The safer management of Controlled Drugs – CQC Annual Update

 In Clinical Guidelines, Medicines Management Processes, NICE guidelines

Each year, the Care Quality Commission (CQC) publishes a report on the management of Controlled Drugs in England. Good practice and issues relating to Controlled Drugs are shared by the CQC with other UK agencies and consequently this report has national relevance.

The CQC has made four key recommendations:

  • GPs should be informed when CDs are prescribed so that they have an overview of all their patient’s medication to improve safety
  • Commissioners should be aware of the responsibilities and governance arrangements for CDs, particularly for new services
  • Healthcare professionals should be aware of and vigilant about security risks, such as loss of personal identification (e.g. badges or passwords) and report losses to help prevent fraud
  • Controlled drugs in Schedules 4 and 5, such as benzodiazepines and dihydrocodeine, should also be monitored to reduce the risk of theft.

Ashtons produces the Record of Drugs Liable for Misuse (DLMs) book, which is specially designed for monitoring any medicines which may be misused, and this is ideally suited for recording Schedule 4 and 5 Controlled Drugs. The DLM Report is also available from Ashtons and this enables managers to keep track of what has been ordered and therefore assists monitoring. Ashtons also provides a CD Register for the statutory recording of Schedule 2 CDs.

Advice on managing Controlled Drugs is provided by NICE guidance [NG46] and the CQC expect organisations to have procedures for reporting and acting on incidents relating to CDs appropriately (via their Accountable Officer) and to disseminate safety alerts.

Following concerns, recently publicised, that patients at Gosport War Memorial Hospital were prescribed opioids ‘without medical justification’ in the 1980s and 1990s, resulting in increased patient mortality, the CQC recommends that services should incorporate self-assessment and clinical audit into their Controlled Drug governance and review their reporting culture.

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