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Policy for Management of All Aspects of Medication

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POLICY FOR THE MANAGEMENT OF ALL ASPECTS OF MEDICATION

Policy statement / key objective

.

POLICY REFERENCE NUMBER CL 005

DATE RATIFIED (this version) July 2014

NEXT REVIEW DATE July 2017

APPROVED BY (state group) Drugs and Therapeutics

ACCOUNTABLE DIRECTOR Chief Pharmacist

POLICY AUTHOR Chief Pharmacist

The Trust will have systems in place, which ensure, Medicines are managed in

a safe and secure manner



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EXECUTIVE SUMMARY

Subject Policy for the Management of All Aspects of Medication

Applicable to

All employees of Lancashire Care NHS Foundation Trust, bank or agency staff who are involved in any aspect of medication

Key Policy Issues

To ensure standardised medicines management processes across the trust which encompass local and national guidance and legislation

Date Issued

January 2011

Dates Policy reviewed

January 2011, May 2014

Next review due date

July 2017

Policy written by

Chief Pharmacist

Consultation Drugs and Therapeutics Committee

Policy reviewed by:

Drugs and therapeutics committee

Lead responsible for policy

Director of Nursing and professional development Director of Operations/Deputy Chief Executive

Monitoring arrangements

Annual prescription chart audit Monitoring of medication-related incident reports and subsequent investigation Pharmacy intervention quarterly reports Elearning packages

Approved by Policy and Governance EMT

Authorised by Policy and Governance EMT

Signature Dee Roach

Related procedural documents

See Appendix 1



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Contents Page No

Executive Summary 2 Introduction 4 Legislation 5 Prescribing 6 Ordering and supply of medication 6 Storage of medication 7 Administration of Medication 7 Disposal of Medication 8 Transport of Medication 8 Documentation 8 Clinical Trails 8 Training 10 Monitoring 10 Appendix 1 15 Appendix 2 17



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1. Introduction 1.1 Rationale

The Department of Health requires that NHS Trusts establish, document and maintain an effective system to ensure that medicines are handled in a safe and secure manner.

This policy document outlines the mandatory legal and ethical aspects involved in the processes surrounding medication and will cover the following areas.

Legislation Section 2

The Procurement of Medication Section 3

The Prescribing of Medication Section 4

The Ordering and Supply of Medication Section 5

The Storage of Medication

Section 6

The Administration of Medication

Section 7

The Disposal of Medication

Section 8

The Transportation of Medication Section 9

Documentation Section 10

Clinical trials Section 11

Training Section 12

Monitoring Section 13

1.2 Scope

This policy applies to all employees of Lancashire Care NHS Foundation Trust (the “Trust”) including Bank and Agency staff, and covers all aspects of medication; this will include those employees who are not working within Trust premises.

This policy also applies to members of staff who are not directly employed by the Trust but act in a professional capacity within the Trust through a service level agreement.

This policy covers those members of staff who are identified as having the required legal authority to engage in the processes listed.

1.3 Principles As part of Clinical Governance the Trust has a responsibility to ensure the safe and effective use of medication.

1.4 Compliance and duties of staff

This responsibility ultimately rests with the Chief Executive but the operational responsibility rests with the Medical Director, the Director of Nursing and the Chief Pharmacist.

It is the responsibility of the Drug and Therapeutics Committee to monitor, advise and amend as appropriate any aspects of the policy, the ratification of any amendments being made through the EMT Governance Committee



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It is the responsibility of the Chief Pharmacist to ensure compliance with all aspects of the policy relevant to the provision of pharmaceutical services by monitoring and auditing the service level agreements negotiated with the locality pharmacy departments.

Managers will ensure that all staff engaged in any activity covered by this policy will receive the appropriate training and supervision. Mandatory medicines management requirements will also be ensured in line with the mandatory training matrix for the trust.

All staff engaged in any activity covered by this policy are required to adhere strictly to the policy and failure to do so may result in disciplinary action.

