FREEDOM OF INFORMATION ACT 2000 THE ROYAL CORNWALL HOSPITALS NHS TRUST RESPONSE TO INFORMATION REQUEST Date Request Received: 15th November 2019 FOI Ref: 8454 Requested Information Question for your pharmacy and/or procurement team regarding the number of medicines and/or nursing services provided to NHS patients by an Independent Homecare Provider 1) In your organisation, which named individuals have the overall responsibility for any homecare provision for your patients? 2) Do you currently have in post an operational lead for homecare services in your organisation – If so, what is their name/role? 3) What are your organisations minimum requirements for accepting a homecare provider? 4) If you have an outsourced outpatient pharmacy, are they able to provide nurse services / training for patients on how to self-inject for medicines administered by sub-cutaneous injection as part of their contract? Can you please advise of total numbers of NHS patients who; 5) Received a homecare delivery service of drug and/or nurse service at dates Jan 2018 / Jan 2019 / October 2019 – please provide these numbers by; a) Drug name b) Therapy / clinical area c) Name of the homecare provider who provided/provides this service d) If possible please identify if these services are NHS funded or pharmaceutical / manufacturer funded services. Response 1) The Chief Pharmacist at the Royal Cornwall Hospitals Trust has overall responsibility for Medicines Homecare services. 2) The Royal Cornwall Hospitals Trust Chief Pharmacy Technician is the Operational Lead for Homecare Services. The lead for the Procurement and Homecare is the operational lead for Pharmacy Medicines Homecare Service 3) All NHS funded homecare medicines services implemented at the Royal Cornwall Hospitals NHS Trust have undergone a robust tender process, which may have been carried out nationally by NHSE&I CMU, regionally by the PPSA (Peninsula Purchasing and Supply Alliance) or by the Trust All pharma funded homecare medicines services that have been initiated since February 2019, have undergone a review by the National Homecare Medicines Committee (NHMC) which includes a review of the Homecare Service Proposal (HSP) Form by the NHMC review group and a review of the contract that sits between the Trust and the homecare provider by the hospital pharmacy homecare team manager and in some instances the Regional Homecare Jemma Dunstan, Information Governance Team V1 Review Date: 2022 Page 1 of 2 Medicines Specialist. Where possible Pharma funded Homecare services have also been part of the PPSA homecare contract or have an approved SLA in place. The minimum requirements for NHS funded homecare medicines services are laid out in the Specification and selection questionnaire (SQ) for each service as part of the tender process. For pharma funded schemes the NHS expectation for minimum reflects the national specification and all requirements of the NHMC Good Practice Principles (GPP). Homecare Providers must meet these minimum standards in order to provide the services to NHS patients. All regional contracts are actively monitored and managed by the regional homecare group. There is a national standard Key Performance Indicator (KPI) dataset. The regional homecare medicines specialist monitors all KPI reports for all services on a monthly basis and any anomalies or declines in service levels are queried directly with each homecare provider and a narrative to explain a perceived decline in service is requested. The Regional Homecare Medicines Specialist acts as the escalation point for all unresolved issues which informs the regional and national agenda. 