoseven 94 Velcade 

25 Eprex 60 Nutropin Aq 95 Ventavis 

26 Exjade 61 Octagam 96 Vigam 

27 Fabrazyme 62 Ovitrelle 97 Viraferon 

28 Ferriprox 63 Pegintron 98 ViraferonPeg 

29 Flebogamma 64 Pregnyl 99 Vivaglobin 

30 Flolan 65 Primacor 100 Xeloda 

31 Forsteo 66 Primaxin 101 Xolair 

32 Gammagard 67 Prograf 102 Zomacton 

33 Gemzar 68 Pulmozyme 103 Zaponex 

34 Genotrope 69 Puregon 104 Zavesca 

35 Glivec 70 Rapamune 


May 2011 

24

1. Introduction 


Specification document for Homecare Medicines – 

Core 

1.1 This specification outlines the general requirements for any Homecare Medicine service 

purchased by the NHS in England. There are further supplementary specifications which outline 

the specific requirements with regard to: 

2. Scope 

• Delivery and service 

• Product (medicines), prescribing and dispensing 

• Information and training for patients and staff 

• Nursing services to be provided 

• Equipment and ancillaries. 

• Compounding Services. 

There may also be some requirements which are therapy specific which should be detailed 

separately. 

These documents have been produced in partnership with Commercial Medicines Unit (CMU) 

and the National Homecare Medicines Committee, in consultation with NHS and industry. 

The guidance should be utilised by all NHS Organisations. 

2.1 This Framework agreement is for provision of a homecare medicines service, which may include 

the following therapies and medicines. 

{insert list here} 

2.2 It is anticipated that the scope in terms of numbers of patients and boundaries of provision will 

change during the term of this framework but will be limited to the therapies listed and patients 

being treated by the Purchasing Authorities listed. Provision will be made for implementing these 

changes in a way that is acceptable to all parties, and taking into account patient choice and 

significant market changes. 

2.3 Further detail of the product and services requirements are provided throughout this specification. 

Appendix XX gives further detail on the current provision of these services and an indication of 

any planned developments and strategic direction. 

3. Definitions 

Appendix One 

May 2011 

25

4. Duration of Framework 

4.1 Subject to the provision of the Terms and Conditions, this framework shall remain in force for the 

period of [Period] months commencing 1 [Month] 20XX. In addition there will be an option to 

extend the framework for up to a further 24 months. 

5. Selection, Registration and Discharge of Patients 

5.1 Patient selection will be carried out by the Purchasing Authority. The Purchasing Authority will 

confirm the patient‟s motivation and suitability for the home delivery scheme. 

5.2 Assessment of the patient‟s home environment will be the responsibility of the Purchasing 

Authority. 

5.3 Service will not commence until the Purchasing Authority has gained patient consent and the 

Purchasing Authority has evidence as to the suitability for the patient to receive a home delivery 

service. 

5.4 The Purchasing Authority will complete a registration form for each patient, for dispatch to the 

Contractor. The NHMC recommended standard registration form is included at Appendix Two. 

On receipt of the registration paperwork, the Contractor will identify the service elements and 

activate as required. 

5.5 The Contractor will adopt and use the Purchasing Authority‟s patient unique identifier to identify 

each patient once the registration forms have been accepted. 

5.6 The Contractor will make initial contact with the patient to confirm registration, and explain the 

process in line with the requirements of the patient information section of this specification. 

5.7 As the home delivery of each patient is transferred to the Contractor, it will be the responsibility of 

the Contractor and the Purchasing Authority to ensure a smooth transition from hospital to homebased 

supply. As the patient's delivery is transferred to the contractor, it will be the responsibility 

of the Contractor and the Purchasing Authority to ensure a smooth transition to the contractor. 

Agreement must be made and stated on the original order of when homecare provision needs to 

commence. It is the responsibility of the Purchasing Authority to communicate this to the patient. 

5.8 Following registration the Contractor must receive an official order in addition to a prescription 

from the Purchasing Authority to commence a delivery. Failure to receive an official order could 

result in non payment 

5.9 When patients care transfers between contractors, the contractors involved must follow the 

NHMC Change Management Policy. See appendix three. 

5.10 In the event of a patient no longer requiring the Homecare medicines service due to transfer to 

another therapy, admission into hospital or returning to collecting medicines from hospital, the 


May 2011 

26

Purchasing Authority may request the Contractor to collect all new and un-used stock and 

dispose of them as necessary or reimburse the Purchasing Authority. Where a patient's care is 

transferred between contractors, all contractors must follow the NHMC procedure for change 

management with patient or patient's family consent. All equipment will be collected and returned 

to the appropriate provider. 

5.11 In the event of a patient‟s death the process described in 5.10 will be carried out with particular 

sensitivity at a time convenient to the patient‟s family or carer. 

6. Quality of Goods 

6.1 The Contractor warrants represents and undertakes that any goods held and then supplied by it 

will: 

6.1.1 Pass any tests and trials the Purchasing Authority requires to satisfy itself that the goods 

are not injurious to health including without limitation any tests and trials conducted by 

NIBSC where applicable. 

6.1.2 Meet the product specification. In the event of any dispute as to whether the goods have 

been supplied in accordance with the relevant specification, the authority shall refer the 

matter to the regional quality control pharmacist who shall keep a sample of the goods 

which the regional quality control pharmacist has previously approved as being in 

accordance with the specification and this sample shall be used as the standard against 

which all goods shall be measured in order to determine whether they have been 

supplied in accordance with the relevant specification; and 

6.1.3 The Contractor shall operate and maintain a quality control monitoring system which 

meets the requirements of the MHRA and NIBSC and is approved by the Purchasing 

Authority and make available to Purchasing Authority on demand the results of such 

quality control monitoring. 

6.1.4 The Contractor shall adhere to any relevant national quality standards and general 

guidance recommended by bodies such as the National Pharmaceuticals Supply Group 

(NPSG), the Pharmaceuticals Market Support Group (PMSG), the National Homecare 

Medicines Committee (NHMC), Department of Health (DH), National Health Service 

(NHS), Care Quality Commission (CQC) and National Patient Safety Agency (NPSA). 

6.1.5 The reasons for any faulty or spoiled products will be notified by the Contractor to the 

Purchasing Authority in writing within 24 hours of the complaint or sooner where deemed 

appropriate 

7. Management Information 

7.1 The Contractor must ensure that records of all hospital sales detailing volumes and prices are 

kept and given to a nominated Authorised Officer of the Purchasing Authority on a monthly basis 

in the format given in Appendix four on an agreed date in an electronic format. 


May 2011 

27

7.2 The Contractor must comply with all requests by the Department of Health, CMU, the National 

Homecare Medicines Committee (NHCMC) and the Purchasing Authority for management data 

to be provided in respect of the products supplied under this framework. This information is to be 

provided within 10 working days for ad hoc requests. 

7.3 All reports of usage and expenditure will be coded so that patients‟ names are not revealed by 

using a patient unique identifier. All requirements of the Data Protection Act 1998 and updates 

must be met in full. 

7.4 Particular care must be taken on the security of patient information. Where identifiable patient 

personal information must be transmitted this must be by high level encryption, suppliers to be 

accredited to ISO27001. Level 2 of the Information Governance Toolkit should be adhered to. 

(Further information can be found on 

www.connectingforhealth.nhs.uk/systemsandservices/infogov or www.psnc.org.uk/IG) 

On occasion there will be a requirement to transmit data via electronic communication (i.e. email) 

and/or computer disc (CD). When electronic means are used, each party shall ensure as 

far as reasonably practicable, that data is properly stored, is not accessible to unauthorised 

persons, is not altered, lost or destroyed and is capable of being retrieved only by properly 

authorised persons. 

Each party may apply special protection to electronic messages by encryption or by other agreed 

means, and may apply designations to the messages for protective interchange, handling and 

storage procedures. Unless the parties otherwise agree, the party receiving a message so 

protected or designated shall use at least the same level of protection and protective procedures 

for any further transmission of the message and its associated data for all responses to the 

message and for all other communications by interchange or otherwise to any other person 

relating to the message. 

If either party becomes aware of a security breach or breach of confidence in relation to any 

message or in relation to its procedures or systems (including, without limitation, unauthorised 

access to their systems for generation, authentication, authorisation, processing, transmission, 

storage, protection and file management of messages) then it shall immediately inform the other 

party of such breach. On being informed or becoming aware of a breach the party concerned 

shall: 

Immediately investigate the cause, effect and extent of such breach; 

report the results of the investigation to the other party; and 

use all reasonable endeavours to rectify the cause of such breach. 

8. Performance Monitoring 

8.1 The Purchasing Authority is responsible for monitoring Key Performance Indicators. Key 

Performance Indicators have been developed for the purpose of monitoring the performance of 

the Contractor and are detailed in Appendix five. The required information will be provided to the 

authorised officer at the Purchasing Authority at agreed intervals. In addition to this, the 

Homecare Provider is responsible for informing on any change in performance standards. 


May 2011 

28

8.2 Contractors are required to provide a named contact responsible for the provision of 

management and performance information. The information must: 

be in the spreadsheet format prescribed by the Purchasing Authority 

contain product and/or service level detail for each NHS site or organisation and other 

third parties if appropriate 

be provided to the Purchasing Authority within five working days of the end of the 

appropriate sales month. 

8.3 Framework monitoring meetings will be held with each of the successful Contractors by the 

Purchasing Authority at agreed intervals. 

8.4 On occasion a questionnaire will be issued by the Purchasing Authority to the patient and/or carer 

in order to ascertain the quality of the level of service. This will be required to be included with 

deliveries that are dispatched by the Contractor. The Questionnaire will be supplied in an 

appropriate envelope by the Purchasing Authority. The distribution of questionnaires will be 

provided free of charge by the Contractor and questionnaires will be returned by patients directly 

to the Purchasing Authority. A standard questionnaire is included in Appendix 6 but this may be 

subject to change by the Purchasing Authority. 

9. Arrangements for the Payment of Invoices 

9.1 The Contractor shall issue invoices detailing the unique patient identifier, items supplied, itemised 

unit costs and framework references. 

9.2 Invoices to include service charges, these charges must be separately stated on the invoice 

documentation and indicated by the Contractor even if only consumables and ancillaries. 

9.3 The patient endorsed delivery note must be sent with each invoice by the Contractor Agent to the 

Purchasing Authorities‟ Finance Department or Pharmacy as agreed. Only invoices that are 

cross-referenced to patient endorsed delivery notes must be authorised for payment by the 

Purchasing Authority. 

10. Confidentiality 

10.1 All contractors must comply with Section 35 on confidentiality in the NHS Conditions of Contract 

for the Supply of Services. 

10.2 Patient and family confidentiality must be respected and preserved at all times. No circulars or 

questionnaires should be sent to patients, relatives, carers or GPs without the prior consent and 

agreement of the Authority. No patient contact will be made, other than that required by the 

Framework Participant‟s staff in the performance of their duties, or unless specifically requested 

to do so by the Participating Authority clinical team or other authorised personnel 


May 2011 

29

10.3 All information, including prices, made available to the service Contractor or the service 

Contractor‟s employees under this framework must not be divulged for any purposes to any other 

party including other companies within the group. 

11. Communications 

11.1 Key individuals will be designated the point of contact for the homecare service within the 

Purchasing Authority and their contact numbers will be made known to the Contractor. These 

contacts will be for: 

• Queries on referrals 

• Finance/invoice queries 

• Emergency/out of hours 

• Performance monitoring 

• Contractual queries 

• Management information 

• Complaints and adverse incidents. 

