Managing the Performance of Homecare Medicines Services

Managing the Performance of Homecare Medicines Services

Jane Kelly, Procurement Project PharmacistMick Butterfield, Specialist Technician: Homecare Medicines

PDIG Award

Project proposal Survey other Trusts across the UK to find out how

they performance manage their Homecare Contracts On-line Survey

Distributed via primary and secondary care e-mail networks

Limitations Distribution of survey Secondary care bias

National Survey

114 responses obtained

Differing geographic locations

Homecare Provider survey 100,000 patients Top 6 companies 5 homecare companies

responded

Survey Results - BackgroundSector Response (95 responses from hospital)

Hospital83%

PCT17%

4.2%No

95.8%Yes

Is the Homecare route ever used in your organisation? (n = 95)

Survey Results - Background

Survey Results -BackgroundApproximate number of patients on Homecare medicines (n = 93)

23

96

2 16

46

0

5

10

15

20

25

30

35

40

45

50

0-100 101-500 501-1000 1001-2000 2000-3000 3000+ Don't Know

Numbers of patients

Num

ber

of re

spon

ses

Survey Results -BackgroundTop 10 Homecare therapy areas (n = 78)

0

10

20

30

40

50

60

70

Anti TNFs

HIV med

icine

s

MS Treatm

ents

EPOs

Methotr

exate

Immun

oglob

ulin

Paren

teral

Nutritio

n

IV Antib

iotics

Growth Horm

one

Efalizu

mab

Survey Results - BackgroundHomecare Providers (n = 71)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Health

care

at Home

Bupa (Clin

ovia)

Centra

l Homec

areCale

a

Fresen

ius Med

icareWillo

w

Polar Spee

d

Intecare

Grifols

Careology

Nutricia

Clinica

l care

Health

care

Logistics AAH

Perc

enta

ge o

f res

pons

es

Why is performance management important?

Puts the patient at the centre of the homecare service Aims to deliver safe and effective patient care Ensures the same high quality standards at home as in

hospital Aims to engage the clinical multidisciplinary team,

procurement, and homecare providers for the benefit of the patient

Aims to demonstrate value for money Monitors compliance and contractual obligations Helps inform at future homecare contract adjudications

Practical performance management

Contracting Key performance indicators Service Reviews Patient Surveys

Contracting

Performance management starts with a well written tender document and service specification

A ‘specification checklist’ is one of the documents on the NHMC website

The specification must include clear information about how the homecare service is going to be performance managed and / or audited

Survey Results - ContractingWho arranges the contract for each therapy area? (n = 77)

5%4%

2%

29%

60%

Pharmacy

Supplies

Clinical Team

Primary Care Trust

ProcurementHub/Confederation

Survey Results – Contracting

Pharmacist 72%Pharmacy procurement 66%

Clinician 68% Nurse 37%

Pharma. sponsored 32%

Supplies 13%

Finance 11%

Patient 10%

Key Performance Indicators

Agreed KPI’s can be used to assess the quality of the service provision

Targets are set to maintain a high level of service to our patients

KPI results are reviewed regularly with the homecare provider and action taken to resolve any issues

Survey Results -KPIsRank the following KPIs in terms of importance (62 / 32)

0

20

40

60

80

100

Com

plai

nts

Inci

dent

s

Del

iver

yw

indo

w

Invo

ices

Faile

dde

liver

ies

Emer

genc

yde

liver

ies

No.

invo

ices

No.

deliv

erie

s

Spen

d

Incidents and Complaints Monitoring

Formal incident and complaints procedures

Sharing Trust policy with Homecare companies

Define contact pathways

Collaborative reporting / resolving issues

Service Reviews

Who – involve the whole team Frequency – quarterly, half yearly or yearly

depending on contract Agenda

Review actions from last meeting Presentation of KPIs Review incidents and complaints Invoice/finance issues Staff changes Contractual changes

Survey Results – Performance managementDo you performance manage your homecare contracts? (n = 69)

10%

13%

13%

21%

43%Yes, AllMostSomeOnly when necessaryNever

Survey Results – Service ReviewsHow often is performance reviewed? (n = 40)

ad-hoc47%

at contract end5%

annually17%

half-yearly3%

quarterly15%

monthly13%

Survey Results –Service Reviews

Pharmacist 72%Pharmacy procurement 66%

Clinician 40% Nurse 44%

Pharma sponsored 14%

Supplies 12%

Finance 10%

Patient 0%

Patient Surveys

Just 17% have used patient questionnaires to review the performance of the homecare provider

Surveys are undertaken after a change of provider or every year

Patients are asked to rate the performance of their homecare service provider

Ensure results are fedback to clinical teams / homecare providers and patients

Patient consent to homecare

Current project at Leeds is to review how patients consent to homecare

Professional guidance is that healthcare professionals should obtain consent for everything involving the patient

How should consent be obtained and recorded?

Survey Results – Patient ConsentDo patients have a choice? (n = 61)

Usually39%

Never5%

Always38%

Rarely18%

Patient Consent

Are patients asked for their consent to homecare? (n = 73)

All41%

Most10%

Some6%

Don't Know43%

Don’t Know 43%

Survey Results – Patient consentIs the consent informed? (n = 71)

All35%

Most13%Some

7%

Don't Know45%

Survey Results - NHMC

72% did not know NHMC existed

15% had visited the website

70% who visited the web site used the information they found there

Summary

Contracting – ensure clear service specification that includes performance management

Formal Review – pharmacy should co-ordinate formal reviews of service at regular intervals

Homecare incidents and complaints – ensure these are reported and learned from

Patient involvement – increase patient involvement

NHMC – raise profile in the NHS

Future / Next Steps

Visit other centres

Share best practise with NHMC

Managing the Performance of Homecare Medicines Services

Documents

Transcript of Managing the Performance of Homecare Medicines Services