The challenge
Clinical homecare has quietly supported hundreds of thousands of NHS patients each year, offering safe, high-quality treatment outside of hospitals. Yet its role has been under-recognised and seen as operational rather than strategic. This has meant that the service is largely absent from national policy conversations. There was little awareness of the sector’s scale, the investment made by providers, or the value homecare could offer the wider health and care system.
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The National Clinical Homecare Association (NCHA) asked ZPB to change this narrative. The aim was to create a credible, independent report that would reposition homecare as a vital enabler of healthcare delivery, combining robust evidence with compelling real-world insight to reach system leaders and shape national policy.
What we did
We led a multi-dimensional programme of work that brought together economic analysis, patient experience research, expert insight, and strategic storytelling.
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At the heart of the report was novel economic modelling. Drawing on sector-wide data and national datasets, we developed a cost-benefit model that estimated the total annual value of clinical homecare to the UK health economy at £264 million. Our analysis highlighted:
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The equivalent of 15 NHS Trusts’ worth of elective day-case capacity delivered in patients’ homes
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£43 million in value from improved treatment adherence, based on QALY (quality-adjusted life year) modelling
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22,000 tonnes of COâ‚‚ emissions avoided annually through optimised delivery routes
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Improved access for 75,000+ patients in rural or remote areas, advancing equity and geographic inclusion
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To complement the modelling, we designed and delivered the first national patient experience survey in clinical homecare, including a comparator group of hospital-based patients. The findings demonstrated significantly higher levels of satisfaction, convenience, and ability to maintain employment among those receiving treatment at home.
We also conducted opportunity mapping, using disease prevalence and treatment eligibility data to estimate how clinical homecare could expand in the future. This forward-looking analysis helped shape strategic recommendations for policymakers and providers.
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The content was steered by a senior advisory group of system leaders and refined through a rigorous quality assurance process. The final report was professionally designed to ensure accessibility and impact, and launched alongside a coordinated media and stakeholder engagement campaign.
The impact
The result was Best Kept Secret: The Value of Clinical Homecare to the NHS, Patients and Society, the first report to set out a complete, evidence-led picture of the homecare sector and its untapped potential.
Its impact has been substantial:
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Policy recognition: The report has been cited by NHS England, MPs, the Department of Health and Social Care, ABPI, and the General Pharmaceutical Council. It contributed to the alignment of clinical homecare in the NHS 10 Year Plan.
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Stakeholder engagement: Report downloads exceeded expectations, reaching 185 (target: 150), with over 100 from NHS trusts, commissioners, and policy bodies.
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Media reach: The findings were featured in The Times (print and online, est. reach: 398,180), HSJ, National Health Executive, LaingBuisson and Times Radio — ensuring the campaign reached senior NHS stakeholders and health influencers.
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Strategic influence: The work repositioned the NCHA as a strategic voice in the future of healthcare delivery and opened doors to new conversations at national level.
ZPB continues to support the NCHA in using the report to engage decision-makers, support policy development, and drive lasting change in how care is delivered beyond the hospital.
Award wins and nominations
“We commissioned ZPB to develop a report that would increase understanding of the value of the clinical homecare industry, through new data and insight. ZPB were highly collaborative, ensuring the views and opinions of our member organisations informed the report, with clear opportunities for feedback and input throughout. ZPB’s understanding of the NHS and political landscape was key to positioning our industry in the most impactful way. The Best Kept Secret report delivered on its ambition and continues to be used by senior health policy makers to drive forward use of homecare in the NHS.”
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Chris Carver, NCHA Board Member