• Prescription Queries 

The Homecare provider must also provide a list of their designated key contacts for the specific 

areas listed above. Please complete Appendix XX. 

11.2 The Contractor must provide a named individual, deputy, and contact details for the above 

categories and ensure this information is kept up-to-date. 

11.3 A free phone Help Line will be available 8:00am to 6:00pm (plus answer phone or emergency 

bleep outside those hours) 365 days a year, for patients and carers to contact the service 

Contractor by telephone for information on their products and services. All clinical issues or errors 

and/or incidents must be fed back by the contractor to the purchasing authority within 24 hours or 

sooner if deemed appropriate. 

12. Managing Complaints and Adverse Incidents 

12.1 Any complaints regarding the delivery or service, received from patients by the Purchasing 

Authority will be forwarded in writing to the Contractor for a written resolution within two weeks, 

unless requested by the Purchasing Authority to the contrary. 

12.2 The Contractor must provide a complaints procedure and an incidents reporting procedure. The 

Purchasing Authority will share in advance their incidence policy and serious untoward incident 

policy with the contractor and the contractor must adhere to these policies. 

13. Sub-Contractors 

13.1 Where sub-contractors are used for the provision of products and service within this Framework 

agreement, all requirements within this specification will be extended to the sub-contractor and 

individuals involved. It is the responsibility of the Contractor to ensure that all sub-contractors 

meet these requirements and to inform the Purchasing Authority of any and all intended sub 


May 2011 

30

14. Legal 

contracted parts of the service. No change can be made without the express permission of the 

Purchasing Authority. 

14.1 The requirements detailed in this specification are in addition to and compliment the NHS 

Conditions of Contract for the Supply of Service where the medicines and/or products are being 

sourced separately i.e. through national and/or regional frameworks or local arrangements. If the 

Contractor is required to source the medicines as well as provide the homecare service both the 

NHS Conditions of Contract for the Supply of Service and the NHS Conditions of Contract for the 

Purchase of Goods will apply. Where there is duplication on terms the supply of service will take 

precedent. 


May 2011 

31

1. Delivery scheduling 



Delivery and Service 

1.1 The Contractor shall ensure that the goods are delivered safely and securely to the patient‟s 

nominated address at any time between Monday and Friday, 8:00am and 6:00pm. Normal 

delivery dates should include Bank Holidays except Christmas day and New Years day. If this 

necessitates a revised delivery date, this should be immediately prior to the Bank Holiday. The 

Purchasing Authority will be advised of and agree with such arrangements. Deliveries recorded 

outside core hours without prior arrangement will result in that delivery charge being credited to 

the Purchasing Authority. 

1.2 The Contractor shall operate an emergency delivery service whereby delivery will be made within 

24 hours of the request being made by the Purchasing Authority at the agreed costs per delivery. 

1.3 Deliveries should be made available for Saturday, early morning (before 8:00am) evening (after 

6:00pm) and Sunday deliveries. 

1.4 The Contractor must agree a delivery time with the patient or carer which is convenient to the 

patient and/or carer and the delivery must be made within a two hour window (i.e. 10am – 12pm) 

as agreed with the patient and/or carer. The delivery time should be confirmed with the patient at 

least 24 hours in advance, and in accordance with any agreed Key Performance Indicators 

(KPI‟s) 

1.5 Delivery date will be no more than two working days after date of dispensing. 

1.6 If a patient is not available at the agreed delivery time, it is the patient‟s responsibility to contact 

the Contractor to re-arrange delivery. 

1.7 The frequency of deliveries depends on each patient group and stability of product, it is usually 

between every 4-12 weeks. 

1.8 Under sections 3 and 6 of the Health and Safety at Work Act 1974 there is a duty to protect 

people not in a company's employment who may be affected by handling loads they have 

supplied. 

Therefore it is good practice for manufacturers and suppliers to mark weights (and, if relevant, 

information about the heaviest side) on loads if this can be done easily. 

Please see: 

http://www.hse.gov.uk/msd/loadguidance.htm 

1.9 If it is anticipated that there will be failure to achieve the planned delivery time, the patient and/or 

carer must be contacted prior to the expected delivery to arrange an alternative delivery time if 

requested by the patient and/or carer. It is expected that providers will develop innovative 

communication methods such as text reminders, online tracking. 

May 2011 

32

2. Refrigeration 

2.1 Where applicable, the Contractor must be able to maintain the cold chain, and provide details of 

validation, up to the point of delivery required for the medicines. 

2.2 The Contractor may be required to provide refrigeration facilities for the product in the patient‟s 

home. Further detail of this requirement is outlined in Equipment and Ancillaries specification. 

3. Delivery location and stock control 

3.1 The Contractor will work with the patient, with their consent, to ensure an appropriate stock level 

within the patient‟s home as agreed by the patient‟s prescriber. 

3.2 All drivers should deliver all items to the agreed location within the patient‟s home, in some 

circumstances this may be in the supplied refrigerator, unless directed by the patient and/or 

carer. 

3.3 Where applicable, all stock delivered is unpacked and rotated enabling normal access to the 

product on a first-in-first-out basis. 

3.4 Stock identified as out of date will be removed from the patient‟s home with the patients consent 

and replaced by the Contractor upon approval from the Purchasing Authority. 

3.5 To ensure against over-provision, the Contractor, as required or requested by the Purchasing 

Authority, will at regular intervals not exceeding three months duration, undertake a stock check 

of items delivered to the patients home with patient consent to ensure stocks are within agreed 

levels and dates. The information obtained from such stock checks will be presented to the 

Purchasing Authority. The Purchasing Authority may wish to carry out its own check of stocks at 

a patient‟s home. Any shortage or surplus stock should be reported as an incident (noncompliance). 

4. Waste and disposal 

4.1 The Contractor will be responsible for the safe disposal of the patient‟s clinical waste (in 

accordance with legislation ruling at any time during the framework period on the collection, 

transportation and disposal of hazardous waste) at intervals agreed with the Purchasing Authority 

and will provide approved sharps disposal boxes and appropriate clinical waste bags or 

containers. 

4.2 All current UK and EU law and regulations on medicines waste must be adhered to by the 

Contractor. 

4.3 The delivery personnel must remove all delivery packaging. 


May 2011 

33

4.4 Further information can be found in the Department of Health‟s document, „Safe management of 

healthcare waste‟ Please refer to: 

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D 

H_126345 

5. Staffing and compliance 

5.1 The Contractor must ensure that all staff having face to face access to patients, have undergone 

Criminal Records Bureau (CRB) clearance. Contractors will bear the cost of carrying out these 

checks and will indicate how often these are reviewed and how frequently staff are re-checked. 

5.2 All delivery staff, own or courier should be trained adequately in all appropriate aspects of their 

part of the service and in patient‟s confidentiality requirements. 

5.3 The service is to be provided in a courteous, helpful and confidential manner. Drivers are to be 

flexible and respect patient‟s needs. Products must only be delivered and signed for to the 

agreed location. 

5.4 The Contractor will adhere to the conditions of entry into the patient‟s home which may be laid 

down from time to time by the Purchasing Authority or the patients themselves. 

5.5 On no account should any agent or servant of the Contractor enter into the patient's home unless 

requested by the patient for any reason. The Contractor will issue specific instructions and take 

all necessary steps to ensure compliance with this. 

5.6 The delivery personnel will carry identification, to be shown on arrival and of smart appearance 

and fully conversant with the delivery system. Wherever possible, patients should receive 

deliveries from the same driver. Patients must be informed in advance, if there is to be a 

permanent change of driver or if the regular driver is on holiday, or if a courier service is to be 

used. 

5.7 The delivery transport must not bear any markings other than those required by law. 

6. Receipt of delivery 

6.1 The Contractor must have a list of designated signatories (name and example signature) who are 

the only persons who can sign on receipt of delivery. The delivery driver must have a copy of 

these signatories to match with who is signing on delivery. 

6.2 The Contractor must give patients the opportunity to provide an alternative and/or additional 

delivery address. This information will form part of the Contractor‟s welcome pack. 

6.3 All deliveries require a signature. If a patient is not contactable, the Purchasing Authority must be 

notified immediately unless previously agreed. 


May 2011 

34

6.4 If the Purchasing Authority agrees to a postal delivery service then postal deliveries will be first 

class and require a signature. If a patient is not available a card will be left explaining when and 

from where the parcel may be collected. 

6.5 All Contractors should have the facility and procedures for holding keys for patients, if requested. 

6.6 If there is no-one at home at the agreed delivery date and time, the driver will speak to the coordinator 

who will in turn liaise with the Purchasing Authority. If a second delivery has to be 

organised, a supplementary charge may be levied to the Purchasing Authority. The 

supplementary charge will not be levied if the patient is absent due to a sudden hospital 

admission that the Purchasing Authority may be unaware of. 

7. Patient support 

7.1 The Contractor should monitor usage trends and will inform a designated person of the 

Purchasing Authority immediately, with regard to any patient who gives cause for concern. Areas 

of concern may include evidence of neglect, poor stock control, over or under use of product, 

deteriorating health. The Purchasing Authority should also be notified if there are any areas of 

concern, such as poor stock control or under or over usage. 

7.2 At the initiation of a service for a new patient, for a first time delivery to a patient, a minimum of 

three working days notice must be given by the contractor of the patient's first delivery. 

7.3 Where delivery is not made to the patient directly, the Contractor must make contact with the 

patient post delivery to ensure that the patient has received the medicines within 24 hours. 

7.4 All contact between the Contractor and the patient must be logged by the contractor with a full 

audit trail and made available to the Purchasing Authority on request. 

8. Compliance with the Appropriate Policies 

8.1 The Contractor shall ensure, when in the patient‟s home, that its employees and agents shall in 

the performance of this framework comply with all relevant health and safety policies and working 

practices in force within the Purchasing Authority from time to time (including without limitation 

smoking and alcohol consumption policies). 

9. Holiday Service 

9.1 The Contractor will be required in exceptional circumstances to provide additional supplies to 

cover patient holidays and travel away from home. The supplier should ensure it is clear whether 

this can be provided free of charge. Where this is not feasible, details of the approximate cost of 

a holiday service should be identified. The holiday service should be able to deliver and/or 

arrange all medicines, including third party ancillaries and equipment. A local contact name or 

number in case of queries should be identified. The Contractor is also required to comply with 

the NHMC's UK specification on holiday services. All subcontractors must comply with these 

terms. 


May 2011 

35

1. The dispensing process 



Product Prescribing and Dispensing 

1.1 All prescriptions must be signed by a legally authorised prescriber and screened and validated by the 

appropriate clinical pharmacist at the Purchasing Authority. 

1.2 The product and/or medicine must be dispensed and labelled in accordance with current legislation by the 

Contractor. The Contractor must supply examples of current labels before the adjudication meeting. 

1.3 All prescriptions must be additionally clinically checked by a registered pharmacist at the Contractors 

premises and undergo final dispensing accuracy checks by a registered pharmacist or registered 

technician. 

1.4 The Contractor must have documented procedures for batch tracing and to facilitate batch recall. This 

must be implemented and maintained in line with MHRA guidance. 

1.5 Contractors must supply all products and medicines as agreed. 

1.6 The Contractor must supply all dispensed licensed product and/or medicine with a full manufacturer 

patient information leaflet 

1.7 It is the responsibility of the Contractor to put right any failure to dispense the full supply required within a 

timescale that ensures the patient has their required dosage at all times. The Contractor must show 

evidence of contingency arrangements and processes in the event of a short-fall in supplies. 

1.8 All dispensed product and/or medicine supplied to patients by the Contractor must have a shelf life which 

is appropriate to the duration of treatment. 