4) At present the Royal Cornwall Hospitals Trust has no service in place from the Outsourced OPD provider for nursing services or patient training for SC injection 5) Please refer to Appendix 1 for the Royal Cornwall Hospitals Trust Homecare Delivery Service Attachment(s) Appendix 1 – Homecare Date Response Sent: December 2019 Jemma Dunstan, Information Governance Team V1 Review Date: 2022 Page 2 of 2 Early 2018 DRUG COMPANY Total patients Darbepoetin Alfa (Aranesp) LPCH 163 Interferon Beta 1a (Avonex) Healthcare @ Home 10 Etanercept (Benepali) Rheum Healthcare @ Home 227 Etanercept (Benepali) Rheum Healthcare @ Home 3 Etanercept (Benepali) Derm Healthcare @ Home 21 Interferon Beta 1b (Betaferon) Healthcare @ Home 1 Bronchiestasis LPCH / Baxters 2 Certolizumab (Cimzia) Healthcare @ Home 70 Certolizumab (Cimzia) Healthcare @ Home 1 Colistimethate (Colobreathe) LPCH 0 Glatiramer Acetate (Copaxone) LPCH 15 Secukinumab (Cosentyx) Rheum Healthcare @ Home 58 Secukinumab (Cosentyx) Derm Healthcare @ Home 6 Cystic Fibrosis LPCH / Baxters 30 Etanercept (Enbrel) Rheum Healthcare @ Home 48 Etanercept (Enbrel) Rheum Healthcare @ Home 5 Etanercept (Enbrel) Derm Healthcare @ Home 4 Teriparatide (Forsteo) LPCH 12 Fingolimod (Gilenya) Healthcare @ Home 44 Trastuzumab (Herceptin) Healthcare @ Home 27 HIV Applied Dispensary (H@H) 5 Adalimumab (Humira) Rheum Healthcare @ Home 158 Adalimumab (Humira) Rheum Healthcare @ Home 8 Adalimumab (Humira) Derm Healthcare @ Home 56 Adalimumab (Humira) Derm Healthcare @ Home 10 Adalimumab (Humira) Gastro Healthcare @ Home 135 Ivacaftor (Kalydeco) LPCH 2 Tobramycin (TOBI Podlaer) LPCH 1 Magnesium Infusion Healthcare @ Home 1 Epoetin Beta (Neo-recormon) LPCH 2 Somatropin (Omnitrope) LPCH 15 Abatacept (Orencia) LPCH 17 Peginterferon Beta-1a (Plegridy) Healthcare @ Home 22 Interferon Beta 1a (Rebif) Healthcare @ Home 5 Somatropin (Saizen) Bupa 0 Golimumab (Simponi) Healthcare @ Home 37 Golimumab (Simponi) Healthcare @ Home 1 Pegvisomant (Somavert) LPCH 3 Dimethyl Fumerate (Tecfidera) Healthcare @ Home 24 Tocilizumab (RoActemra) LPCH 66 Tocilizumab (RoActemra) LPCH 4 Ustekinumab (Stelara) Derm Healthcare @ Home 34 Ustekinumab (Stelara) Rheum Healthcare @ Home 2 Ustekinumab (Stelara) Gastro Healthcare @ Home 15 Anakinra (Kineret) Healthcare @ Home 2 Teriflunomide (Aubagio) Healthcare @ Home 2 Normal Immunoglobulin (Hizentra) Alcura 1 Apremilast (Otezla) Derm Healthcare @ Home 32 Apremilast (Otezla) Rheum Healthcare @ Home 13 Alirocumab (Praluent) Healthcare @ Home 34 Evolocumab (Repatha) Fresenius 2 TPN Bupa/Calea/H@H 5 Tofacitinib (Xeljanz) Healthcare @ Home 25 Baracitinib (Olumiant) Healthcare @ Home 49 Lanreotide (Somatuline) Healthcare @ Home 2 Total 1533 Early 2019 DRUG COMPANY