2. Legislation

The following legislation is mandatory regarding the use of medicinal products and will be referred to where appropriate in the policy.

The Medicines Act 1968

The Misuse of Drugs Act 1971

The Misuse of Drugs Regulations 2001

The Controlled Drugs (Supervision of Management and Use) Regulations 2006

The Health Act 2006

The Poisons Act 1972

Medicinal Products (Prescription by Nurses Act) 1992

The Medicines and Human Use (Prescribing) Miscellaneous amendment order May 2006

Misuse of Drugs Regulations (2012) Misuse of Drugs (Amendment No.2) (England Wales and Scotland) Regulations 2012 (Statutory Instrument 2012/973)

The advisory documents listed in Appendix 2 have been issued over a number of years to supplements the statutory documentation listed above.

3. Procurement of medication A procedure will detail how external providers ensure safe, effective and economic procurement of medication. The principles are that:

All medication supplied to the trust is initially provided under service level agreements from external providers.

These service level agreements will ensure that services are provided in line with legal guidance, national and local requirements.

External providers will be required to provide evidence of registration, copies of any licenses held e.g. wholesaler dealers licenses or licenses for the management of controlled drugs and copies of local procedures for the procurement, supply and transport of medication.



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4. Prescribing Medication

All prescribers are required to read and adhere to the prescribing standards and requirements described in the Procedure for Prescribing Medication (CL005 DD) the legislation described therein and the relevant trust policies and procedures outlined below. They must also work within the boundaries and codes of practice of their relevant professional body, and practice within the limits of their competency.

All non-medical prescribers need to adhere to the requirements o f the Operational Policy for Non-Medical Prescribers (CL024), and the procedure for non-medical prescribing (CL024 A). All Non-Medical Prescribers will also adhere to the ratified non-medical prescribing protocol for their service/team where this exists.

Prescribers will make reference to the procedures detailed in Appendix One, when prescribing any medication/s covered by specific procedures e.g. clozapine, anticoagulants, oral anticancer medicines. Reference will also be made to any relevant local protocols. Any specific procedures in appendix one covering prescribing in a particular patient population or for a specified condition must be followed e.g. rapid tranquillization procedure, substance misuse prescribing guidelines. Procedures supporting prescribing on different types of prescription charts or via electronic prescribing systems will also be referenced as appropriate e.g. Procedure for the use of FP10 prescriptions

5. Ordering and supply of Medication Local procedures will detail how medication is ordered from external providers 5.1 Controlled Drugs

Refer to the Procedure for the Management of All Aspects of Controlled Drugs

(CL005 Y)

5.2 Ward Stock Medications i. Local procedures will be followed in each locality for obtaining stock medication

from the Pharmacy department. A written copy of the procedure will be available on the ward.

ii. A list of all stock medication will be agreed in consultation with LCFT pharmacy

staff and the ward manager and a copy of the agreed list will be kept on the ward. The list will be subject to review at regular intervals to reflect changing prescribing patterns.

iii. Where a technician/assistant topping up service is in place, the Pharmacy Technician/assistant will visit the ward on the appropriate top-up day to re-stock the ward stock cupboards.

iv. In the event that stock medication runs out prior to the top-up the Pharmacy

department should be contacted and a requisition using agreed stationary should



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be sent to Pharmacy stating clearly what is required and signed by the Nurse requisitioning it. An agreed list of signatories will be in place

v. All stationary used for the requisitioning of medication should provide a

permanent record of what is ordered and be stored in a locked cupboard when not in use. Where electronic systems are in place for ordering medication a permanent record must be kept by the ward.

vi. Records of all stock holding in any ward/department/clinic will be made and

include all receipts and transfers. Refer to the Procedure for the Accountability of Medication on Inpatient Units (CL005 T)

5.3 Individual Patients medication

Refer to the Procedure for the Accountability of Medication on Inpatient Units (CL005 T)