1.9 The pharmacist employed/engaged by the contractor has the legal responsibility of ensuring that the 

patient has adequate information with respect to the dispensed medicine. Patient information can be given 

by the dispensing pharmacist, purchasing authority or other healthcare worker who has appropriate 

professional training. The professional responsibilities should be known to all parties. 

2. Product and/or medicine manufacture 

2.1 For blood products and unlicensed medicinal products, records of supply, including batch number and 

expiry date must be kept by the Contractor for all patients, for the statutory period by the Contractor. The 

Purchasing Authority will share its unlicensed medicines policy which the contractor must comply with. 

3. Packaging and labelling requirements 

May 2011 

36

3.1 All product and/or medicine supplied by the contractor against prescription shall be packaged for each 

patient and shall be clearly individually labelled with the name or unique patient identifier of the patient, 

date of dispensing and delivery date. 

3.2 The Contractor will comply with the General Pharmaceutical Council (GPhC) Standards for home delivery 

of product and/or medicine or machines and will ensure the integrity of the product is maintained 

throughout the delivery process. 

3.3 Before dispatch the Contractor should ensure that the weight of any package over 5kg is clearly specified 

on the external packaging of the product and/or medicine. 

3.4 Contractors must adhere to MHRA and NPSA guidance 'Best Practice Guidance on the Labelling and 

Packaging of Medicine or Product‟. This guidance is subject to review and is re-issued annually. 

3.5 The Contractor must ensure that all product and/or medicine are stored, transported and delivered in a 

clean condition in accordance with those specified by the product license holder and manufacturer. The 

patient reserves the right to return and/or reject goods which, upon inspection, after delivery, are found to 

be in a damaged condition. The reasons for any faulty or spoiled products will be notified by the 

Contractor to the Purchasing Authority in writing within 24 hours of the complaint or sooner where deemed 

appropriate 

3.6 The Contractor must ensure that packs are sealed as appropriate. 

4. Product and/or medicine recall 

4.1 In the event of the goods being recalled, initiated by the manufacturer of the goods, the Secretary of State 

for Health or MHRA (or any such similar regulatory body), the Contractor shall, without delay arrange for 

the collection of such goods and credit the Purchasing Authority for any goods delivered but unused by 

the patient including part-used product and/or medicine. 

4.2 The Contractor must report the outcomes to the Purchasing Authority of all product and/or medicine 

recalls that may affect the product and/or medicine included in this framework, whether any faulty batches 

have been found or not. 

4.3 The Contractor should recover any expenses associated from the manufacturer. 

4.4 Product and/or medicine within the expiry date which have spoiled as a consequence of the manufacturing 

process or poor packaging will be withdrawn. 

4.5 Any spoiled product and/or medicine will be uplifted with patient consent, from their home, by the 

Contractor by the next working day at no cost to the Purchasing Authority. 

5. Quality control, COSHH and issues 

5.1 The Contractor shall operate and maintain a quality control monitoring system which meets the 

requirements of the MHRA and is approved by the Purchasing Authority and make available to Purchasing 

Authority on demand the results of such quality control monitoring. Please provide evidence of a suitable 

system being in place e.g. ISO 9001:2008, MHRA guidance note 14. 

5.2 The Contractor shall operate and maintain compliance in relation to environmental standards 

(ISO 14001 ). 


May 2011 

37

5.3 The Contractor shall reply within 24 hours in writing to all enquires and complaints by the Purchasing 

Authority relating to the quality, performance and availability of the goods notwithstanding that the grounds 

for such enquiry or complaint may be inherent in the specification. 

6. Product and/or medicine licensing 

6.1 Each party‟s rights and obligations arising in connection with this order shall be suspended unless and 

until the Contractor can demonstrate to the Purchasing Authority‟s satisfaction that: 

the Contractor has a valid MHRA wholesaler dealer license and/or is registered with the General 

Pharmaceutical Council (GPhC); 

the goods have a valid product licence awarded by the MHRA or EMEA applicable to all 

categories of the goods; and 

the goods have been supplied in accordance with current legislation and if such goods are 

medical devices that they are CE marked. 

7. Product and/or medicine purchasing by Homecare Contractor 

7.1 The Contractor must seek agreement with manufacturers and wholesalers to provide product and/or 

medicine at the Purchasing Authority framework prices. 

7.2 The Purchasing Authority is responsible for ensuring that the Contractor has updated framework prices 

throughout the duration of the framework period. 

7.3 The Purchasing Authority will inform the Contractor of any and all start dates of new prices if frameworks 

are re-negotiated with manufacturers. Product and/or medicine provided by manufacturers or wholesalers 

to the Contractor for the use of patients of the Purchasing Authority under this framework are not for 

resale by the Contractor to any third party. 

7.4 All new product and/or medicine that become available during the framework period are to be offered to 

the Purchasing Authority at framework price, i.e. the same level of discount as all awarded product and/or 

medicine on the framework, after prior approval of the Purchasing Authority. 

8. Product and/or medicines liability 

8.1 The Contractor shall ensure that they comply with the requirements of all relevant legislation, Codes of 

Practice and guidance relating to good and correct practice and particularly in relation to product liability at 

Common Law and under Statute - such as the provisions of the Consumer Protection Act 1987. 

8.2 The Contractor will be responsible for the ordering, receipt, control and payment for all product and/or 

medicine from nominated Contractors and will be responsible for the maintenance of adequate stock 

levels to satisfactorily meet the requirements of this framework. 


May 2011 

38



Equipment and Ancillaries 

1. Provision of equipment and maintenance 

1.1 The Contractor must provide and pay for all equipment required for the safe and effective storage 

and administration of the medication except where the Purchasing Authority has requested the 

use of its own equipment. 

1.2 Where servicing and maintenance are required by the Purchasing Authority for its own 

equipment, the maintenance service will be fully comprehensive. The Terms and Conditions 

applicable to any Maintenance Contracts arising as a result of this purchase are „NHS Conditions 

of Contract for the Maintenance of Equipment‟ July 2007. Suppliers should complete the 

enclosed maintenance schedule detailing the service they intend to offer. 

1.3 All equipment provided by the Contractor should come with a complete set of data sheets with 

clear instructions for use. 

1.4 The Contractor will possess current GMP certification or CE accreditation if equipment is to be 

supplied in a sterile condition. The Contractor must be registered to ISO 9001:2000. 

1.5 The Contractor will be required to take responsibility for servicing, maintenance and emergency 

support for all equipment used to provide the treatment. 

1.6 Where replacement equipment is required, the Contractor will provide this to the patient in a time 

frame agreed with the Purchasing Authority based on the clinical needs of the patient. 

1.7 Any modifications to equipment which affects its operation will be accompanied by additional 

training for staff and patients as appropriate as requested by the Purchasing Authority and 

provided by the Contractor at no extra cost. 

1.8 The Purchasing Authority reserves the right to state which suppliers and supply route the 

Contractor will use to obtain equipment and consumables for the treatment of their patients. 

1.9 The Contractor will be responsible for providing a complete maintenance service for equipment 

used by patients at home. The Contractor will put into place a protocol to ensure that the 

maintenance provided satisfactorily meets the Purchasing Authority‟s and equipment 

manufacturer's requirements. The equipment supplier may provide the maintenance service 

directly or may liaise with the Contractor to ensure that maintenance and emergency provision of 

equipment is efficiently managed. 

May 2011 

39

1.10 Syringe drivers and infusion pumps will be serviced at annual intervals. A loan-equipment 

replacement option will be provided for equipment removed from the patients home for repair, 

testing or periodic servicing. 

1.11 Repairs will be performed or replacement equipment provided by the Contractor to the patient in 

a time frame agreed with the Purchasing Authority based on the clinical needs of the patient of a 

fault being reported to them. Such a loan shall be deemed to be a Contract for the Hire of Goods 

as defined by section 6 of The Supply of Goods and Services Act 1982. 

1.12 The Contractor should provide a manual to include step by step instruction on how to use the 

equipment. It should give problem-solving help lines and the name and telephone number of the 

co-ordinator should be provided. DVD and/or video and/or audio tape to aid training, in the 

patient‟s home are also useful options. Technical literature of equipment is also to be provided if 

necessary. 

1.13 Where appropriate there should be a separate instruction manual for children. 

1.14 The Contractor should provide a check list so that an appropriate clinician can assess the patient 

as competent to use the equipment and the patient can countersign. A copy of this will be kept in 

the patients notes. 

1.15 All information should be regularly updated in order to reflect any developments and/or 

innovations in delivery systems and equipment. 

2. Refrigeration 

2.1 The Contractor will supply a suitable medicines refrigerator, which has been PAT tested and 

should be installed by the Contractor into the patient‟s home prior to the first scheduled delivery 

of medicines. If there is no fridge provided because the volume of refrigerated product is deemed 

too small by the Purchasing Authority to warrant its own fridge, then the patient must need to 

have suitable space in their own domestic fridge and be trained on how to store the product and 

monitor temperatures according to the manufacturer‟s instructions by the Contractor. Appendix 

eight example refrigerator specification. 

2.2 A permanent record of the refrigerator temperature must be made available to the Purchasing 

Authority and will be noted each time a delivery is made together with any details or action taken 

or instructions given to maintain the temperature within acceptable limits of any fridge that has 

been provided. If the temperature of the refrigerator falls outside the range of +2 degrees C to +8 

degrees C, the Contractor will be responsible for advising the Purchasing Authority and seeking 

authorisation on the continued use of the medical product and the refrigerator. 

2.3 Where the Contractor has supplied a refrigerator and where the integrity of the product is 

compromised due to the failure of the Contractor to service and maintain the refrigerator (if 

supplied), the Contractor will be responsible for stock replenishment at no additional charge to 

the Purchasing Authority within a timescale that ensures the patient has the required product to 

continue treatment. 


May 2011 

40

3. Third Party Ancillary Items 

3.1 Ancillary items will be determined by the clinical needs of the patient and will reflect the local 

clinical practice of the Purchasing Authority. 

3.2 Ancillary requirement forms will be completed by the Purchasing Authority at the beginning of a 

patients home delivery inclusion. These will be sent to the Contractor who will be responsible for 

checking ancillary product requirements with the patient in the first pre-delivery call. It is the 

Contractor‟s responsibility to check stock levels and replenish the patient‟s additional 

requirements for ancillary products on a regular basis. 

3.3 The Contractor will be responsible for the ordering, receipt, control and payment for all ancillary 

products from agreed suppliers, and as agreed with the Purchasing Authority, and will be 

responsible for the maintenance of adequate stock levels to satisfactorily meet the requirements 

of this framework. The Contractor will ensure that adequate shelf-life remains on products 

delivered to patient‟s homes. 


May 2011 

41

1. Training 



Training and Education for Staff and Patients 

1.1 Contractors should supply information on the level of knowledge and expertise on the medicines 

and equipment used in the clinical specialities of their staff involved in homecare services 

provision, including the methods and frequency of training and accreditation used. The 

Purchasing Authority should check the contractors training manuals and accreditation status to 

ascertain they are equivalent of the Purchasing Authority. Any gaps indentified need to be 

addressed. 

1.2 Where the Purchasing Authority changes it's provider of medicine or device, the Purchasing 

Authority may require the Contractor to provide the retraining of patient's in the use of the new 

medicines or device. If the change of medicine or device is enforced upon the Purchasing 

Authority by the manufacturer, of the medicine or device, then the Contractor should seek the retraining 

costs from the manufacturer. 

1.3 Contractors must agree with the Purchasing Authority a training and education plan detailing the 

implementation of the new framework. This will include timescales, number of company resource 

available and a detailed training programme. This should be completed in line with the framework 

start date. 

