1. Homecare Medicines ‘Towards a Vision for the Future’ – Taking Forward the Recommendations Final Report Mark Hackett Chairman of the Homecare Medicines Strategy Board and CEO University Hospital North Staffordshire

2. Outline Brief recap on background Governance, RPS Standards & Toolkit Systems outcomes, Short term and Long term Procurement guidelines Moving forward

3. Re-Cap Progress update provided at PDIG 6 th June delivered by Howard Stokoe - Project overview including Objectives - Progress summary of work streams Homecare Medicine’s still has limelight and focus Moving towards new policy ownership within NHS England Savings are still a reality if implemented properly more so now than ever The work this project has delivered is just the start, and is an enabler for hospitals to implement or improve Homecare Medicine services

4. Governance, RPS Standards and Toolkit - With thanks to Martin Stephens for delivery of the Governance and Patient Charter products - With thanks to Carol McCall NCHA, Ray Stephens and the RPS for delivery of the Standards - Governance guidelines and patient charter to be available with the first tranche of the toolkit - Toolkit will be in continuous development and owned by the NHMC – Chair Allan Karr - Toolkit and standards will be made available on line - All tools and products will be editable with own branding Spring 2013Summer 2013Autumn 2013Autumn/Winter 2013/14 Governance guidelines produced – awaiting formal approval Standards delivered and RPS accredited – In circulation Toolkit in development with first tranche expected to be made formally available by December 2013 Patient charter produced – awaiting formal approval

5. Systems - With thanks to Andy Alldred and Andrew Davies for delivery of the work stream and key products -Following a very successful requirements capture event last year the work stream was able to define a number of short term solutions which are available in the report -Longer term system enhancements have been articulated and the work stream are currently developing the business case to take this work forward Spring 2013Summer 2013Autumn 2013Autumn/Winter 2013/14 Output based specification document produced highlighting required system enhancement Business case development Short term recommendations made that can be adopted straight away

6. Procurement With thanks to CMU, industry groups and nhs procurement pharmacists for developing this work stream -Agreement with ABPI and NCHA to share detail of industry lead service level agreements -Joint work to develop generic service specification to add to toolkit -Recommendations in autumn 2013 for levels of procurement intervention -Recommendations for ensuring competitive market for supply of home care medicines Spring 2013Summer 2013Autumn 2013Autumn/Winter 2013/14 - Development of nationally agreed KPIs for inclusion in handbook - Agreement to share non commercial details of manufacturer derived SLAs Discussion to determine levels of procurement by therapy group - Recommendations on levels of procurement finalised - CMU website updated to provide visibility of manufacturer derived SLAs - Revised generic service specification published

7. Moving Forward – Opportunities - Market Robustness -Open and transparent SLA’s -More effective provider contract management - Comprehensive cost transparency - Gain-share -PbR excluded drugs in 2011 accounted for somewhere in the region of £2.6b (of that Homecare Medicines is estimated £1b) -There should be clear, up front agreements on the share of financial savings with both commissioners and providers - Process Efficiencies -Greater patient choice – a number of options -Operating more cost effective processes -Making available hospital resources

8. Realising the benefits gained Savings made on the drug Further savings are created at provider level Savings could be further shared with strategic commissioning / or made as a contribution in achieving NHS savings targets Provider shares the saving with the Commissioner Provider uses some of that gained capital to initiate/increase/improve the use of Homecare Medicine services Process becomes more efficient: - Patient has more choice - The process costs the hospital less to operate - The hospital achieves VAT relief on the drugs/service

9. What should Providers do now? Assess current volume of homecare medicine operations Assess current practise against The RPS Standards The short term systems improvement recommendations Implement improvement plans Implement governance procedures Agree how savings will be captured and realised with regional commissioner through uplift of Homecare Medicine Baseline further opportunities to increase Homecare Medicine’s services

10. With thanks … NameOrganisationWork stream Chris TheakerCommercial Medicines Unit – DHProcurement Andrew AllredHarrogate and District NHS Foundation TrustSystems Ray FitzpatrickRoyal Wolverhampton Hospitals NHS TrustStandards Kim GayLeeds Teaching Hospitals TrustNA – Finance Clare HowardNHS EnglandGain share Martin StephensUniversity Hospital Southampton NHS Foundation TrustPatient Choice and Governance Howard StokoeCommercial Medicines Unit - DHProcurement Carole McCallNational Clinical Homecare Association (former)Standards Samantha OgdenABPI Nick PayneNational Clinical Homecare Association (former) Mark CartwrightBritish Generic Manufactures Association Allan KarrNational Homecare Medicine Committee (Chair)Toolkit