Question to the Department of Health and Social Care:

To ask His Majesty's Government whether Market Authorisation Holders set different (1) Key Performance Indicator measurements, and (2) clinical pathways, for the same therapy.

Marketing Authorisation Holders (MAHs) are encouraged to use the national Key Performance Indicators (KPIs) published in the Royal Pharmaceutical Homecare Services Handbook 2014 in their contracts with homecare providers. MAHs may also use additional or alternative specific KPIs where they consider this necessary. Neither NHS England nor National Health Service trusts are directly party to those contracts between MAHs and homecare providers, and therefore do not have visibility of the KPIs agreed in each case.

The treatment choice is determined by the clinician in the hospital trust in conversation with the patient, based on the best available evidence and cost-effectiveness aligned to national and local guidance where available. The homecare medicines service provider is contracted to undertake supply and delivery, and administration in some cases. The homecare medicines service provider does not determine the clinical pathway.