1.4 Training of patients and/or carers will be agreed by the Purchasing Authority and Contractor and 

will be designed according to individual need. In certain circumstances training may be initiated 

by the Purchasing Authority and continuing education and training devolved to the Contractor. 

1.5 Prior to hospital discharge, there should be a facility if requested, whereby the Contractor has 

nursing personnel trained to appropriate agreed standards. Such personnel should be available 

to do patient and/or carer education at ward level or at the patients home throughout the 

framework period and should be prepared to undertake further training until patient and/or carer 

are competent. If this level of competence is not attained then self administration should not be 

considered. There should be signed agreement of training delivered by both parties. 

1.6 If a nursing service is required by the Purchasing Authority, training of the Contractors clinical 

nurse specialist will be undertaken by the Purchasing Authority. This training should include level 

three clinical knowledge to ensure competence in Trust protocols. All clinical nurse specialists 

employed by the Contractor must be deemed competent by the specialist nurse within the 

Purchasing Authority before commencing delivery of hands on patient care. 

1.7 The Contractor must provide therapy specific on-going training and education support. This will 

include: 

May 2011 

42


Delivery of training packages to the Contractor's and Purchasing Authority's new staff; 

Refresher courses for existing staff; 

Provide access to advice and/or support on to patients; 

Regular training focusing on Audit and new Developments in the therapy; 

Educational materials which support the current use of their products and services. 

These would include product data (which is regularly updated), computer generated 

slides, videos, and interactive learning tools. This should be available free on loan; 

Instruction manuals translated into various languages, in pictorial format, and large print 

where appropriate; 

Separate instruction manual and training programme for children where appropriate; 

Check list so that the patient and/or carer can self-evaluate whether he or she has been 

appropriately trained. A copy of this will be placed in patients notes; 

Supply of results of regular regional and/or national audits for benchmarking purposes. 

2. Patient and carer education and information 

2.1 Contractors should provide and demonstrate how they are able to provide communication tools 

such as leaflets, brochures, and other media to patients, carers, and staff, samples to be 

provided. 

2.2 Contractors should include how they will ensure patient confidentiality and data protection is 

respected in all aspects of the homecare services provided when training is received by their 

staff. 

2.3 Should a patient and/or carer not be fluent in English, information should be provided in their own 

language. Contractors should indicate which languages they are able to provide this service for at 

no extra cost. 

2.4 The Contractor will provide each patient with a „welcome pack‟ that has been agreed with the 

Purchasing Authority, detailing useful and helpful information, as a minimum this should include 

details on: 

Welcome – role of the driver and provider 

Therapy information – description of service and items they will receive 

Training and support – help cards 

Ordering and delivery information – stock management, customer care teams, what to do 

if…. driver details 

Contacts – out of hours 

Holiday and Travel service 

Glossary of terms. 

Prescription Queries 

May 2011 

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1. Nursing Services 



Nursing Services 

1.1 The standard of nursing care provided will be comparable in every way to the care that a patient would 

expect to receive in a hospital setting. 

1.1 This guidance gives an outline of the minimum nursing services required to treat a home patient, however 

the specific care will be dependant on the therapy and speciality. 

1.2 The purchasing authority will identify and authorise the requirement of nursing services as part of the 

approval process. 

1.3 The Contractor must employ suitably qualified nursing staff for adults and children as appropriate, this 

level of care will be agreed with the Purchasing Authority. 

1.4 The Contractor must ensure that the nursing staff they employ have been legally checked specifically: 

The Nurse has a current NMC (Nursing and Midwifery Council) registration. The Nurse has sufficient 

experience and skills, and/or has received sufficient training, as applicable, to enable him/her to carry out 

his/her duties in the delivery of the Services. 

As a registered nurse, the Nurse is subject to the Nursing and Midwifery Council Code. 

The Nurse is subject to a satisfactory Criminal Record Bureau (enhanced disclosure) checks and with 

effect from 1 July 2010 the Nurse will be registered with the Independent Safeguarding Authority. 

The Nurse is subject to satisfactory pre-employment medical checks and holds a valid Fitness to Practice 

certificate issued by an independent occupational health provider. 

The Nurse should have a personal portfolio with a summary of their verified qualifications and Personal 

Identification Number issued by the NMC as well as, CRB and pre-employment medical screening, 

generic training and competency assessments/validations available for inspection. 

1.5 The contractor must facilitate CPD for all employed nursing staff and must demonstrate for all staff: 

job specifications 

orientation and induction 

evidence of CPD 

individual‟s responsibility towards Health and Safety. 

1.6 The Contractor must ensure the nursing staff have been assessed as competent in: 

May 2011 

44

phlebotomy 

knowledge of phlebotomy in relation to specific medication – blood tests throughout the course of 

treatment 

cannulation 

intravenous therapy in line with RCN and NMC guidelines 

anaphylaxis management/ basic life-support 

relevant equipment management 

aseptic technique 

adult and paediatric management which is evidence based in line with NICE guidance 

side effect management 

disease awareness 

specific therapies as prescribed. 

1.7 Contractors must ensure nursing staff have knowledge of clinical governance and be committed to clinical 

supervision, customer care and complaints handling. 

1.8 Contractors must ensure that nursing staff are given copies of hospital and PCT policies and comply to work 

within them including: 

Medicines Policy 

Anaphylaxis Management Guidelines 

Infection Control Manual 

Policy for consent to examination or treatment 

Health and safety 

Records Management Policy 

Zero tolerance and policy for the withdrawal of care 

Lone Worker Policy (incorporating working alone care and chaperoning) 

Resuscitation Policy and Guidelines 

Confidentiality 

Data protection 

Acceptance of gifts 

Adverse incident reporting policy 

1.9 Contractors must ensure that the risk management policy is calculated in collaboration with the Hospital/ 

PCT Clinical Governance Departments and be deemed to be of an acceptable risk score. 

10.1 Example of a Rick Management Tool 

10.2 

10.3 RISK MANAGEMENT TOOL 

10.4 IMPACT 

10.5 LIKELIHOOD 


May 2011 

10.6 2- MINOR 

10.7 

10.8 2- UNLIKELY 10.9 4- Acceptable Risk 

10.10 

10.11 Potential Risks- Patient safety 

Anaphylaxis All nursing staff involved in the administration of will be trained in the treatment of 

anaphylaxis and will act in accordance with the agreed anaphylaxis policy. Anaphylaxis kits 

will be replaced yearly. 

MRSA Patient will receive either a daily cannula or the peripheral cannula will not stay insitu for 

greater than 72 hours, which falls within infection controls guidelines. 

45

Intravenous 

Cannulation 

10.12 


The nurse will remain with the patient for the duration of the infusion. The nurse competent 

in cannulation and IV administration will observe the cannula forsigns of tissuing regularly. 

If the nurse suspects tissuing they will remove the cannula immediately. The nurse will not 

attempt more than 3 unsuccessful cannulations. 

Training- All nurses must complete a cannulation-training course and be have level of 

competence assessed. 

Infection Control Disposable sterile dressing packs will be used in the home setting to reduce the chance of 

infection. 

10.13 

It is considered best practice to use volumetric pump to regulate the infusion flow rate. This 

will wiped with 70% alcohol between each patient contact as infection control procedures. 

Blood spillages- In the unlikely event that a blood spillage occurs, the nurse must act in 

accordance with the infection control policy. 

Disposal of sharps The nurse will carry a sharps container with them and remove this from the patient‟s home 

following each infusion in accordance with infection control policy. 

Cardiac arrest In the unlikely event of cardiac arrest the nurse will carry a mobile phone to call 999. The 

nurse will then start CPR, using a mouthpiece in accordance with the resuscitation policy. 

All nurses must attend a yearly mandatory CPR training update. 

10.14 Potential risks- staff safety 

Violent patient The nurse must act in accordance with the Zero tolerance and policy for the withdrawal of 

care. 

Buddy system It is considered best practice to ensure that another member of staff knows where the nurse 

Transportation of 

drug 

is at all times. 

The nurse will collect the drug in person store in a secure facility. 

Contractors must outline transparent procedures for handling of concerns or complaints with full 

details on how to contact their Medical Director 

Contractors must maintain professional indemnity (medical malpractice) insurance and encourage nursing staff to 

ensure they are professionally indemnified personally by membership of an appropriate union such as The Royal 

College of Nursing. 

Contractors must ensure that nursing staff deliver clinical procedures and services 

in accordance with written protocols agreed with the hospital/ PCT. 

Contractors will ensure that the Hospital / PCT designate an appropriate suitably medically qualified Practitioner to 

be available for the Nurse to contact at all times whilst the Nurse is involved in delivery of the service. The named 

hospital / PCT Designated Practitioner will obtain in advance any approvals required for delivery of any of the 

services. They will also ensure that the Nurse is provided with adequate facilities and information for the 

performance of the services in accordance within agreed protocols and parameters. 

Contractors must ensure that Nursing staff are responsible to the Hospitals/ PCT Designated 

Practitioner, in respect of clinical matters. 

May 2011 

46

The Hospital / PCT must ensure that all patients are informed that their personal information may be shared with 

other healthcare professionals and may be used to support clinical audit for the purpose of assuring and monitoring 

the quality of their treatment. 

Contractors must use its best endeavours to ensure that any services are performed at the times and venues 

agreed between the parties and shall give as much notice as reasonably practicable if for any reason they are 

unable to deliver any services at times and venues agreed between the parties. 

Contractors must ensure that in accordance with NMC code of conduct the Nurse will keep confidential all patient 

identifiable data to which the Nurse may have access during the provision of the Services. The Nurse will deal with 

all confidential information in accordance with any reasonable policy of the Recipient in accordance with clause 11 

hereunder and in accordance with the provisions of the Data Protection Act 1998. 

Contractors must ensure that the Nurse will not remove any patient identifiable information from the Recipient‟s 

premises at any time other than as set out in the service documentation. The Nurse may report anonymised 

aggregated data to other parties only if the Nurse has obtained written consent from the patient to the 

anonymisation of their data and the reporting of anonymised aggregated data in accordance with a consent form. 

The contractor will ensure that they use only anonymised data so that no individual patient or Trust can be 

identified by name or other characteristics in publications or in educational and/or promotional materials and that all 

data will be processed in accordance with the Data Protection Act 1998. 

Contactors will ensure that the Nurse will obtain informed consent from the patients prior to participation in the 

service and that the Nurse will ensure that patients are clearly informed that they have the right to refuse such 

consent and participation. 

2. On Call service 

2.1 The Contractor will provide an out of hour‟s service. Such a service will support the purchasing authority‟s 

patients where circumstances dictate there are issues that need resolution. Such a service will also make 

use of a variety of forms of communication technology that will be specified in the out line of the service. 

2.2 The hours of contact should be from: 

Nursing support 7:00am to 10:00pm, 7 days a week (including bank holidays). 


It is important to realise that the service hours of a nurse may extend beyond this in attending to 

a patients needs. 

Administration support 8:00am to 6:00pm, 5 days a week excluding bank holidays. 

3. Nursing support services 

3.1 Patient support: 

Nurses will have the duty to advise over the telephone or provide attendance at patients homes. 

3.2 Nurses have a responsibility to report to the Purchasing Authority immediately of any errors or adverse 

events. The Contractor must ensure clear guidelines and procedures are developed and communicated 

to all nurses to follow if any adverse reactions occur. 