5.4 Leave/Discharge Prescriptions

Refer to the Procedure for the Accountability of Medication on Inpatient Units (CL005 T) and the Protocol for Use of Leave and Discharge Prescriptions (CL005

5.5 Out of Hours Supplies i. Where medication is required outside normal Pharmacy working hours local

procedures will be in place for obtaining medication. ii. Any medication obtained from Hospital Emergency cupboards will be recorded

clearly in the area obtaining the medication. Refer to the Procedure for the Accountability of Medication on Inpatient Units (CL005 T)

5.6. Supply via Patient Group Direction Supply of medication via Patient Group Direction will be in accordance with the

Trust Procedure 5.7. Homecare Medication All medication supplied by Homecare will be in line with the recommendations of

The Homecare Medicines Report – ‘Towards a Vision for the Future’, December 2011

6. Storage of Medication

Refer to the Procedure for the Storage of Medication (CL005 EE)

7. Administration of Medication All staff involved in the administration of medication should read and adhere to the Procedure for the Administration of Medicines (CL005 W). Do cu men ta t ion o f a dm in i s t r a t i on w i l l b e in l i ne w i t h re qu i remen t s o f p ro cedu res f o r t he p re sc r i p t i on cha r t i n u se ( see A ppe nd i x O ne ) . If patients are self-administering medication then all staff will be familiar with and adhere to the Procedure for the Implementation of a Patient Self-Medication Programme (CL005N) or the SOP for Self-Administration of Medicines at Longridge Hospital (CL005CCC). Where relevant to the specific medication administered, staff must also follow requirements in the procedures listed in Appendix One



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8. Disposal of Medication 8.1 Controlled Drugs see Appendix 4

Refer to the Procedure for the Management of All Aspects of Controlled Drugs (CL005 Y)

8.2 Disposal of Patient’s Own Medication

Refer to the Procedure for the Management and Use of Patients Own Drugs (CL005 J)

8.3 Disposal of all other Medication

All other medication when no longer required by the ward will be disposed of on site in accordance with the Waste Policy and requirements for the management of pharmaceutical waste (Reference details of the Waste Policy)

9. Transportation of Medication

Refer to the Procedure for the Transport of Medication (CL005 FF)

10. Documentation 10.1. FP10 Prescription pads

Refer to the Procedure for the Use of FP10 prescriptions (CL005 H)

10.2. Inpatient, leave and discharge prescription forms Whilst not considered as controlled stationary every effort should be made to ensure the secure storage of such documentation to avoid inappropriate use.

Refer to the Protocol for Use of the Inpatient Prescription Charts (CL005 R) and the Protocol for Use of the Leave and Discharge Prescriptions (CL005 S) or the Procedure for the use of inpatient charts at Longridge Hospital

10.3. Outpatient prescription forms

For safety reasons when these prescription pads are not in use they should be stored in a secure facility

10.4. Community prescription forms.

For safety reasons when these prescription pads are not in use they should be stored in a secure manner. Refer to the Protocol for use of the community prescription chart (CL005 QQ), Protocol for use of the Community Prescription and Administration Chart (CL005 PP) and/or Protocol for Use of the Repeat Community Prescription Form (CL005SS)

10.5. Controlled Drug Requisition Books

Refer to the Procedure for the Management of All Aspects of Controlled Drugs (CL005 Y)

11. Clinical Trials 11.1. Where a Consultant wishes to recruit patients from the Lancashire Care NHS Trust into a Clinical Trial, full Ethics Committee approval must be obtained prior to commencement of the Trial.



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11.2. The Drugs and Therapeutics Committee must be informed of the application to the Ethics Committee by the lead investigator. This should take place at the same time as the application is made to the Ethics Committee

11.3. The Pharmacy department must be informed of any clinical trial application. 11.4. The Lancashire Care NHS Trust Research Director will be informed of any

Clinical trial application. This should take place at the same time as the application is made to the Ethics Committee.

