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

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7. Summary Conclusions The aim of this review was to assess the arrangements in place for the management of controlled drug use in hospitals in Northern Ireland in relation to regulations put in place following the Fourth Report of the Shipman Inquiry, The Regulation of Controlled Drugs in the Community. All trusts have appointed Accountable Officers and it is clear where they fit into overall trust governance processes. Consideration should be given to a formal controlled drug report being provided for each trust board. All Accountable Officers have received necessary training. In two cases the Accountable Officers considered that appointment of a designated officer was needed in order for them to fully discharge their responsibilities in relation to controlled drugs. There was good awareness of the role of the Accountable Officer among senior trust staff and within pharmacy staff. However, awareness should be improved among ward staff and junior medical staff and this could be addressed through training. Robust incident reporting mechanisms were in place, and trusts provided examples of incidents involving controlled drugs that had been identified and dealt with appropriately. In all trusts a large proportion of incidents involved Schedule 3, 4 and 5 drugs. All trusts were aware of the need for increased monitoring in these areas. Trusts should also consider the need for further awareness training for staff in the potential for abuse of controlled drugs. All trusts had developed detailed standard operating procedures for management of controlled drugs in pharmacies. All trusts, with the exception of the Northern Trust, had developed detailed standard operating procedures for use in wards that use controlled drugs. The Northern Trust was in the process of developing its ward procedures. All trusts had systems for monitoring and auditing of controlled drug use. All trusts had developed medicines management training programmes for staff, which contained modules regarding use of controlled drugs. These sections should in future have more emphasis within the total programme of medicines management. It was clear that in those wards with a designated pharmacist, awareness and training in the area of controlled drug management were of a high standard. Systems to assure the security of controlled drugs were robust at both pharmacy and ward level and there were also robust systems in place to assure the security of controlled drugs on transport to hospitals that did not have their own pharmacy. 36
Members of the LIN have reported and the review team agreed that practice has improved as a result of the ability to share information regarding use and possible abuse of controlled drugs. RQIA considers that following the Fourth Shipman report, The Regulation of Controlled Drugs in the Community, robust systems have now been put into place for the management and use of controlled drugs in hospitals in Northern Ireland. 37
Page 1: The Regulation and Quality Improvem
Page 5 and 6: Table of Contents Membership of the
Page 7 and 8: Membership of the Review Team Gilli
Page 9 and 10: 2. Introduction and Background 2.1
Page 11 and 12: Safer Management of Controlled Drug
Page 13 and 14: and pre-arranged inspections, follo
Page 15 and 16: 3. Terms of Reference 1. To assess
Page 17 and 18: 4. Methodology Key stages of the re
Page 19 and 20: Downe Hospital; Lagan Valley Hospit
Page 21 and 22: 6. Findings 6.1 Term of Reference O
Page 23 and 24: During ward inspections, staff know
Page 25 and 26: 6.1.5 Monitoring and Auditing of Co
Page 27 and 28: Recommendation 7 Trusts should cons
Page 29 and 30: In the Belfast Trust, the controlle
Page 31 and 32: 6.2 Term of Reference Two To assess
Page 33 and 34: disposal. Where hospitals have a fo
Page 35 and 36: On receipt of a controlled drug at
Page 37 and 38: and pharmacy from which the drug wa
Page 39 and 40: collaborate with cross-border group
Page 41: 6.4.3 Conclusion Responses from all
Page 45 and 46: Recommendation 12 Trusts should con

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

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