May 2011 

47


May 2011 

48

Award criteria and weightings - details for adjudication purposes 

Framework Agreement for a Home Delivery Service - 

XXXXXXX 

OJEU Reference 

Offer Reference 

Ref Indicators Weight Reference Supplier A Supplier B Supplier C Supplier D Supplier E Supplier F Supplier G 

Supplier infrastructure of home delivery 

company 

SUP1 Description of service - premises, 

structure, company profile, contact 

names, confidentiality, previous 

homecare experience, implementation 

programme, communication leaflets 

SUP2 Experience of HIV homecare delivery 

SUP3 Training and education of staff - 

methods and frequency of training and 

accreditation used, records of training 

[5a_12.1] 

[5b_4.1] 

[5b_4.2] 

[5d_2.3] 

[5d_2.4] 

[5d_2.5] 

[5e_1.1] 

[5e_2.1] 

[5b_4.3] 

[5b_4.4] 

[5b_4.5] 

[5b_4.6] 

[5b_7.1] 

[5b_7.2] 

[5d_1.1] 

[5d_1.2] 


49

SUP4 Method of recruiting / registering 

patients - patient consent form, 

registering patients, patient 

confidentiality 

SUP5 Adherence to legal and advisory 

practices e.g. COSHHProduct licensing 

and product liability.EU lawHealth & 

Safety 

SUP 6 Member of the National clinical 

homecare association (NCHA) 

Supplier infrastructure Total 

Quality Assurance 

QA1 Performance standards i.e. Quality std, 

service performance, complaints, 

contingency planning, disposal, patient 

survey 

[5d_1.3] 

[5a_5.2] 

[5a_5.3] 

[5a_5.4] 

[5a_5.5] 

[5a_5.6] 

[5a_8.3] 

[5a_10.1] 

[5d_2.2] 

[5a_13.1] 

[5c_5.1] 

[5b_3.6] 

[5b_8.1] 

[5c_7.1] 

[5a_6.1] 

[5b_1.6] 

[5b_3.5] 

[5b_6.6] 

[5b_7.3] 


50

QA2 Prescription process, validation, length, 

records, errors 

QA3 Audit i.e. proof del, service reporting, 

complaints, contingency planning 

Quality Assurance Total 

Storage and Distribution 

DIST1 Delivery of medicines - post, vehicle, 

courier, emergency, failures to deliver, 

lost medicines, traceability, product 

[5c_1.7] 

[5c_2.2] 

[5c_2.3] 

[5c_3.8] 

[5c_3.7] 

[5c_4.1] 

[5c_4.2] 

[5c_4.3] 

[5a_9.3] 

[5c_1.1] 

[5c_1.2] 

[5c_1.3] 

[5c_2.2] 

[5b_5.1] 

[5b_6.4] 

[5b_1.3] 

[5b_6.5] 

[5b_3.4] 

[5a_5.7] 

[5a_5.9] 


51

ecall, cold chain, waste disposal 

[5b_1.1] 

[5b_1.2] 

[5b_1.4] 

[5b_1.5] 

[5b_1.8] 

[5b_2.1] 

[5b_2.2] 

[5b_3.2] 

[5b_3.5] 

[5b_4.7] 

[5b_4.8] 

[5b_4.9] 

[5b_5.2] 

[5b_5.4] 

[5b_5.5] 

[5b_5.6] 

[5b_5.8] 

[5c_1.4] 

[5c_1.6] 

[5c_1.8] 

[5c_1.9] 

[5c_1.10] 

[5c_1.11] 

[5c_3.1] 

[5c_3.2] 

[5c_3.3] 


52

DIST2 Drug purchasing by Homecare supplier 

- agreement from manufacturer, 

access/updating contract pricing 

Storage and Distribution Total 

Customer Services 

CUST 

Provision of Data 

1 

CUST 

2 

CUST 

3 

Customer services, communication, 

free phone help lines, response time 

Invoicing and payment - invoice 

queries, payment method, discounts, e- 5 

[5c_3.5] 

[5c_3.6] 

[5c_6.1] 

[5c_6.2] 

[5c_6.3] 

[5a_8.1] 

[5a_8.2] 

[5a_8.3] 

[5a_8.4] 

[5b_6.3] 

[5a_11.1] 

[5a_11.2] 

[5b_6.3] 

[5b_6.4] 

[5b_6.5] 

[5b_7.2] 

[5b_1.10] 

[5b_5.4] 

[5d_2.1] 

[5a_9.1] 


53

commerce arrangements, emergency 

delivery 

Customer Services Total 18 

Price Total Score 

Homecare Service Total 100 

[5a_9.2] 

[5a_9.3] 

[5b_1.2] 

[5c_6.4] 

[5c_7.2] 

Offer 

schedules 

0 0 0 0 0 0 0 


54

Commercial Medicines Unit homecare medicine team. 


Castle View House 

East Lane 

Runcorn 

WA7 2AA 

Liz Payne 

Category Manager 

Tel. 01926 857313 

Liz.Payne@cmu.nhs.uk 

Carol Clark 


Tel. 01282 850672 

Carol.Clark@cmu.nhs.uk 

Simon Perkins 


Tel. 01928 794601 

Simon.Perkins@cmu.nhs.uk 

Karen Bell 

Sourcing Specialist 

Tel. 01928 794615 

Karen.Bell@cmu.nhs.uk 


May 2011 

55

Glossary of Terms 

Name Acronym Description 

Accredited checking 

Technician 

Appendix 1 

ACT Accredited checking technician jobs are 

similar to pharmacy technician jobs. While 

the latter receives the prescription, takes out 

the drugs from shelves and packs them, the 

former checks the dispensed prescription for 

its accuracy. Checking, labelling and packing 

have all become formal procedures and the 

accredited checking technician will be trained 

in all these in a pharmacy context. 

Benefits Tracking Tool BTT Benefits Tracking Tool. Integrated date 

warehouse and reporting tool providing 

stakeholders with a single point of access for 

their management information. Manages the 

performance of CMU framework agreements 

maximise compliance by NHS trusts to 

improve future estimates of framework 

agreement and product volumes and values. 

British Pharmacopoeia BP The British Pharmacopoeia (BP) is the 

authoritative collection of standards for UK 

medicines 

British Standard BS British Standards are produced by BSI British 

Standards, a division of BSI Group that is 

incorporated under a Royal Charter and is 

formally designated as the National Standards 

Body (NSB) for the UK. 

BS 7320 British standard specification for sharps 

containers 

Benefits Tracking Tool BTT BTT is an integrated data warehouse and 

reporting tool providing our stakeholders with 

a single point of access for their management 

Collaborative procurement 

hubs 

information. 

CPH‟s Collaborative procurement organisations 

within the NHS, generally referred to as 

collaborative procurement hubs (CPHs), 

commercial procurement collaborative (CPCs) 

or supply management confederations 

(SMCs), consist of NHS trusts and primary 

care trusts. These are normally within the 

same strategic health authority or regional 

boundary, collaborating to make the most 

effective procurement and supply chain 

decisions, in conjunction with CMU and other 

organisations including Office of Government 

Commerce (OGC) and Regional 

Developments Agencies, in order to provide 

best value for stakeholders within their 

respective health economies. 

56 

May 2011 © Crown Copyright 2011

Contractor Someone whose business is to supply a 

particular service or commodity. Can be 

referred to as a supplier or an offeror 

CE Accreditation Declaration of conformity 

CE Mark CE marking when applied to any product or 

equipment indicates that the manufacturer or 

its authorised representative has declared that 

the product or equipment complies with all 

applicable European Directives. The principal 

function of the EU directives is to ensure free 

trade of goods within the European 

Community 

Compliance Compliance (or Adherence) is a medical term 

that is used to indicate a patient's correct 

following of medical advice. Most commonly it 

is a patient taking medication (drug 

compliance) 

Criminal Records Bureau CRB 

Delivery packaging Is any additional packaging that is not 

required by the patient following a treatment. 

Department of Health DH 

European Medicines Agency EMEA European agency for the evaluation of 

medicinal products 

European Pharmacopoeia EP The European Pharmacopoeia (Ph. Eur.) of 

the Council of Europe is a pharmacopoeia, 

listing a wide range of active substances and 

excipients used to prepare pharmaceutical 

products in Europe 

General Practitioner GP 

Good Manufacturing Practice GMP Good Manufacturing Practice (GMP) is 

defined as “That part of Quality Assurance 

which ensures that products are consistently 

produced and controlled to the quality 

standards appropriate to their intended use.” 

The principles and guidelines for GMP are 

stated in the Directive 2003/94/EC for 

medicinal products. 

Quality risk management ICH Q9 ICHQ9 is a document on quality risk 

management. The principles can be applied 

in connection with pharmaceutical 

development and preparation of the quality 

part of marketing authorisation dossiers 

Pharmaceutical Quality System ICH Q10 ICHQ10 is a document on pharmaceutical 

quality system and provides an example of a 

pharmaceutical quality system for the entire 

57 


product lifecycle. 

Internal standards organisation ISO ISO 9001: 2008 - Quality management 

system 

Key performance indicators KPI‟S Key Performance Indicators are quantifiable 

measurements, agreed to beforehand, that 

reflect the critical success factors of an 

organisation 

Manufacturers Licence ML Medicinal products manufactured in the UK 

must be produced on a site that holds an 

appropriate Manufacturer's Licence (ML). 

Medicines and Healthcare 

Products Regulatory Agency 

Medicines Pharmacy and 

Industry Group 

MHRA An executive agency of the Department of 

Health. Enhance and safeguard the health of 

the public by ensuring that medicines and 

medical devices work and are acceptably 

safe. No product is risk-free. Underpinning all 

the work lie robust and fact-based judgements 

to ensure that the benefits to patients and the 

public justify the risks 

MPIG MPIG are responsible for the PPRS and 

report to DH Board who report to the 

Secretary of State. 

Multi disciplinary team Collaborative efforts of professionals from 

different disciplines toward a common goal. 

Can be made up of Consultant's, Clinician's, 

Nurses, Pharmacists and Healthcare 

National Clinical Homecare 

Association 

National Health Service NHS 

National Health Service Quality NHS QA staff 

Assurance Staff 


(CMU) 

Workers. 

NCHA Represents and promotes the interests of 

industries whose business is substantially to 

provide medical supplies and/or clinical 

services directly to patients in the community 

within an appropriate quality framework. 

Provide a forum for lobbying on issues that 

affect homecare. Set and debate policy 

decisions with the National Homecare 

Medicine Supply Committee and other 

relevant government bodies. 

CMU is an executive agency of the 

Department of Health. CMU work to ensure 

that the NHS in England makes the most 

effective use of its resources by getting the 

best possible value for money when 

purchasing goods and services. We enhance 

and safeguard the health of the public by 

ensuring that medicines and medical devices 

work and are acceptably safe. No product is 

risk-free. Underpinning all our work lie robust 

58 


National Homecare Medicines 

Committee 

National Institute for Biological 

Standards and Control 

National Pharmaceutical 

Supply Group 

and fact-based judgements to ensure that the 

benefits to patients and the public justify the 

risks 

NHMC Facilitated and managed by Commercial 

Medicines Unit. NHMC formed to develop 

appropriate systems, policies and procedures 

in order to assist service users, service 

providers and patients. 

NIBSC The National Biological Standards Board 

(NBSB) is a non-departmental public body 

(NDPB) of the UK government. NIBSC 

provides independent testing of biological 

medicines for the UK market 

NPSG Provide advice to Chief Executive, CMU, 

concerning the cost effective purchasing and 

distribution of pharmaceutical products to the 

NHS in England. Acts as a focal point for the 

NHS for pharmaceutical issues of a national 

nature and provide pharmaceutical advice 

accordingly. Acts as a link between 

pharmacists and CMU at national level. 

Advise the Department of Health and 

pharmaceutical industry on significant 

commercial matters. 