11.5. Once Ethics Committee approval has been obtained a formal application to the Drug and Therapeutics Committee must be made. This should include a copy of the trial protocol including any relevant costs and the relevant approval from the research director.

11.6. All supplies of clinical trial material will be held and issued by the locality

Pharmacy department and will only be supplied to the patient on receipt of the appropriate documentation.

11.7. The locality Pharmacy department will hold any code breakers for clinical trials being conducted in their locality. 11.8 It is essential that the funding issues surrounding the use of trial drugs in the

Post-trial phase be clarified prior to commencement. Where the drug company is unwilling to maintain supplies at the end of the trial the consent form must indicate to the patient that supplies will only be maintained for the duration of the trial.

11.9 Where the use of the trial drug in the post-trial phase is proposed a formal

application must be made to the Drug and Therapeutics Committee for inclusion in the Formulary.

11.10 All patients who are recruited into the Trial must give informed consent based

on comprehensive information provided to them by the Consultant who is nominated to run the Trial.

11.11. This informed consent must be documented within the Clinical Notes and

patients must receive a copy of the consent form. 11.12 Prescribing, dispensing and administering of clinical trial drugs will follow the

same process as for licensed preparations. 11.13. No stocks of clinical trial preparations will be stored at ward or department

level. They will be dispensed on an individual patient basis by the Pharmacy department.

The Good Research Practice Guidelines (R&D 001) will be followed



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12. Training 12.1. M e d i c i n e s management training will be a mandatory requirement for

identified staff groups. The format of the mandatory medicines management training is described as per the Trust Training needs Analysis.

12.2. Checking and monitoring of non-completion of the mandatory medicines management training module will be as described in the Statutory/Mandatory Training Procedure.

12.3. W h e r e pharmacy staff provide additional training on medicines on an ad

hoc basis or at the request of managers within the trust, attendance records will be completed and forwarded to the training department for inclusion on the OLM database.

12.4. Pharmacy staff will input on an ongoing basis to the induction programme

of junior medical staff.

13. Monitoring

13.1 The medication audit trail All teams and departments must ensure that a procedure details how a comprehensive and complete audit trail of all transactions involving medication will be ensured. Where the Procedure for the Accountability of Medication is not suitable, a local procedure ratified by the Drugs and Therapeutics Committee will be implemented



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Standard Time

frame/format How Whom

Prescribing responsibilities and prescribing standards

Annual Prescription chart audit

Datix reports detailing pharmacy interventions involving prescribing

Where prescribing errors have been reported via the datix/IR1 system the appropriate educational supervisor or nonmedical prescribing lead will be informed

Biannual Thematic analysis of prescribing errors reported via the Datix/IR1 system

An annual audit will monitor prescribing standards against the trust procedure. Action plans to address any deficiencies will be agreed by the Drugs and Therapeutics Committee and monitored by the network governance groups.

A quarterly report of prescribing interventions will be prepared and forwarded to the Associate Medical Directors. This will allow for ongoing monitoring of prescribing standards.

The educational supervisor will be expected to discuss the prescribing error in supervision

The non-medical prescribing lead will make arrangements to explore the incident with any non- medical prescriber making an error A thematic analysis of prescribing errors across all networks within the trust allows for identification of trends and themes. Action plans can be identified, agreed by the Drugs and Therapeutics Committee and forwarded to the network governance

Pharmacy department will conduct the audit

D&T will agree the action plan

Network governance group will monitor progress against the action plan

Medication Safety Officer to prepare the report.

Medication Errors subcommittee to review the report, agree actions in partnership with the networks Educational supervisor Non-medical prescribing lead

Medication Safety Officer to prepare report.

Medication Errors Subcommittee to agree action plans

Network governance groups to monitor progress against action plans


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Monitoring of side effects

POMH-UK audits POMH-UK audit reports will be presented to the Drugs and therapeutics committee.