Total patients Darbepoetin Alfa (Aranesp) LPCH 163 Interferon Beta 1a (Avonex) Healthcare @ Home 10 Etanercept (Benepali) Rheum Healthcare @ Home 232 Etanercept (Benepali) Rheum Healthcare @ Home 3 Etanercept (Benepali) Derm Healthcare @ Home 21 Interferon Beta 1b (Betaferon) Healthcare @ Home 1 Bronchiestasis LPCH / Baxters 3 Certolizumab (Cimzia) Healthcare @ Home 74 Certolizumab (Cimzia) Healthcare @ Home 1 Colistimethate (Colobreathe) LPCH 0 Glatiramer Acetate (Copaxone) LPCH 15 Secukinumab (Cosentyx) Rheum Healthcare @ Home 56 Secukinumab (Cosentyx) Rheum Healthcare @ Home 1 Secukinumab (Cosentyx) Derm Healthcare @ Home 6 Cystic Fibrosis LPCH / Baxters 35 Etanercept (Enbrel) Rheum Healthcare @ Home 45 Etanercept (Enbrel) Rheum Healthcare @ Home 5 Etanercept (Enbrel) Derm Healthcare @ Home 4 Teriparatide (Forsteo) LPCH 10 Fingolimod (Gilenya) Healthcare @ Home 43 Trastuzumab (Herceptin) Healthcare @ Home 20 HIV Applied Dispensary (H@H) 5 Adalimumab (Humira) Rheum Healthcare @ Home 168 Adalimumab (Humira) Rheum Healthcare @ Home 10 Adalimumab (Humira) Derm Healthcare @ Home 57 Adalimumab (Humira) Derm Healthcare @ Home 10 Adalimumab (Humira) Gastro Healthcare @ Home 160 Ivacaftor (Kalydeco) LPCH 2 Tobramycin (TOBI Podlaer) LPCH 1 Magnesium Infusion Healthcare @ Home 1 Epoetin Beta (Neo-recormon) LPCH 2 Somatropin (Omnitrope) LPCH 15 Abatacept (Orencia) LPCH 16 Abatacept (Orencia) LPCH 1 Peginterferon Beta-1a (Plegridy) Healthcare @ Home 22 Interferon Beta 1a (Rebif) Healthcare @ Home 5 Somatropin (Saizen) Bupa 0 Golimumab (Simponi) Healthcare @ Home 37 Golimumab (Simponi) Healthcare @ Home 1 Pegvisomant (Somavert) LPCH 3 Dimethyl Fumerate (Tecfidera) Healthcare @ Home 23 Tocilizumab (RoActemra) LPCH 65 Tocilizumab (RoActemra) LPCH 5 Ustekinumab (Stelara) Derm Healthcare @ Home 35 Ustekinumab (Stelara) Rheum Healthcare @ Home 2 Ustekinumab (Stelara) Gastro Healthcare @ Home 16 Anakinra (Kineret) Healthcare @ Home 2 Teriflunomide (Aubagio) Healthcare @ Home 2 Normal Immunoglobulin (Hizentra) Alcura 1 Apremilast (Otezla) Derm Healthcare @ Home 32 Apremilast (Otezla) Rheum Healthcare @ Home 13 Alirocumab (Praluent) Healthcare @ Home 34 Evolocumab (Repatha) Fresenius 2 TPN Bupa/Calea/H@H 5 Tofacitinib (Xeljanz) Healthcare @ Home 25 Baracitinib (Olumiant) Healthcare @ Home 54 Lanreotide (Somatuline) Healthcare @ Home 2 Total 1577 Mid 2019 DRUG COMPANY Total Patients Darbepoetin Alfa (Aranesp) LPCH 235 Interferon Beta 1a (Avonex) Healthcare @ Home 8 epoetin beta (Eprex) LPCH 1 Etanercept (Benepali) Rheum Healthcare @ Home 220 Etanercept (Benepali) Rheum Healthcare @ Home 4 Etanercept (Benepali) Derm Healthcare @ Home 20 Interferon Beta 1b (Betaferon) Healthcare @ Home 1 Bronchiestasis LPCH / Baxters 0 Certolizumab (Cimzia) Healthcare @ Home 72 Certolizumab (Cimzia) Healthcare @ Home 1 Colistimethate (Colobreathe) LPCH 0 Glatiramer Acetate (Copaxone) LPCH 21 Secukinumab (Cosentyx) Rheum Healthcare @ Home 57 Secukinumab (Cosentyx) Rheum Healthcare @ Home 1 Secukinumab (Cosentyx) Derm Healthcare @ Home 10 Cystic Fibrosis LPCH / Baxters 35 Etanercept (Enbrel) Rheum Healthcare @ Home 17 Etanercept (Enbrel) Rheum Healthcare @ Home 2 Etanercept (Enbrel)