HPN homecare in England

National tender for Home Parenteral Nutrition (HPN) Services in England (adults and children)

Outline of home parenteral nutrition (HPN) homecare

HPN care is the process through which feeds and fluids are provided directly to patients at home, along with any care that may be needed to administer feeds/fluids safely. The NHS has provided HPN for many years, albeit through different processes across England as each local NHS region has until now made its own decisions regarding the best way for care to be provided.

The need for change

Following a review of the provision of HPN it became evident that while services were good there was a need for all companies providing homecare to patients to improve in certain areas.

An in-depth national tender was undertaken where all companies wishing to provide homecare to HPN patients in England applied and were taken through a rigorous process. Each was required to meet a number of quality standards, the outcome was that six companies were approved to provide HPN services in England (adults and children).

How will I know what is meant to be happening?

During this process it became clear that those on the receiving end of this service should be able to measure the service being provided. A Patients Homecare Charter is being produced so you can see the standards that homecare supplies must meet. You too have a role to play in relation, to your or your child s, homecare so the charter will outline important information from both perspectives. We will update you when the charter is ready.

How will this affect me?

Many of you will not be aware of any changes as a result of the national tender process. However we are aware that some of you noticed changes during the initial introduction period. We recommended then that any unexpected changes you saw were reported to your healthcare professionals/nutrition team. This advice still stands; anything unfamiliar to you must be reported as soon after the event a possible. Your own healthcare professionals/nutrition team are responsible for all decisions relating to your homecare and not the homecare company.

As already stated no aspect of your, or your child s, homecare should change without your knowing in advance. Under the terms of the framework there is flexibility for the individual needs of each patient. The stock/ancillaries, feeds, pump, deliveries, etc should not change; however, where improvements in the provision of the service have been applied, changes may occur but you will be notified.

Stock (ancillaries) there is no need to fill your house with large volumes of stock items. A regular and appropriate flow of stock should arrive with you at timely intervals. If you find yourself worrying about low or no buffer stock then please contact your own healthcare professionals/nutrition team.

Feeds (PN) this should not change unless for medical reasons the PN prescription changes. If you notice a change in the PN bag itself and were not aware of the change or have any problems physically using a PN bag do let your healthcare professionals/nutrition team know.

Pump your healthcare professionals/nutrition will decide which pump you will use. It is a clinical not a corporate decision. Different people may have different requirements due to lifestyle choices or abilities. All pumps that have been accessed by LITRE are part of the framework and must be supplied in line with your healthcare professionals/nutrition team s instructions.

Deliveries you should be seeing a regular driver along with notification of expected deliveries.

Holidays/travelling away from home before making any holiday/travel arrangements you should enquire as to the holiday service your homecare company has in place. You may be able to locate this information in the patient manual/information they provide you with. Depending on what you will be asking them to do permission may be necessary from your healthcare professionals/nutrition team if there is a change from your normal homecare package, extra delivery or stock/ancillaries …. Remember to consider your usual delivery during any travel plans.

Pharmacy fridge this is possibly one of the significant changes patients will see. While domestic fridges are adequate a pharmacy fridge is designed to keep PN in the right environment maintaining an even and more accurate temperature throughout the fridge. Should a problem arise with the fridge then this can be detected straight away.

What else could change?

Some patients may change companies; it may be better for some patients to be with another company due to their personal needs. Nothing should change without you being informed, you may even be part of the decision making. Where a change of company is deemed necessary full written information will be provided to you in advance of any changes being made. You must have a complete understanding of how and when changes will take place.

We know that many patients are extremely happy with the HPN service they receive and this should not change. The national procurement exercise aims to ensure that all key aspects of good quality HPN care remain and to make that care available for all patients across England.

Finding out more about your own homecare

The best place for you to get information about your own homecare is from your own healthcare professional/nutrition team/consultant.


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