Where actions are required these will be monitored via the network governance groups

All staff in the audited teams and depts. Lessons learnt to be cascaded to other teams/depts.

Administration of medication

Annual mandatory medicines management training

Ongoing assessment of staff competencies and training needs for those who have been involved in an administration error Biannual Thematic analysis of medication administration errors

See appendix 1

When administration errors occur, pharmacy is informed and investigates accordingly. Managers are informed and are required to consider whether there are any competency issues to address. Any remedial actions are taken at the time of the incident to maintain patient safety

A thematic analysis of medication administration errors across all networks within the trust allows for identification of trends and themes in administration errors. Action plans can be identified, agreed by the drugs and therapeutics committee and forwarded to the network governance committees who have the responsibility for monitoring compliance

All staff Managers Training department

Lead Pharmacists. Ward and team managers, Medicines Management Nurses Medication Safety Officer to prepare report.

Medication Errors Subcommittee committee to agree action plans

Network governance groups to monitor progress against action plans


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Self-administration of medication by patients

Ongoing review of any incidents reported via the Datix system for patients involved in self-administration

Ongoing monitoring of patients self- administering is a requirement of the procedure

This will allow for any trends to be identified

Nursing staff will engage in discussions about self- medication on an ongoing basis during 1:1 sessions with the patient

Pharmacists will see patients undertaking self- administration as required by the procedure. All such contacts will be recorded on the Datix pharmacy intervention monitoring system. This will allow reports to be generated of patients seen as part of the self- medication scheme

Lead Pharmacists

Nursing staff

Pharmacists

Safe disposal of medication

Quarterly controlled drugs audits Ongoing monitoring of controlled drugs whilst in use on a ward Quarterly reports for the local intelligence network

Pharmacists conduct quarterly controlled drugs audits and any issues involving controlled drugs identified at this stage are reported to the lead pharmacist, Accountable Officer and manager so that remedial action can be taken

When controlled drugs are in use pharmacists monitor on a weekly basis to identify any issues or concerns promptly.

The Chief Pharmacist as Accountable Officer prepares a quarterly report of any significant issues involving controlled drugs (including safe disposal concerns) for the local intelligence networks

Pharmacists, Accountable Officer, managers Pharmacists

Chief Pharmacist


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Datix/IR1 reporting on an ongoing basis of issues involving safe disposal of medication

Pharmacists and managers would investigate any such incidents at the time and identify and training or competency issues

Pharmacists and managers

Training Quarterly training reports

Review of training records

Chief Pharmacist

The M e d i c a t i o n E r r o r s S u b c o m m i t t e e a n d Drugs and Therapeutic Committee will be responsible for monitoring compliance with all of the above and providing assurance of compliance to EMT governance via quarterly reports. An action plan will be developed and monitored by the Drugs and Therapeutic C o m m i t t e e to a d d r e s s issues o f noncompliance with this p o l i c y


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Appendix 1 - Supporting Policies and Procedures

CL005A Substance Misuse Network Prescribing Protocol And Prescribing Guidelines

CL005B Protocol For The Introduction Of New Drugs

CL005C

CL005D Procedure For The Initiation And Management Of Clozapine

CL005E

CL005F Procedure For The Use Of Zuclopenthixol Acetate (Clopixol Acuphase)

CL005G

CL005H Procedure For The Use Of FP10HP Prescriptions

CL005I Protocol For The Management And Introduction Of NICE Technology Appraisals Reviewing Medication

