On 14th April 2016 NICE published NICE Guidance (NG46) “Controlled drugs: safe use and management”.
This guideline covers systems and processes for using and managing controlled drugs safely in all NHS settings except care homes. It aims to improve working practices to comply with legislation and have robust governance arrangements. It also aims to reduce the safety risks associated with controlled drugs.
NECS Medicines Optimisation team will be producing a briefing document on the guidance including implications for CCGs, provider services and GP practices. This will be available on this website on May 26th 2016.
Controlled Drugs: Learning from Incidents February 2016
Included in this bulletin:
- Medicines for palliative care
- What to do with unused medicines when a patient dies
On 30 November 2015 health professionals obtaining supplies of schedule 2 and schedule 3 controlled drugs in the community must use a mandatory requisition form.
The requirement to use the mandatory form applies to the professionals listed:
- A practitioner
- A person who is in charge of a laboratory
- The owner of a ship, or the master of a ship which does not carry a doctor among the seamen employed in it
- The master of a foreign ship in a port in Great Britain
- The installation manager of an offshore installation
- The person in charge or acting person in charge of an organisation providing ambulance
The form must be used only when stocks of the relevant controlled drugs are to be obtained in the community, including from wholesalers but outside settings such as hospitals where supply to wards are governed by different provisions. The scope of the form includes pharmacy to pharmacy transfer of stocks.
Professionals can complete the form online or download onto local drives prior to the form being completed, printed and signed in wet ink. However, the form is designed to reset anytime it is saved with added data to prevent confidential details of requisitioners falling into the wrong hands. The form also has an in-built security mechanism which generates a unique code when completed electronically. This facility is not available for forms that are printed blank.
Please note: All GP practices including dispensing doctors will now have to use the new requisition forms when ordering from a wholesaler, however community pharmacies don’t. All practices that have previously used a wholesaler to order CD’s should have been supplying a signed order but this didn’t have to be the requisition form.
The new approved requisition form, in electronic format, is available here.
The supplier must then submit all CD requisitions they have processed to the NHS Business Services Authority on a monthly basis, using the FP34PCD form which should be downloaded from the NHS BSA website.
New wording for instalment prescribing
Additionally, the Home Office has approved new wording for instalment prescribing. The new wording can be used immediately and can also be ‘mixed and matched’ to express the prescriber’s intention. However, as usual, where this intention is not clear it may be necessary, subject to the professional judgment of pharmacy teams and dispensers, to contact the prescriber. The new wording may be found at Annex A of the Home Office Circular (027/2015).
From 1st June 2015
The current prescription writing exemption applicable to temazepam prescriptions will cease and therefore all temazepam prescriptions will be required to meet full prescription writing requirements as for any other Schedule 2 or 3 controlled drugs.
- The quantity prescribed must be written in words and figures, e.g. 28 (twenty eight)
- The quantity should not exceed 30 days’ supply, unless in exceptional circumstances (as with all other controlled drugs).
- The prescription must clearly state the form (e.g. tablets, capsules), strength and dose. The dose must be as specific as possible; ‘Take one as directed’ is acceptable however ‘Take as directed’ is not.
- Any instalment directions (on an FP10MDA prescription) must include the amount to be supplied and the interval to be observed between supplies, e.g. Supply 7 tablets every Monday
We understand that the necessary changes to practice computer systems will be made remotely by the system suppliers. We are also seeking details with respect to how pharmacies will be advised to process any temazepam prescriptions written in advance of 1st June 2015 (any relevant further information will follow).
Further information can be obtained from the following link:
From 1st July 2015
Although the regulations will be amended to permit the electronic prescribing of Schedule 2 and 3 controlled drugs where Electronic Prescribing System (EPS) is used, the current EPS message format cannot support the inclusion of words and figures and this will therefore require a change to the EPS specification. Once this work is completed, prescribing and dispensing system suppliers will be able to make the necessary technical adjustments to their software to enable electronic transfer of Schedule 2 and 3 controlled drugs. Further updates will follow in due course.