Click on the documents below to download:
Appendices include National standard forms and templates for example
- Appendix 1 – National Homecare Patients’ Charter ★★
- Appendix 4 – Patient registration and consent form ★★★ (NHMC)
- Appendix 4b – Patient change request form ★★★ (NHMC)
- Appendix 5 – Template homecare patient satisfaction questionnaire ★★★ (NHMC)
- Appendix 10 – National KPI definitions V4 approved 10/11/16 ★★★ (DH Commercial Medicines Unit) Note: These are current operational KPIs.
- Appendix 10 – National KPI definitions V5 approved 10/11/16 ★★★ (DH Commercial Medicines Unit) Note: This version 5 is the same as version 4 with the addition of governance KPIs. It is published now, for information, to allow implementation work to continue. This version is approved and will supersede version 4 in January 2018.
- Appendix 11 – Example product quality assessment for an unlicensed compounded antibiotic ★ (Quality Control North West)
Additional appendices were added to support the further guidance on managing complaits and incidents in Homecare Services.
- Appendix 20a – Template patient complaint and incident form (homecare organisation) ★★★ (NHMC)
- Appendix 20b – Template complaint and incident form (patient self-reporting) ★★★ (NHMC)
- Appendix 20c – Template for acknowledgement for complaints and incidents ★★ (NHMC)
- Appendix 20d – Template for response to complaints and incidents ★★★ (NHMC)
- Appendix 21 – AIC reporting template ★★★ (AIC)
- Appendix 22 – Homecare complaint and incident codes master list ★★ (NHMC)