Portable Appliance Testing PAT There is a legal obligation for many 

businesses and organisations to take 

precautions to ensure any electrical 

equipment is safe, maintained and fit for 

purpose. It has become common practice for 

PAT testing to be carried out as part of a 

regular system of maintenance and 

inspection. 

Purchasing Authority Secondary Care Trusts, Primary Care Trusts, 

Foundation Trusts, Collaborative Procurement 

Hubs and Confederations 

Pharmaceutical Price 

PPRS A British mechanism for determining the 

Regulation Scheme 

Pharmaceutical market Support 

Group 

prices the NHS pays for brand name drugs. 

PMSG Committee of pharmacists from England, 

Wales, Northern Ireland and Scotland. A 

representative from each purchasing group or 

division makes up the English representation. 

Provide strategic advice to the pharmaceutical 

industry and contracting groups. The PMSG 

use market intelligence including Phate 

analyses and licence and patent information 

Pharmex Pharmex collects and stores medicinal 

59 


Regional Quality Control Regional QC 

Royal Pharmaceutical Society 

Great Britain 

product transaction usage and spend level 

details from trusts. 

RPSGB The Royal Pharmaceutical Society of Great 

Britain (RPSGB) is the statutory regulatory 

and professional body for pharmacists and 

Pharmacy Technicians in England, Scotland 

and Wales. 

Serious Untoward incidents SUI‟s An SUI is in general terms something out of 

the ordinary or unexpected, with the potential 

to cause serious harm and/or likely to attract 

public and media interest that occurs on NHS 

premises or in the provision of an NHS or a 

commissioned service 

Service Level Agreemen SLA A service level agreement (frequently 

abbreviated as SLA) is a part of a service 

contract where the level of service is formally 

defined. In practice, the term SLA is 

sometimes used to refer to the contracted 

delivery time (of the service) or performance. 

Sub-contractor A subcontractor is an individual or in many 

cases a business that signs a contract to 

perform part or all of the obligations of 

another's contract. A subcontractor is hired 

by a general contactor (or prime contractor) to 

perform a specific takes as part of the overall 

project. 

United States Pharmacopoeia USP The United States Pharmacopoeia (USP) is 

an official public standards–setting authority 

for all prescription and over–the–counter 

medicines and other health care products 

manufactured or sold in the United States. 

60 


Patient Registration Form 

Appendix 2 

61 


62 


Appendix 3 

How to organise changeover of suppliers for existing homecare services 

1. Purpose 

To describe how to change to a new supplier for an existing homecare service. 

Appendix 1 summarises the tasks needed to be undertaken by department. 

Appendix 2 is intended to be used as an aide-memoire for the tasks. 

Appendix 3 is an example of a suggested agenda for each meeting (part 1 and 2). 

2. Scope 

All staff involved in the homecare service for an area where there is a change in supplier 

3. Responsibility 

Pharmacy Procurement manager 

4. Equipment /resources 

Contract specification, access to meeting rooms 

5. Procedure 

As part of contract award, a member of the procurement team should be nominated as project manager to facilitate the 

change process. The project manager can then act as a central point of contact for all involved and can have responsibility 

for ensuring the actions below are carried out efficiently. 

5.1. Initial Planning 

5.1.1 After award of contract, a meeting to discuss the change management process should be arranged. Typically, this 

will be a two hour meeting. The first hour (part one) will include the trust‟s multidisciplinary team and the new 

suppliers. For the second hour (part two), the group will be joined by the incumbent supplier. Ideally this meeting 

should be arranged within one month of contract award to ensure a timely and efficient transition of services. 

5.1.2 Suggested attendees at the meeting: 

Lead pharmacist for the therapy area(s). NB: If homecare service is for adults and paediatrics, both lead 

pharmacists should be included. 

Clinical Nurse Specialist/clinicians for the therapy area(s). NB: If homecare service is for adults and 

paediatrics, both Clinical Nurse specialists should be included. 

Pharmacy Procurement team. 

Appropriate representation from the new supplier. Typically: 

o Business Development Manager 

o Customer Services Manager 

o Pharmacy/Dispensary Manager 

o Logistics Manager 

o Finance Manager 

Appropriate representation from the incumbent supplier. Typically: 

o Business Development Manager 

o Customer Services Manager 

5.1.3 Send e-mail to new supplier 3 weeks before meeting to establish what information is required from 

Trust/incumbent supplier to ensure smooth transition. 

5.1.4 Send e-mail to incumbent suppliers 2 weeks before with a request to provide information from the new supplier, 

typically the following: 

i. All patients names on homecare service (including current, on hold, planned and unscheduled patients) 

ii. Copies of current prescriptions 

iii. Summary of prescription status (number of deliveries made against it, number of deliveries left, date of 

renewal) 

63 


iv. Patient demographics by drug/treatment type (name, address, unit number, date of birth, next of kin) 

v. Hardware - details of any pumps, refrigerators etc in the patients possession that are currently owned by 

the incumbent suppliers. 

vi. List of current ancillary items in the patient‟s home. 

vii. Future delivery schedules 

viii. Special delivery instructions by patient e.g. alternative delivery addresses, instructions on how to access 

property, any patients who currently use the „key holding‟ facility, if offered 

ix. Any consent data 

x. Inventory of current stock holding 

5.1.5 Trust to prepare and make available at the meeting all required data received 

The above information must not be stored on electronic devices, CDs, memory sticks or similar without suitable encryption. 

It is suggested that the advice of the trust‟s data protection and governance manager is sought. 

5.2. Meeting - Part One: Suggested Agenda Items 

5.2.1 Introductions and welcome - allow the group to meet and all names and job titles minuted for future reference. 

5.2.2 Overview of specification - go through key points of the specification to ensure clarity in the expected service level 

from the trust and new supplier. 

5.2.3 Patient data required - review list of data required by the new supplier/Trust (as requested 3 weeks before 

meeting). Ensure systems and deadlines are in place to help with the smooth transition of this information. 

5.2.4 Prescription format/requirements - discussion between the clinical team/new suppliers regarding the style and 

format of the prescription and registration documents. It may be helpful to provide the new supplier with a copy of 

the old prescriptions in advance of the meeting. Thought should be given to any lead times with printing and a 

contingency plan in place should the bespoke prescriptions not be ready in time (e.g. will new suppliers accept 

prescriptions on stationery from incumbent supplier in the interim?). 

5.2.5 Prescription process - 

How long will the prescription be valid for? 

What will be the expected turnaround time for new and existing prescriptions? 

How should treatment/prescriptions be cancelled? 

Will suppliers send a reminder to the Trust informing of expiry of prescription (prescription 

management service) or will this be handled by the clinical team? 

Will a buffer stock be required? 

5.2.6 Delivery Schedule - clarification and agreement regarding how often treatments will be delivered 

and any unusual delivery schedules for specific patients. Discussion will also be held with new 

supplier regarding how patients who currently use a key holding facility will be recruited to the 

service. 

5.2.7 Ancillary list - Clarify and agree list of ancillaries with new supplier and clinical team. Discuss how 

ancillaries will be replaced (set monthly amount delivered or „topped up‟ as necessary). 

5.2.8 Removal of waste - Agreement from new supplier of how they intend to handle removal of waste 

(i.e. packaging etc) and clinical waste (i.e. full sharps bins, expired stock etc). 

5.2.9 Purchase of hardware - discussion surrounding whether new supplier intends to purchase any 

relevant hardware from incumbent supplier or provide patients with new equipment (if requested in 

specification). 

5.2.10 Invoicing requirements - agreement on best process for invoicing trust for homecare services. The 

Trust need to consider the following: 

64 


o Will an order be raised before the prescription is sent or retrospectively? 

o Who will receive the invoice? 

o Will any new drug codes/cost centres need to be set up on the pharmacy computer 

system? 

o Will the Trust require a consolidated monthly invoice or an individual invoice? 

What data will the Trust require on the invoice (e.g. cost per case drugs will require 

some way of identifying the patient name. unit number) 

5.2.11 Start dates: 

o Of contract - Group to suggest a start date of contract which will be agreed in part two of 

meeting. 

o New patients - typically, new patients would start on or immediately after the contract start 

date with the new supplier. It may be sensible to delay potential new starters until after the 

new contract start date, unless this would disrupt the patient‟s treatment. 

o Existing patients - will all existing patients receive their deliveries from one set date or will 

there be a phased approach (in cases of large patient numbers)? The main issue 

surrounding the transfer of existing patients is how to handle the mid prescription patients 

i.e. they have received half their deliveries against a six month prescription. This can be 

handled one of three ways: 

Process Pros Cons 

1) Rewrite all prescriptions with a 

new six month validity 

2) Rewrite the remainder of the prescription 

i.e. if two months of treatment have been 

made against a six month prescription, new 

prescription is written for four months 

3) Stagger the changeover of contract. 

Patients come on to the new service upon 

expiry of old prescription 

Assured accuracy and 

currency of new prescriptions 

Transcription can take place 

directly from copies provided 

by incumbent supplier 

Would ensure that prescription expiry is 

staggered 

Assured accuracy and currency of new 

prescriptions 

Would reduce bottleneck of workload 

for all staff 

Assured accuracy and currency of new 

prescriptions 

Large workload for clinical team 

Prescriptions will all expire at same 

time in six months 

May prove to be a complicated task 

Would require detailed information and cooperation 

from incumbent supplier 

Greater possibility of error in delivery times 

Would prolong the length of time taken to 

transfer patients (up to six months) 

Would reduce any savings made on contract. 

5.2.12 Contacting patients - key staff from the Trust and new supplier should be given the responsibility of contacting 

patients. The patients should be contacted in a three stage approach: 

i. Letter from the Trust informing patients of change, when change will be effective from, reasons for 

change and reassurance that their care will not be affected. 

ii. Goodbye letter from incumbent supplier informing patient that their deliveries will be made by another 

supplier effective from the agreed date. The letter should be agreed by the Trust before being sent to 

patient. 

iii. A welcome letter and welcome pack from new supplier, reassuring patient of seamless care, and 

informing them of their new contact number and the date from which the change will be effective. This 

letter should be agreed by the Trust before being sent to patients. 

5.2.13 Review and summary of actions. Each agreed action should have a date of completion and a person responsible. 

5.3. Meeting - Part Two: Suggested Agenda Items 

5.3.1 Introductions and welcome - Introduce the incumbent suppliers to the rest of the group from part one. 

65 


5.3.2 Required patient data - review of data provided by incumbent supplier to ensure all required fields of data have 

been provided. The clinical team will carefully review accuracy of data after the meeting and feedback to 

incumbent supplier any errors. 

5.3.3 Ancillary items - agreement requested from incumbent supplier that ancillary items currently with the patient will 

not be removed upon contract termination. 

5.3.4 Hardware - person identified from new supplier and incumbent supplier charged with negotiating over the sale of 

hardware. Agreement should be reached within one week of date of meeting and fed back to project manager. 

5.3.5 Proposed start date of contract - discussion by all on the feasibility of start date. 

5.3.6 Existing patients - agreement made between all regarding the most efficient process of managing the transfer of 

existing patients. 

5.3.7 Contacting patients - incumbent supplier to be informed that patients will require a letter to say goodbye and 

wishing them well for the future. The letter shall be sent after initial contact by the Trust has been made. Project 

manager to agree letter and advise incumbent supplier when to issue. 

5.3.8 Review and summary of actions. Each agreed action should have a date of completion and a person responsible. 

5.4. Tasks for clinical team following meeting 

5.4.1 Arrange letter to inform patients of change and provide telephone number of a Trust contact who they can call if 

they have any questions. 

