Did the Homecare Industry rise to the Challenge in 2020? – We will let you be the judge.

Alison Davis – Chair of the National Clinical Homecare Association – (NCHA).

2020 has brought extraordinary unprecedented global challenges with the arrival of Coronavirus (COVID-19). These challenges have tested every aspect of society, from healthcare systems, economies and governments, not to mention the personal tragedies that countless families have experience and are still trying to come to terms with.

The impact on everyone has yet to be fully understood. However, what is understood is that in these times, many people have and are doing amazing things that improve the lives of others. This article aims to give you a flavour of not just the challenges COVID-19 has brought to the ‘UK Homecare Industry’, but the way in which collaboration between the National Clinical Homecare Association (NCHA) and the National Homecare Medicines Committee (NHMC) – NHS, is diligently working together to ensure that the safety of new and existing patients remains an overriding priority.

At this time, I am proud to share aspects of how the Homecare Industry has performed, including how our wonderful NHS colleagues and the NHMC have helped us to deliver care to the patients we seek to serve. We recognise it is not over yet, with many challenges remaining and no doubt new ones will arise. However, the NCHA and NHMC both understand that ‘Extraordinary challenges call for Extraordinary Collaboration’, which we are committed to supporting to improve healthcare for all.

At this time, I believe it is appropriate time to give thanks and recognise the tremendous support and effort given by everyone employed in the homecare industry / NHS. In addition, to recognise the effective leadership and help provided by Susan Gibert and the NHMC team to all of our members. We could not have delivered our part without you! Furthermore, it would be remiss of me not to thank the Pharmaceutical Industry, who in many cases fund service provision and most importantly to our Patients and Carers enrolled on our services. We thank you all for the kind words and messages we have received which has really helped support all staff at this time. Rest assured, we are here and will continue to be here to support you.

A view from the National Homecare Medicines Committee (NHMC), NHS – by Susan Gibert, Chair

Working closely with the NCHA and its members during this difficult and unprecedented time has been a real privilege. The working relationship between NHMC and NCHA has always been good, but this crisis has shown how important and effective this relationship can be. Patient safety was at the forefront of every discussion, any issues identified as potential risks were dealt with promptly and efficiently which is a testament to all involved.

Successful collaboration is not always easy. To be successful collaboration must be based on clear, open and honest communication, delivered with mutual respect and support. This was definitely achieved between with Alison, the NCHA and the NHS.

Throughout the crisis we are working with an agreed and combined purpose. Regular crisis calls between key NHS stakeholders from all four UK nations and all NCHA members were set up from the beginning of March onwards and these will continue until the end of the Covid crisis.

Other groups were also involved and these included:

  • The NHSE Specialised Commissioning Group, which held weekly meeting with NHMC Chair and CMU homecare lead – with an interest in and support for Homecare Providers
  • ABPI (Association British Pharmaceutical Industry) holding 2 online meetings for discussion forums to take place to ensure good communication during this crisis. The openness with the ABPI homecare group also demonstrated the good working relationships that NHMC and NCHA have jointly harnessed over the last 4 years.

NHMC took action and put in place a number of measures to support the homecare providers:

  • Securing appropriate supplies of PPE (Personal Protective Equipment) for front line key workers; i.e. Nurses. Not an easy challenge to deliver on
  • Cooperative collaboration with NCHA and sign off of an industry Business Continuity Plan (BCP) for sub-group workings – Superintendent group, Nurse group, Patient Communication group, Industry doorstep and over the threshold procedure
  • Requests for twenty thousand (20,000) patients to move from secondary care service to clinical homecare to ensure continuity of care and reduce risks to patients. In total 20,000 + patients were under 765 different contracts
  • Support in recognising homecare provider staff as key workers – in order for them to access childcare and schooling for their children
  • Accessing COVID-19 polymerase chain reaction (PCR) swab testing for staff equivalent to that available for NHS staff and household members, before general testing was available

A True Partnership Approach – See Mun Wong – North West Regional Lead, Outsourced Medicine Supply Services

The Homecare Providers reacted very quickly in the rapidly changing environment, to maintain their business continuity and to meet increased NHS Demand during the COVID-19 crisis, thereby helping even more vulnerable patients (in excess of 20,000) to be shielded at home during the pandemic. This has been an important factor in maintaining the stability of the healthcare system within the NHS during the pandemic. As we are entering the recovery phase, many more chronic patients who have been receiving treatments in the hospital are now being managed at home with homecare support.

A careful approach has ensured patient safety throughout. It has also been great to see the joint effort from all providers as evident in the NCHA industry-wide business continuity plan, where providers have supported each other during this difficult time. A big thank you to all members of the NCHA for your effort and team spirit.

A shared personal perspective from Andrew Wilson – East Midlands Pharmacy Collaboration (EMPC)

The COVID-19 challenge has to be one of the biggest challenges we have faced (and facing) in respect to Homecare service provision. Not only do we have this Pandemic hitting patients, it is also affecting those that care for them in all aspects of our society, be it Care Homes, Hospitals, Hospices or people caring / isolating at Home.

It may be logical to think that facing this virus, the NHCA members would understandably step back and decide to furlough staff and cease taking on any new patients, to help mitigate the threat to their individual members, business and staff. I would have expected this approach to happen. Instead, the Homecare Providers / NCHA have done amazing things that I would never have thought possible. The NCHA members are working together willingly and have stepped up to support of the NHS as it seeks to manage vulnerable patients. The co-ordination between the NCHA and the NHMC has been a great example of how a partnership should work and is a credit to all those who have been part of it.

This new heightened platform of working has shown ‘How good it can be’ when we work as one enlarged group across the sector – Therefore I would like to express my thanks.

A Vote of Thanks

To the NCHA members, I’d like to say “Thank you” for being amazing people, enabling your business to make amazing achievements at this really difficult time. Please take a few moments to take in and appreciate this success story, you have been a huge part of.
Andrew Wilson – EMPC

On the Frontline – Reflections from a Homecare clinical team.

For one homecare provider with around 500 homecare patient visits a month, it’s business as usual for our nurses, as they continue to provide an important homecare service during COVID-19. Whilst the coronavirus situation is rapidly changing and affecting how everyone is working, we continue to adapt and ensure we are able to provide critical support to patients in their homes. We support a wide range of patients with critical conditions, such as cancer, haematology, rheumatology and growth hormone deficiency amongst many others and it’s our duty to continue to provide this vital service. The nurses have also stepped in to support the NHS and treat patients deemed most at risk via provision of homecare support. These patients would normally be looked after via outpatient clinic visits.

To protect the clinical team, all our nurses have Personal Protective Equipment (PPE). A nurse manager stated, “We are doing all we can to ensure the safety and wellbeing of our nurses and patients during this pandemic. To ease pressure, we have also started to offer video calling to patients to help provide training so that patients can learn how to self- administer their injections at home”.

My Patients Need Me

“I felt very emotional visiting a patient with suspected symptoms of COVID-19, as in my 19 years of being a nurse, it was the first time that I wore full PPE. The severity of this virus hit me and it suddenly became very real. It does feel a little scary at the moment, but my patients need me and I need to keep doing my job for them. I am lucky that I work with such an amazing team, as we are all supporting each other through this incredibly challenging time.” says Kathie – Alcura Nurse