Private firms harming NHS patients by failing to deliver medicines, Lords report warns
Private healthcare companies are harming NHS patients in their own homes by failing to supply essential medicines, then escaping censorship amid an alarming lack of oversight from ministers and regulators, members of the House of Lords have warned.
More than 500,000 patients and their families rely on private companies paid by the NHS to deliver essential medical supplies, medicines and healthcare to their homes. The home care pharmaceutical services sector is estimated to be worth billions of pounds.
A report from the Lords Public Services Committee says patients are suffering harm due to “real and serious problems” with services provided by for-profit companies. The lack of one person or organization with overall control or oversight of the sector means poor performance goes unchecked, the report says.
The 44-page report, published on Thursday, does not name any companies, but it comes after an investigation by The Guardian revealed how patients were repeatedly harmed by failed, delayed or missed deliveries of medicines by the largest companies in the sector. supplier, Sciensus.
“There are serious problems with the way services are delivered,” the Lords report says. “Some patients experience delays, receive the wrong medicine or do not learn how to administer their medicine. (This) can have serious consequences for the health of patients, sometimes requiring hospital care. This leaves NHS staff either trying to extinguish the problems caused by problems in home care medicines, or assuming that those services will fail.”
The report also confirms The Guardian’s reporting that the failure to provide adequate services is ‘so serious or so predictable’ that NHS doctors often feel compelled to intervene to ensure patient safety.
“The taxpayer is effectively paying for the service twice: once for the private provider to deliver it, and again for the NHS to pick up the pieces where private providers fail,” the report said.
Ministers have no idea how much is paid to private companies to supply home care medicines and therefore cannot assess value for money, the report said. Given that this figure is likely to amount to billions of pounds per year, this lack of awareness is ‘shocking’ and ‘completely unacceptable’.
The Guardian has previously revealed how patients who were already seriously ill became sicker due to the failings of Sciensus, Britain’s largest private provider of home care medicines. Watchdogs had been notified of shortcomings but had failed to act.
Colleagues confirmed that they too had discovered “irreconcilable differences” between how NHS patients and doctors viewed the quality of home care medicines and how regulators viewed it.
The committee said it was convinced by the “weight of evidence” that “real and serious problems” existed in the sector. Witnesses described a “toothless enforcement culture,” the report said.
The report describes distressing cases of harm to patients as a result of failing drug services in home care, including irreversible joint damage, skin and eye problems and abdominal pain. In some cases, patients abandoned by private healthcare providers ended up in emergency rooms. Others required surgery on the NHS.
Estelle Morris, the committee’s chair, said: “The system has become a broken and complex mess, with no individual or body named having overall responsibility for defining and ensuring performance across the sector. It is not even possible to assess performance at the moment: no one is publishing data.”
Despite clear failures by private healthcare providers, many NHS patients were left “in the dark”, she added, as watchdogs had failed to hold for-profit companies to account.
“The regulators in this sector are weak,” Lady Morris said. “We saw a hands-off approach where no supervisor wanted to look too closely at performance and no one was in charge.”
She said: “Accountability in the provision of home care medicines is crucial and someone needs to get to grips with the whole system and have the responsibility to get things right.”
The committee’s report calls for an independent review of the sector and for the government to urgently appoint an individual to take the lead and take responsibility for home care medicine services.
NHS England must identify how many patients have been harmed by these failures and develop and implement a consistent set of performance metrics.
“Most of our recommendations can and should be implemented quickly,” Morris said.
Sarah Campbell, the chief executive of the British Society for Rheumatology, said the report confirmed the experiences of its members and patients, and she called for all recommendations to be adopted immediately.
“The chaotic and disjointed nature of the home care system has been clearly highlighted and the voices of patients and doctors have finally been heard,” she said.
Ruth Wakeman, director of the charity Crohn’s & Colitis UK, said the report’s recommendations were “an important step forward in improving the accountability and quality of medicines services in home care”.
She said: “We have long been calling for a complete overhaul of home care medicines. Patients have told us about their dire need and the harm caused by the poor quality of their home care services.”
An NHS spokesperson said: “The committee is right to say that home care services can reduce pressure on hospitals and the wider NHS, and while many services work well, the NHS is working with trusts, regulators and commercial providers to deliver safe, effective and efficient home care for patients.
“We have already taken steps towards appointing a single responsible officer for home care services, who will be supported by the National Medicines Commission for Home Care to make measurable improvements in the performance of home care services across the country.”