5.4.2 Rewrite any prescriptions or registration forms required by the new supplier in advance of first delivery. 

5.4.3 Check the list of patient demographics and prescription copies provided by incumbent supplier for accuracy 

5.4.4 Review and follow-up any named actions resulting from the meeting 

5.4.5 Notify project manager once a task has been completed. 

5.5 Tasks for new supplier following meeting 

5.5.1 Print new prescriptions and registrations forms in agreement with requirements of clinical team. 

5.5.2 Arrange deliveries for existing Trust patients to ensure seamless care. Deliveries should match closely the next 

expected delivery date by the incumbent supplier. Patients should not be left without treatment beyond their due 

date. 

5.5.3 Upon notification by Trust, the new supplier will send out welcome packs and letter to patients stating the 

following: 

i. Brief overview of company 

ii. Reassurance that they will receive seamless care and quality service 

iii. A named contact at the company along with a direct telephone line, preferably free-phone or 

geographical number. 

iv. A back up contact in case of absence or holiday 

v. A 24 hour emergency number if appropriate 

vi. Date of next delivery 

5.5.4 Negotiate with incumbent supplier regarding purchase of hardware. Negotiations should be completed within one 

week of meeting. If agreement cannot be reached, new supplier will have a contingency plan to replace hardware. 

5.5.5 Arrange a key holding service for patients if required as part of contract. 

66 


5.6. Tasks for incumbent supplier following meeting 

5.6.1 Arrange goodbye letter to patients 

5.6.2 Enter into negotiations with new supplier regarding purchase of hardware. If agreement cannot be reached, 

incumbent supplier will arrange for removal of hardware from patients home. This will be conducted discreetly and 

at the patient‟s convenience and soon after installation of new equipment by new supplier. 

5.6.3 Incumbent supplier will be fully compliant in the transfer of patient data and ensure that such data is transferred 

securely. 

5.6.4 Patients who have provided a key to the incumbent supplier for access to house during deliveries will have their 

key returned to them securely with last delivery or before end of contract date. 

5.7. Miscellaneous tasks following meeting 

5.7.1 A robust invoicing system set up. Trust may need to add new drug codes and/or cost centres to stock 

management system. 

5.7.2 Arrange follow up meeting at least one week prior to contract start date to review actions if necessary. Meeting 

should include all named contacts including incumbent supplier. 

5.8 Tasks following start of contract 

5.8.1 Clinical teams to feed back to project manager any initial problems 

5.8.2 New supplier‟s named contact will also act as trouble-shooter for initial problems 

5.8.3 Meeting to be arranged after two months to assess changeover process. 

5.8.4 In liaison with Trust, new supplier will conduct a patient survey to assess the effectiveness of the changeover. 

67 


Task list for changing contract to new supplier for homecare medicines 

1. Pharmacy Procurement Team Tasks 

After award of contract: 

1.1 Identify key staff to attend a change management meeting and assign a „project leader‟ to manage the changeover of 

suppliers. 

1.2 Arrange change management meeting between clinical teams, new supplier and incumbent supplier. 

1.3 Book room for meeting. 

1.4 Notify attendees of time and venue 

1.5 Request details from new supplier regarding what information they need for the meeting 

1.6 Arrange agenda for meetings 

1.7 Send meeting agendas to clinical team and new supplier 

1.8 Send relevant section of meeting agenda to the incumbent supplier 

1.9 Send list of requirements identified in 1.5 to incumbent supplier along with a request to provide patients demographics 

at the meeting 

1.10 Print off contract specification for meeting 

1.11 Liaise with procurement business manager (if not attending meeting) to assess invoicing requirements 

Points at meeting (part one): 

a) Intro and welcome 

b) Overview of specification 

c) Patient data required 

d) Prescription format/requirements 

e) Prescription process 

f) Delivery schedule 

g) List of ancillaries 

h) Removal of waste 

i) Purchase of hardware 

j) Invoicing requirements 

k) Agreement on start dates 

l) Process for contacting patients regarding change of contract 

m) Review and summary of actions including assigning a designated named contact for new supplier and clinical team 

Points at meeting (part two) 


b) Patient data required 

c) Ancillary items 

d) Hardware 

e) Proposed start date of contract 

f) Transfer of existing patients 

g) Contacting patients 

h) Review and summary of actions including assignment of a named contact at incumbent supplier 

Post meeting 

1.12 Check with information governance manager that the method of transfer of data is compliant with guidance relating to 

the transfer and security of patient identifiable data 

1.13 Inform PASA of change of contract (if required) 

1.14 Produce Gantt chart for time line of actions and distribute to all involved 

1.15 Organise follow up meeting to occur 1 week before agreed start date 

1.16 Write letter to inform patients of supplier change. Agree with clinical team prior to distribution 

1.17 Send patient letter to new supplier to distribute on behalf of the Trust 

1.18 Inform incumbent supplier that they can now send their „Goodbye‟ letter 

1.19 Inform new supplier that they can distribute welcome packs. 

1.20 Discuss effect on Trust stock holding with store managers 

68 


Post-start tasks 

1.21 Arrange patient questionnaire to assess changeover 

1.22 Arrange post change meeting with new suppliers/clinical teams 

2. Incumbent Supplier tasks 

After award of contract 

2.1 Arrange suitable representation of staff to attend change management meeting at the Trust 

2.2 Prepare file of patient demographic data 

Points at meeting: 

a) Provide requested data to clinical team 

b) Provide new supplier with current list of patient‟s ancillary requirements 

c) Provide new supplier with current hardware held in patients home 

d) Arrange process of negotiation with new supplier for sale/transfer of hardware and ancillaries 

e) Provide Trust procurement team with details of any stock held by company that may be part of a designated allocation under 

the Purchasing and Supplies Agency national framework 

f) Provide project manager with a designated named contact 

Post Meeting: 

2.3 Send letter to patients informing them of their last delivery and provide reassurance that their next delivery will be from 

the new supplier 

2.4 Arrange collection of any hardware in patients home that is not included as part of the sale/transfer of hardware items 

3. Clinical team tasks 

After award of contract: 

3.1 Provide list of all current, on hold, and planned patients to procurement team 


a) Provide a named contact for clinical team 

b) Agree how to transfer data for existing patients 

c) Agree start date of new contract 

d) Agree style and format of prescription 

e) Agree on prescription process 

Post meeting 

3.2 Check all data provided by incumbent supplier for accuracy and forward checked data to the project manager 

3.3 Write new prescriptions and registration forms if necessary and forward to new supplier 

3.4 Agree patient letter with procurement team 

3.5 Act as information contact for patients regarding the switch 

Post-start tasks: 

3.6 Monitor and record any initial problems with deliveries. Notify project manager and new suppliers named contact of any 

incidents/occurrences 

3.7 Attend meeting to assess efficiency of change management process 

4. New Supplier tasks 

After award of contract 

4.1 Arrange suitable representation of attendees for meeting 

4.2 Send list of preliminary requirements to procurement team 

69 



a) Present change management plan 

b) Provide clinical team and project manager with examples of prescription/registration form stationery 

c) Arrange negotiations with incumbent supplier for possible purchase of hardware 

d) Provide project manager with a named contact 

e) Agree start date of contract 

Post meeting: 

4.4 Assist clinical teams in the writing of new prescriptions 

4.5 Arrange initial delivery schedules 

4.6 Arrange installation of hardware in patient‟s homes if not included in the sale/transfer of hardware from the incumbent 

supplier 

4.7 Distribute „welcome packs‟ to patients before first scheduled delivery 

4.8 Telephone patients to arrange mutually convenient time for first delivery 

Post-start tasks 

4.9 Make first delivery - provide feedback and evidence to project manager and clinical team that these have occurred 

4.10 Attend post change review meeting 

4.11 Distribute a Trust led questionnaire to assess the patient‟s opinion of the switch 

70 


1 - Pharmacy Procurement Team Tasks after award of 

contract 

1.1 Identify key staff to attend meeting. Assign a project manager 

1.2 Arrange implementation meeting between clinical teams and new 

homecare supplier 

1.3 Book room for meeting 

1.4 Notify attendees of time and venue 

1.5 Send e-mail to new supplier requesting details of pre-requirements 

for meeting 

1.6 Arrange agenda for both meetings 

1.7 Send agenda to clinical team and new supplier 

1.8 Print off contract specification for meeting 

1.9 Liaise with procurement business manager (if not attending 

meeting) to discuss invoicing requirements 

Points at meeting: Part 1 


b) Overview of specification 

c) Patient data required 

d) Prescription format/requirements 

e) Prescription process 

Individual 

Responsibility 

Deadline/ Date Completed 

71 


Points at meeting: Part 2 


contract 

f) Delivery schedule 

g) List of ancillaries 

h) Removal of waste 

i) Purchase of hardware 

j) Invoicing requirements 

k) Agreement on start dates 

l) contacting patients 

m) Review and summary of actions - assignment of 

named contact for new supplier and clinical team. 


b) Patient data required 

c) Ancillary items 

d) Hardware 

e) Proposed start date of contract 

f) Transfer of existing patients 

g) Contacting patients 

h) Review and summary of actions including 

assignment of a named contact at incumbent 

supplier 

Individual 



72 


Post meeting: 


contract 

1.12 Check with Information Governance and Data Protection Manager 

that the method of transfer of patient data is secure 

1.13 Inform PASA of change of contract (if required) 

1.14 Produce Gantt chart of change process and distribute to clinical 

teams, existing supplier and new supplier 

1.15 Arrange follow up meeting to check progress 

1.16 Draft letter to patients for clinical teams approval 

1.17 Send letter to new supplier to distribute on behalf of LTH 

1.18 Inform incumbent supplier they can now distribute a letter of 

goodbye to patients 

1.19 Inform new supplier that welcome packs can be sent out to 

patients immediately after the letter from the Trust 

1.20 Discuss with pharmacy supplies on proposed effect (if any) on 

stock holding 

START DATE 

1.22 Plan for questionnaire to assess efficiency of change management 

plan 

1.23 Arrange post change meeting with new suppliers/clinical teams 

Individual 



73 


2 - Existing Provider Tasks after award of contract 

2.1 Arrange suitable representation of staff to attend change 

management meeting at the Trust 

2.2 Prepare file of current patient data and any other data 

requested by procurement team 

Points at meeting 

post meeting: 

a) Provide requested data to clinical team 

b) Provide new supplier with current list of patient's ancillary 

requirements 

c) Provide new supplier with current hardware held in patients 

home 

d) Arrange process for negotiating sale/transfer of hardware 

items 

e) Provide procurement team with details of any stock held 

that may be part of a designated allocation under the 

Purchasing and Supplies Agency national framework 

f) Provide project manager with a designated named contact 

2.3 Letter to patient informing them of their last delivery and 

provide reassurance that their next delivery will be from the 

new supplier. 

