Medicines Management Policy - Dudley Primary Care Trust

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10. Controlled Drugs (CDs) NB Accountability for the use of controlled drugs rests with the Accountable Officer for the PCT (currently the Specialist in Pharmaceutical Public Health) 10.1 Who can prescribe controlled drugs All medical prescribers can prescribe schedule 2, 3, 4 and 5 CDs. Following agreement by the Home Office’s Advisory Council on the Misuse of Drugs (ACMD), changes to regulations on 1 May 2006 enable nurse independent prescribing of some CDs. Nurse Independent Prescribers can prescribe some CDs independently, but only for specific conditions. These include diamorphine and morphine for palliative care and post-operative pain relief. A list of these CDs and medical conditions is contained in the Drug Tariff (see part XVIIbii) and also in the BNF. For further information visit www.ppa.org and www.bnf.org.uk . Nurse Independent Prescribers are also able to prescribe lower strength Pharmacy (P) and General Sales List (GSL) medicines containing codeine phosphate and dihydrocodeine tartrate. Community Practitioners and Pharmacist Independent Prescribers cannot at present prescribe CDs independently. All supplementary prescribers are able to prescribe any CD provided it is listed in the clinical management plan. Controlled drug schedules are as follows: Schedule 1 (CD licence) • Have no recognised medicinal use and include hallucinogenic drugs. • Examples include coca leaf, LSD and mescaline. • Production, possession and supply of these drugs are limited to research or other special purposes. • Practitioners and pharmacists may not lawfully possess Schedule 1 drugs except under licence. Schedule 2 (CD) • Includes the opiates, secobarbital, amphetamine and cocaine. 28
• Are subject to safe custody requirements and so must be stored in a locked receptacle, usually in an appropriate CD cabinet or approved safe, which can only be opened by the person in lawful possession of the CD or a person authorised by that person. • A licence is required to import or export drugs in Schedule 2. • The drug may be administered to a patient by a doctor or dentist, or by any person acting in accordance with the directions of a doctor or dentist. • A register must be kept for Schedule 2 CDs and this register must comply with the relevant regulations. • The destruction of CDs in Schedule 2 must be appropriately authorised and the person witnessing the destruction must be authorised to do so. • Are subject to handwriting requirements as in 10.3.1 Schedule 3 (CD No Register) • Includes a small number of minor stimulant drugs and other drugs which are less likely to be misused than the drugs in Schedule 2. • Are exempt from safe custody requirements and can be stored on the open dispensary shelf except for temazepam, buprenorphine and diethylpropion, which must be stored in a locked CD receptacle. • Are subject to the same special handwriting requirements as Schedule 2 CDs, except for temazepam and phenobarbital. Phenobarbital and temazepam can be dispensed in response to a computer-generated prescription but the prescriber's signature must be added by hand. • There is no legal requirement to record transactions in a CD register. • The requirements relating to destruction do not apply unless the CDs are manufactured by the individual. • Invoices must be retained for a minimum of two years. Schedule 4 (CD Benzodiazepines and CD Anabolic steroids) • Are exempt from safe custody requirements, with destruction requirements only applying to importers, exporters and manufacturers. • Specific CD prescription-writing requirements do not apply. • CD registers do not need to be kept, although records should be kept if such CDs are produced, or if a licensed person imports or exports such drugs. o Part 1 (CD Benzodiazepines): 29
Page 1 and 2: Medicines Management Policy Documen
Page 3 and 4: CONTENTS Section Page 1. Introducti
Page 5 and 6: 1. Introduction This policy deals w
Page 7 and 8: 2. Prescribing of medicines 2.1 Int
Page 9 and 10: Nurse and Pharmacist Independent Pr
Page 11 and 12: 2.7.1 Clarity The prescription form
Page 13 and 14: 2.7.8 Recognised abbreviations Only
Page 15 and 16: 3. Supply of prescription Pads N.B.
Page 17 and 18: 4.0 Security and Safe Handling of P
Page 19 and 20: 6. Transport of Medicines 6.1 All m
Page 21 and 22: 7.7 All medicines shall be returned
Page 23 and 24: 8. Responsibilities of the person a
Page 25 and 26: vi) vii) viii) ix) The drug is bein
Page 27: • Insulin injections by District
Page 31 and 32: 10.3 Prescribing Controlled Drugs 1
Page 33 and 34: 10.5.2 Stock held at PCT premises o
Page 35 and 36: 11. Management of errors or inciden
Page 37 and 38: 12. Verbal orders for the Administr
Page 39 and 40: 14 Alcohol 14.1 Patient/client unde
Page 41 and 42: may imply dealing, as breach of con
Page 43 and 44: 17. General Notes on the Handling o
Page 45 and 46: 19. Compliance aids All compliance
Page 47 and 48: 21. Syringe Drivers Please refer to
Page 49 and 50: 23. Prescribing of Oxygen Please re
Page 51 and 52: This policy was produced by Special

Medicines Management Policy - Dudley Primary Care Trust

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