Sciensus, previously known as Healthcare at Home, is a provider of out-of-hospital healthcare, this can be at home, at work, or in the community. It operates through working with three kinds of provider: public, pharmaceutical companies, and private companies. It employs 1700 staff throughout the UK, including more than 500 clinicians across the UK. The company supports in excess of 200,000 patients every year across 49 therapy areas and 450 chemotherapy regimes.
Last updated: January 2024
Strategy
In July 2021 the company underwent a rebrand - changing its name to Sciensus - which according to the company better reflects its "forward-thinking approach, which aims to harness new digital technology and patient insight to provide patients with more knowledge, more choice and greater convenience."
Sciensus, as Healthcare at Home, began as a supplier of pharmaceutical products to patients in their own homes. In 2013 Healthcare at Home took over the business of drug delivery company, Medco Health Solutions when it pulled out of the UK market. The company has evolved to carry out more than just drug delivery.
The company's strategy is to capitalise off the growing market for intermediate/complex care. This strategy is twofold: to further develop existing expertise in providing medication-related home health care services; and to expand provision of large-scale, clinically-lead services to the NHS and private sector. Their strategic report specifically points out how “the pressure on public finances and the drive to move patient care towards the community setting are both continuing”, which puts them in a secure position.
In 2020, Sciensus set up Sciensus Rare focused on rare disease. Sciensus Rare will be involved with clinical trials at home, access to medicines, supply chain management, patient and family support and outcome monitoring.
They work with 48 pharmaceutical companies to provide their products to the 98,000 patients they support. With private providers they act as a subcontractor to directly provide clinical services to patients including: physiotherapy, occupational health, chemotherapy, IV antibiotics, enteral feeding, and palliative care.
Financials
According to the latest filed accounts at Companies House, Sciensus Pharma Services Ltd (Company No. 02759609) reported revenue for the year to 31 March 2023 of £1,647 million (2022 £1,508.7 million), resulting in a post-tax profit of £10.4 million (2022: £12.4 million).
Investors
Sciensus is a subsidiary of Halcyon Topco. Over 75% of Halcyon’s shares, however, are owned by Vitruvian Partners Llp, a European private equity firm.
Contracts
Sciensus notes on its website that it has relationships with every acute Trust in the UK and is one 37 regional and national frameworks. The company is on the NHS Framework agreements for Pharmacy Dispensing and Delivery Services and for Home Delivery of Intravenous and Subcutaneous Immunoglobulin. The company is the leading deliverer of pharmaceutical products to NHS patients at home.
Pharmacy Homecare Services
In June 2017, the Royal Devon and Exeter NHS Foundation Trust commissioned two contracts for pharmacy homecare services: one for "high tech", worth £22,000,000; and one for "mid and low tech", worth £200,500,000. Out of the total £222,500,000, Healthcare at Home received £211,400,000.
Concerns
Enforcement actions and Violation Tracker
Using the website Violation Tracker, a UK wide database of enforcement actions brought against companies by government regulators in England, Scotland, Wales and Northern Ireland, as of January 2023, Sciensus has 3 enforcement actions from 2016-2022. The database is readily accessible and can be searched by the public for up to date information on enforcement actions.
Safety concerns
In April 2023, The Guardian reported on a four-month investigation into Sciensus, as a result the CQC launched a review of serious and significant concerns raised by patients, clinicians and health groups.
The investigation heard from patients about delayed or missed deliveries of medication to their homes. In some instances, their health suffers as a result, according to clinicians. Other patients say they have become anxious and distressed, and expressed concern about the impact of delivery problems on their long-term health. Some say their frustration is compounded by struggles they face in reaching Sciensus to complain.
The Medicines and Healthcare products Regulatory Agency (MHRA) partially suspended the company’s licence in July 2023 for a period of three months and then for a further nine months because the deficiencies had not yet been fully resolved.
A complaint to the CQC in November 2022 showed that a number of NHS staff have accused Sciensus of not delivering medicines to patients when it was scheduled to do so, and in some cases providing incorrect medication. They also raised concerns with the regulator about missing paperwork and Sciensus not responding to calls or emails. Others raised concerns about lengthy waits for new patients to start having medication delivered. Some waited more than six months, according to the complaint. Hundreds of people have posted negative reviews of Sciensus on the Trustpilot and NHS websites.
The Guardian investigation plus numerous complaints to the CQC triggered an investigation by the House of Lords Public Services Committee. The committee's November 2023 report concluded that patients are coming to serious harm by a lack of regulation of the private companies in the homecare medicines sector. Not only are patients being harmed, but the lack of transparency in contracts and procurement means nobody knows how much the companies are being paid, despite it being billions of pounds, which the Lords described as “shocking and entirely unacceptable.”
In a recent investigation of the business by the Pharmaceutical Journal, 32 trusts recorded 417 patient safety incidents relating to homecare medicines services provided to 96,846 patients during their most recent monthly reporting period, which ranged from May to July 2023. Sciensus was responsible for 66% of these incidents (277), although it provided homecare medicines to fewer than half (44%) of the patients covered in the data.
There have been concerns about Sciensus for some time. In 2021 Healthcare at Home's services were rated "inadequate" and the service was placed in special measures. A report by the CQC found that patients had come to avoidable harm after the company had failed to deliver thousands of medicine prescriptions. The report published in May 2021 said that inspectors found more than 10,000 patients missed a dose of their medicine between October and December 2020 due to problems caused by the introduction of a new information system. Reviews have found some suffered avoidable harm as a result.
The report added: “Some patients’ conditions deteriorated and they had to be admitted to hospital, whilst others experienced psychological trauma because of the uncertainty of not knowing when they would receive their essential medicines.”
Between April and October 2020 there were more than 13,000 incidents involving a missed dose of medicine. The CQC said not all of these resulted in patient harm or were attributed to the provider, but the provider was unable to demonstrate all of the patients had been reviewed.
In 2014 Healthcare at Home was bombarded with complaints over its home delivery of essential prescriptions to NHS patients. The largest issue was its failure to deliver all medications - some life-saving - on time. Problems emerged after Healthcare at Home switched from using an in-house delivery service to Movianto: an American logistics firm operating throughout Europe. When Movianto’s IT systems failed many patients were left without deliveries. The company was investigated by the regulator.
Delivery issues appeared again in 2017, with patients not receiving vital medicines and phone calls not being returned.