CL005J Procedure For The Management And Use Of Patients Own Drugs

CL005K Procedure For The Prescribing Of Unlicensed Or Off Label Medication

CL005L Procedure For Monitoring Of Drug And Vaccine Refrigerator Temperatures

CL005M

CL005N Procedure For The Implementation Of A Patient Self- Medication Programme

CL005O Procedure For High Dose Antipsychotic Medication

CL005P Protocol For The Management Of Pain In Cognitively Impaired Patients

CL005Q Procedure For The Reporting Of Suspected Adverse Drug Reactions

CL005R Protocol For Use Of The Inpatient Prescription Charts

CL005S Protocol For Use Of The Leave And Discharge Prescriptions

CL005T Procedure For The Accountability Of Medication On Inpatient Units

CL005U Protocol For The Authorisation And Administration Of Identified Medication At Nurses Discretion

CL005V Procedure For Prescribing In Children

CL005W Procedure For The Administration Of Medicines

CL005X Procedure For The Safe Use Of High Dose Ampoules Of Diamorphine And Morphine (Opiates)

CL005Y Procedure For The Management Of All Aspects Of Controlled Drugs

CL005Z Prescribing And Administration Protocol For Oral Anti-Cancer Medicines

CL005AA Procedure For The Prescribing, Preparing And Administration Of Injectable Medicines in LCFT Mental Health

CL005AAA Procedure for the Pharmaceutical Management of Alcohol Use Disorders on mental health wards and in community mental health teams CL005BB Standard Operating Procedure Medicines Reconciliation On Admission



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CL005CC

CL005CCC SOP for Self-Administration of Medicines at Longridge Hospital CL005DD Procedure For Prescribing Medication

CL005EE Procedure For The Storage Of Medications

CL005FF Procedure For The Transport Of Medication

CL005GG Procedure For The Management Of Oral Anticoagulants In Supported LCFT Homes

CL005HH Procedure For The Prescribing Monitoring And Administration Of Oral Anticoagulants (excluding newer anticoagulants) In Inpatients Units CL005II Procedure For Prescribing Of Oral Bowel Cleansing Solutions

CL005JJ Procedure For Medicines Reconciliation On Admission Be Pharmacy Technicians

CL005KK Procedure For The Management Of Substance Misuse on Inpatient Mental Health Units

CL005LL Protocol For The Use Of Oxygen In Adults

CL005MM Standard Operating Procedure For The Management Of Nursing Medication Administration Errors And Near Misses In Inpatient And Community Settings

CL005NN Policy For The Management Of Medication In Social Care Settings

CL005OO Protocol for Use of the Administration Record for Medication Prescribed by GP’s

CL005PP Protocol for Use of the Community Prescription and Administration Chart

CL005QQ Protocol for Use of the Community Prescription Chart

CL005RR Receipt and Delivery Record for GP prescribed medication

CL005SS Protocol for Use of the Repeat Community Prescription Form

CL005TT Protocol for NMP within the review and recovery teams and the CCTT CL005UU Procedure for the prescribing and monitoring of lithium therapy CL005VV CL005WW CL005XX CL005YY CL005ZZ

SOP Prescribing and Preparation of injectable medicines including CDs and vaccines (excluding mental health) CL005ZZZ Protocol for Non-Medical Prescribing within the rheumatology service

CL005ZZZZ Protocol for the covert administration of medicines

Cl005ZZZZZ Procedure for the Proposal, development and ratification of PGDs

CL008 Rapid Tranquilisation Policy (Cl008)

CL008A Rapid Tranquilisation Procedure

CL008B Rapid Tranquilisation Procedure For Children And Adolescents Aged 12-18 Years

CL024 Operational Policy For Non-Medical Prescribers

CL024A Non-Medical Prescribing Procedures

CL024B Lancashire Care Foundation Trust Strategy For Non-Medical Prescribing

CL024C Protocol For Non-Medical Prescribing Within The Substance Misuse Network

Good Research Practice Guidelines



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Appendix 2

References

Department of Health and Social Security. (1958) Report on the Control of Dangerous Drugs and Poisons in Hospitals by a Joint Sub-Committee of the Standing Medical Council, Nursing and Pharmaceutical Advisory Committees, Central Health Services Council. The Aitken Report. HMSO London.