2.4 Arrange collection of any hardware in patients home that is not 

part of the transfer/sale of hardware items 

Individual 


Deadline Completed 

74 


3 - Clinical Team Tasks after award of contract 

3.1 Provide list of all current, on hold and planned patients to 

procurement team 


a) Provide a named contact for clinical team 

b) Agree how to transfer data for existing patients 

c) Agree start date of new contract 

d) Agree style/format of prescription 

e) Agree prescription process 

3.2 Check all data provided by incumbent supplier for accuracy. 

Forward checked data to the project manager 

3.3 Write new prescriptions and registration forms, if required, 

and forward to new supplier 

3.4 Agree patient letter of notification with project manager 

3.5 Act as an information contact for patients during the 

changeover 

3.6 Monitor and record any initial problems with deliveries. Notify 

project manager and new supplier named contact of any 

incidents/occurrences 

3.7 Attend meeting to assess efficiency of change management 

process 

Individual 



75 


4 - New Supplier Tasks after award of contract 

4.1 Arrange suitable representation to attend change management 

meeting 

4.2 Send a list of preliminary requirements to procurement team prior 

to change meeting 


Post meeting 

a) Present company change management plan 

b) Provide clinical team/procurement team with examples of 

prescription/registration form stationery 

c) Negotiate with previous suppliers on transfer/purchase of 

ancillary items/hardware 

d) Provide project manager with a named contact 

e) Agree start date of contract 

4.3 Assist clinical teams in rewriting any 'part used' prescriptions for 

existing patients (if required) 

4.4 Arrange initial delivery schedules 

4.5 Arrange installation of hardware in patient's homes if not included 

in the sale/transfer of hardware from the incumbent supplier 

4.6 Distribute 'welcome packs' to patients before first scheduled 

delivery 

4.7 Telephone patients to arrange mutually convenient time for first 

delivery 

START DATE 

4.8 Make first deliveries - provide feedback and evidence to the 

clinical teams that these have occurred 

4.9 Attend post change review meeting 

Individual 



76 


4 - New Supplier Tasks after award of contract 

4.10 Distribute post change questionnaire (provided by Procurement 

team) 

Agenda for part 1 of Change management meeting: 

Individual 


NO TIME AGENDA ITEM PURPOSE OWNER 

1. Introductions and welcome 

2. Overview of specification 

3. Required patient data 

4. Prescription format/requirements 

5. Prescription process 

6. Delivery schedule 

7. Ancillary requirements 

8. Removal of waste 

9. Purchase of hardware 

10. Invoicing requirements 

11. Agreement on start dates 

12. Notifying patients of change 

13. Review of actions 

Agenda for part 2 of meeting (including incumbent supplier): 

NO TIME AGENDA ITEM PURPOSE OWNER 

1. Introductions and welcome 

2. Patient data required 

3. Ancillary items 

4. Hardware 

5. Proposed start date of contract 

6. Transfer of existing patients 

7. Notifying patients of change 

8. Review and summary of actions 


77 


CMU Data collection fields 

78 

May 2011 © Crown Copyright 2011 

Appendix 4

General KPI Summary Trusts are required to amend these specimen KPI's to reflect each therapy area 

Complaints Proof of Delivery 

Type Status ComplaintRef Number of Deliveries returned 

Cost of unused 

products 

Patient (Van/Postal/Other) Issued Unique ref to form Deliveries Number of deliveries returned £ 

Trust Investigation underway Deliveries on time & in full Why 

Manufacturer Resolved Deliveries outside agreed window 

Part deliveries 

Emergency deliveries 

Deliveries outside normal Mon-Fri 

Deliveries where stock has been damaged from homecare provider to patient 

No of Adhoc/Other deliveries (not covered above) 

Why 

Dispensing At Trust level At Delivery location 

Number of Patients Stock check of items 

Prescriptions dispensed Number of Patients registered home 

Items on prescription Unable to be supplied in total/not dispensed Van 

Items dispensed Reason why not dispensed Postal 

Dispensing errors Out of stock On Service 

Dispensed with less than 6 months expiry date Manufacturer unable to supply On Hold 

Off Service 

Why 

Clinical Details of untoward clinical incidents/Adverse Drug Reactions (ADRs) 

1 

2 

3 

4 

5 

Invoicing 

Number of £ Total value of Number of £ Total value of 

Invoices dispatched Invoices dispatched Invoices paid by trust within 30 days Invoices paid by trust within 30 days 

Total invoice lines Total invoice lines Invoices not paid by trust within 30 days Invoices not paid by trust within 30 days 

Invoice queries from trusts Invoice queries from trusts 

Monthly performance rating 

Please self-assess your performance this month: 

79 


Appendix 5

Date: 

Name 

Address 

Dear 

1 

Appendix 6 

2 The XXXXXXXXX Hospital/PCT would like to know what you think of the Home delivery service 

provided by XXXXXX. Please could you complete the enclosed questionnaire and return it to us in 

the pre-paid envelope provided. It is only with your opinions can we continue to maintain and 

improve the service you receive. 

Kind Regards, 

2.1 [A signed copy of this letter is held on file at XXXXXXXXXXXHospital/PCT] 

NAME 

TITLE 

HOSPITAL/PCT 

80 


Name: 

[This survey has been sent to you with the permission of the XXXXXXXXX teams responsible for your treatment] 

Patient Survey 

Name of Treatment: 

Name of Homecare provider: 

Section ONE: How do you currently rate (company name)performance in the following areas: 

Please circle ONE score, where 1= POOR and 5= EXCELLENT) 

Communication 

Poor 

Excellent 

1 2 3 4 5 

Comments: 

Delivery times 

Poor 

Excellent 

1 2 3 4 5 

Comments: 

Customer Services Support 

Poor 

Excellent 

1 2 3 4 5 

Comments: 

Driver assistance/attitude: 

Poor 

Excellent 

1 2 3 4 5 

Comments: 

Clinical Waste Collection (Sharps bins etc) 

Poor 

Excellent 

1 2 3 4 5 

Comments: 

Overall Service 

Poor 

Excellent 

1 2 3 4 5 

81 


Comments: 

Continued overleaf…. 

Section TWO: How important are each of the following to you 

This section is designed to find out which areas of the service mean the most to you, to give us some 

idea of what you, the patient, consider a priority 

(Score 1= Not important 5= Very important) 

Communication 

Not important Very 

important 

1 2 3 4 5 

Comments: 

Delivery times 


important 

1 2 3 4 5 

Comments: 

Customer Services Support 


important 

1 2 3 4 5 

Comments: 

Driver assistance/attitude: 


important 

1 2 3 4 5 

Comments: 

Clinical Waste Collection (sharps bins etc) 


important 

1 2 3 4 5 

Comments: 

Overall Service 


important 

1 2 3 4 5 

Comments: 

Thank You for your time 

82 


Appendix 7 

Procedure to define the framework for reporting of incidents occurring in the 

Homecare Medicines Supply Chain. 

1. Purpose 

To describe the pathway of contact in the occurrence of an „incident‟ in the Homecare Medicine 

supply chain. 

2. Scope 

This procedure covers all events which can be classed as „an incident‟ or a „Serious Untoward 

incident‟, as defined by Trust policies on Incidents and Serious Untoward Incidents. This 

procedure details the pathway for recording, responding and actioning incidents and is not 

intended to direct any remedial clinical activity which may be necessary as a result of the 

incident 

3. Responsibility 

It is the responsibility of all staff members involved in the Homecare Medicines supply chain 

(Trust and Homecare provider staff) to be aware of the procedure and aware of the chain of 

communication in the event of „an incident‟. 

All staffed named as key contacts in the Homecare Incident Contact Matrix will, as part of this 

procedure, read and acknowledge understanding of the procedures for Incident reporting and 

Serious Untoward Incidents. 

4. Procedure 

All Homecare providers will have their own procedure for dealing with incidents which will be 

made available to the Trust. 

4.1. Upon discovery of an incident, the member of staff discovering the incident will complete the 

homecare incident report form (see appendix 1). 

4.2. Attach this form to an e-mail and send to all the named contacts shown on the incident 

contact matrix* (within the Trust and the Homecare Provider). 

4.3. For incidents that have a direct effect on the patient‟s care, the person discovering the 

incident will contact and discuss with the Trust‟s key contact (as shown on contact matrix) the 

nature of the incident. That key contact will then assume responsibility for any remedial action 

that the patient may require. Where an incident has potential to or has caused harm to a 

patient, a senior Pharmacy Manager must be contacted immediately. Incidents classified as 

having potential for harm include, but are not limited to, dispensing errors where patients 

have taken a dose, missed doses, dispensing of expired stock etc. 

4.4. The member of staff assuming the responsibility for the incident will advise the other named 

contacts for that therapy area (as detailed in the contact matrix) the details of the incident, 

what action has already been taken and any subsequent actions required. All future 

communication regarding the incident should be copied to all contacts for information. 

4.5. The homecare provider shall assist the Trust lead in providing remedial care. Emergency 

deliveries will be made available if necessary without prejudice. 

83 


4.6. The Trust lead will complete a Trust incident reporting form (IR1) in accordance with Trust 

policy within 48 hours of the incident. The unique IR1 number will then be communicated to 

the rest of the key contacts (including Homecare provider contacts) by email. 

4.7. The key contact at the Homecare provider must initiate the company‟s incident reporting 

procedure and supply the Trust with the name of an operational lead at the company to assist 

the clinical team with any remedial action. 

4.8. The homecare provider must provide a detailed, chronological report of the incident to the 

Trust, from the moment of occurrence to the point of closure. Report must include details of 

any communication between the Trust, Homecare provider and the patient. The report should 

where possible include a root cause analysis. The report should be communicated via email 

to the key contacts within two weeks of discovery of incident. The report must have a unique 

number and be cross referenced to the Trust‟s IR1 number. 

4.9. An incident shall be classed as „Closed‟ when it is agreed by the clinical lead and the 

Homecare provider key contact that all actions have been undertaken to remedy the incident, 

a root cause analysis has been conducted and actions have been undertaken to avoid/reduce 

the risk of a repeat of the incident. If closure has not been achieved within the 2 week time 

frame defined in point 4.8, then a second and subsequent report shall be required. Closure of 

an incident should be achieved within this 2 week time scale unless circumstances make this 

impossible. The second report should include details as to why closure within 2 weeks was 

not achieved. The first report will include an action plan together with deadlines for the actions 

to enable closure to occur. 

4.10. The IR1 shall be forwarded to the Trust‟s senior Pharmacy Manager for final sign off and risk 

evaluation score. 

4.11. The Homecare provider will keep a record of all incidents per quarter and present these 

figures to the by way of a quarterly report showing number of incidents per month and status 

of incident i.e. „Ongoing‟ or „Closed‟. This data will be used as a performance management 

tool in future service reviews for purpose of learning. 

4.12. The Homecare provider will communicate any key staff changes which may affect the 

reporting framework. This should ideally be done before any of the key contact staff at the 

homecare provider leave or, if not possible, as soon as possible after. 

4.13. The key contact matrix shall be maintained by the Trust. 

84 


Section A: Please Complete All Fields* Before Submitting This Report 

(Fields marked * are mandatory) 

Hospital Name*: IR1 Number*: 

(to be completed by Trust only) 

Issue Raised by*: 

Position and Department*: 

Date Issue Raised*: Date Issue Reported to 

Homecare Provider*: 

2.2 Patient 

Information: 

Patient Initials*: Date of Birth*: 

Hospital Number: 

(optional) 

Details of Issue* 

Does the patient require a written response *? 

Name of First Contact for Completed Report (including email 

address) 

Therapy Area/Contract Name*: 

Yes No (please select ) 

85 


Section B: To be completed by Homecare Provider Personnel Only: 

Investigation and Immediate Corrective Actions Taken: 

Details of Preventative Actions and Conclusion: 

3 Completed by 

Homecare Provider unique 

Reference: 

Date Completed 

(including written 

response to patient 

where appropriate): 

Date Issued to Trust: 

86 


Refrigeration 

87 


Appendix 8 

Temperature range 2-8°c 

Temperature distribution – maintain the required range across its entire load area 

Capacity – at least one third greater than required to allow for circulation of cooled air 

Lockable for child safety 

Suitable indicator/visual alarm to alert if temperature exceeds parameters (for length of time) or 

door left open 

Fridge with fan preferred 

Easy to read temperature measurement shown on outside of fridge, calibrated to proven standard

Commercial Medicines Unit (CMU) - Department of Health

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