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Independent Review of the Management of Controlled Drug Use in ...

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7. Summary Conclusions<br />

The aim <strong>of</strong> this review was to assess <strong>the</strong> arrangements <strong>in</strong> place for <strong>the</strong><br />

management <strong>of</strong> controlled drug use <strong>in</strong> hospitals <strong>in</strong> Nor<strong>the</strong>rn Ireland <strong>in</strong> relation<br />

to regulations put <strong>in</strong> place follow<strong>in</strong>g <strong>the</strong> Fourth Report <strong>of</strong> <strong>the</strong> Shipman Inquiry,<br />

The Regulation <strong>of</strong> <strong>Controlled</strong> <strong>Drug</strong>s <strong>in</strong> <strong>the</strong> Community.<br />

All trusts have appo<strong>in</strong>ted Accountable Officers and it is clear where <strong>the</strong>y fit<br />

<strong>in</strong>to overall trust governance processes. Consideration should be given to a<br />

formal controlled drug report be<strong>in</strong>g provided for each trust board.<br />

All Accountable Officers have received necessary tra<strong>in</strong><strong>in</strong>g.<br />

In two cases <strong>the</strong> Accountable Officers considered that appo<strong>in</strong>tment <strong>of</strong> a<br />

designated <strong>of</strong>ficer was needed <strong>in</strong> order for <strong>the</strong>m to fully discharge <strong>the</strong>ir<br />

responsibilities <strong>in</strong> relation to controlled drugs.<br />

There was good awareness <strong>of</strong> <strong>the</strong> role <strong>of</strong> <strong>the</strong> Accountable Officer among<br />

senior trust staff and with<strong>in</strong> pharmacy staff. However, awareness should be<br />

improved among ward staff and junior medical staff and this could be<br />

addressed through tra<strong>in</strong><strong>in</strong>g.<br />

Robust <strong>in</strong>cident report<strong>in</strong>g mechanisms were <strong>in</strong> place, and trusts provided<br />

examples <strong>of</strong> <strong>in</strong>cidents <strong>in</strong>volv<strong>in</strong>g controlled drugs that had been identified and<br />

dealt with appropriately. In all trusts a large proportion <strong>of</strong> <strong>in</strong>cidents <strong>in</strong>volved<br />

Schedule 3, 4 and 5 drugs. All trusts were aware <strong>of</strong> <strong>the</strong> need for <strong>in</strong>creased<br />

monitor<strong>in</strong>g <strong>in</strong> <strong>the</strong>se areas. Trusts should also consider <strong>the</strong> need for fur<strong>the</strong>r<br />

awareness tra<strong>in</strong><strong>in</strong>g for staff <strong>in</strong> <strong>the</strong> potential for abuse <strong>of</strong> controlled drugs.<br />

All trusts had developed detailed standard operat<strong>in</strong>g procedures for<br />

management <strong>of</strong> controlled drugs <strong>in</strong> pharmacies. All trusts, with <strong>the</strong> exception<br />

<strong>of</strong> <strong>the</strong> Nor<strong>the</strong>rn Trust, had developed detailed standard operat<strong>in</strong>g procedures<br />

for use <strong>in</strong> wards that use controlled drugs. The Nor<strong>the</strong>rn Trust was <strong>in</strong> <strong>the</strong><br />

process <strong>of</strong> develop<strong>in</strong>g its ward procedures.<br />

All trusts had systems for monitor<strong>in</strong>g and audit<strong>in</strong>g <strong>of</strong> controlled drug use.<br />

All trusts had developed medic<strong>in</strong>es management tra<strong>in</strong><strong>in</strong>g programmes for<br />

staff, which conta<strong>in</strong>ed modules regard<strong>in</strong>g use <strong>of</strong> controlled drugs. These<br />

sections should <strong>in</strong> future have more emphasis with<strong>in</strong> <strong>the</strong> total programme <strong>of</strong><br />

medic<strong>in</strong>es management. It was clear that <strong>in</strong> those wards with a designated<br />

pharmacist, awareness and tra<strong>in</strong><strong>in</strong>g <strong>in</strong> <strong>the</strong> area <strong>of</strong> controlled drug<br />

management were <strong>of</strong> a high standard.<br />

Systems to assure <strong>the</strong> security <strong>of</strong> controlled drugs were robust at both<br />

pharmacy and ward level and <strong>the</strong>re were also robust systems <strong>in</strong> place to<br />

assure <strong>the</strong> security <strong>of</strong> controlled drugs on transport to hospitals that did not<br />

have <strong>the</strong>ir own pharmacy.<br />

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