Intended for healthcare professionals


Safety of medicines delivered by homecare companies

BMJ 2018; 361 doi: (Published 22 May 2018) Cite this as: BMJ 2018;361:k2201
  1. Anthony Matthews, research fellow in statistical epidemiology1,
  2. Liam J Donaldson, professor of public health1,
  3. Stephen J Evans, professor of pharmacoepidemiology1,
  4. Sinéad M Langan, associate professor1
  1. 1Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to: A Matthews anthony.matthews{at}

Inadequate surveillance threatens patient safety and public health

Delivery of specialised medicines through homecare companies can help transform the lives of those with conditions requiring regular treatment and monitoring.1 However, the scope and quality of surveillance of medicines delivered in this way in the UK are currently not good enough to provide the protection that patients should expect.

The two routes through which NHS patients have traditionally received medicines are hospital based specialist services and primary care. In the mid-1990s, the UK government opened up a third route, homecare services, to supply medicines directly to patients with long term conditions such as multiple sclerosis, or those requiring complex treatments such as peritoneal renal replacement therapy. NHS hospital doctors prescribe these medications, but they are delivered and sometimes administered directly to patients at home by commercial homecare providers rather than the patient making regular trips to the hospital or collecting them …

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