Question to the Department of Health and Social Care:

To ask His Majesty's Government what are the responsibilities of the (1) National Homecare Medicines Committee, (2) National Clinical Homecare Association, (3) Care Quality Commission, (4) General Pharmaceutical Council, (5)  Chief Pharmacist, (6) NHS Clinical Referring Centre, (7) NHS Pharmacy Homecare Teams, and (8) NHS Clinical Referring Centres, in regard to the provision of homecare medicines services; and whether any of those has responsibility to (a) change, or (b) cancel, contracts, with providers of homecare medicines in instances where they fail to deliver on their contracts; and if so, which one.

Providers of Homecare Medicine services to National Health Service patients do so under framework agreements which may be held at national at NHS England, regional at NHS procurement hubs or local at hospital trust level. This therefore requires a high degree of centralised co-ordination for which the National Homecare Medicines Committee (NHMC) supports and advises the NHS on matters relating to homecare medicines services. The Committee liaises with homecare providers through their trade association the National Clinical Homecare Association to support and co-ordinate development of the homecare market and discuss any system wide issues.

When the Key Performance Indicators indicate that the services levels of a provider on a national NHS England framework, NHS regional framework or contract are not to the standard expected, the NHMC, which is managed by and includes representation from NHS England, enacts an escalation process which involves meetings with individual providers to discuss safety and performance issues.

Each Chief Pharmacist within each NHS organisation, working with their NHS Clinical Referring Centre, is the responsible officer for the homecare medicines services that the hospital provides. Where the escalation process is in place, the affected provider will engage with this process and provide the NHS organisation with a summary of the issues, mitigations and expected timescales for recovery. If necessary, the regulators the Care Quality Commission and the General Pharmaceutical Council are also informed. If the NHS organisation is not satisfied that the required improvements and standards are being achieved then it can choose to change to another provider on the framework agreement, should the terms and conditions permit.

The contracting authority for a national and regional framework agreements may cancel the framework agreement for a provider by issuing a termination notice for a material breach of the terms of the framework which is not capable of remedy or not remedied in accordance with a remedial proposal in line with the terms and conditions of the framework agreement. Similar termination clauses are included in contracts and or framework agreements held directly between local NHS organisations and a provider for homecare medicines services.