Department of Health and Social Security (1970b) Report on measures for Controlled Drugs on Wards by the Joint Sub-Committee of the Standing Medical, Nursing and Pharmaceutical Advisory Committee of the Central Health Services Council. HM (70) 36. HMSO, London.

Department of Health and Social Security (1976). Report of the working party on the Addition of Drugs to Intravenous Infusion Fluids. HC (76) 9. HMSO, London.

Department of Health and Social Security (1976). Application of the Medicines (Labelling) Regulations 1976 to Hospital Pharmaceutical Departments. HN (76) 205. HMSO, London.

Department of Health and Social Security (1977) The Misuse of Drugs Regulations 1973 (as amended). The Misuse of Drugs (Safe Custody) Regulations 1973. The Security of Drugs Liable to Misuse. HC (77) 16. HMSO, London.

Department of Health and Social Security (1978) Poisons: Supply and Storage in Health Service Premises. HN (78) 4. HMSO, London.

Department of Health (1988) Guidelines for the safe and secure handling of medicines (The Duthie Report) HMSO, London.

Department of Health (1991). Misuse of Drugs Regulations (1985). Written Authorities under regulations 25(1) and 26(1) and confidential enquiries. EL (91) 62. HMSO, London.

Department of Health (2005). NHS Modernisation Agency Medicines Matters: A guide to current mechanisms for the prescribing, supply and administration of medicines.

National Health Service Security Manual (1992) Chapter Nine. National Association of Health Authorities and Trusts.

Medicines Control Agency (1992) Guidance to the NHS on the Licensing Requirements of the Medicines Act 1968

Medicines Control Agency (1992) Removal of Crown Immunity: NHS Trusts



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United Kingdom Central Council for Nursing, Midwifery and Health Visitors (2001) Position statement on the covert administration of medicines. UKCC, London

Nursing and Midwifery Council (2002) Guidelines for the administration of medicines. NMC, London

Medicinal Products Prescription by Nurses Act 1992. Commencement order 1994. HMSO, London.

Royal Pharmaceutical Society of Great Britain (1994) The Administration and Control of Medicines in Residential and Children’s Homes. RPSGB, London.

Royal Pharmaceutical Society of Great Britain (2005) The Safe and Secure Handling of Medication: A Team Approach. Revision of the Duthie report 1988. RPSGB London.

Department of Health (1994). Aseptic Dispensing for NHS patients. PL/CPhO (94) 2.

Department of Health. Statement and Standards of Good Practice for Hospital Pharmacy. PL/CPhO (96) 2 and EL (96) 95.

Department of Health (1998) Review of Prescribing, Supply and Administration of Medicines. Report on Supply and Administration of medicines under Group Protocols. HSC 1998/051. HMSO, London.

Department of Health (2000). Patient Group Directions [England only]. HSC 2000/026. HMSO, London.

Mental Health Act Commission (1999). A Code of Practice.

Department of Health (2001). Reference guide to consent for examination/treatment. HMSO, London.



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Glossary

Medicine: - Any substance or combination of substances presented for treating or preventing disease. Any substance or combination of substances which may be administered with a view to making a medical diagnosis or restoring, correcting or modifying physiological or psychological functions.

Prescribe: - To authorise in writing the supply of a medicine.

Dispense: - To prepare clinically appropriate medicine for a patient for self-

administration or administration by another. The act of dispensing includes supply and also encompasses a number of other cognitive functions (e.g. checking the validity of the prescription, the appropriateness of the medicine for an individual patient, assembly of the product). These functions are performed under the supervision of a pharmacist.

Supply: - To supply a medicine to a patient/carer for administration.

Administer: - To give a medicine by either introduction into the body, (e.g. orally

or by injection) or by external application (e.g. cream or ointment). BNF: - The British National Formulary. A joint publication prepared by the

British Medical Association and the Royal Pharmaceutical Society of Great Britain, to provide information about the use of medication.

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