8.16.1. Information Sharing

There is a legal requirement for each NHS CDAO to share information and concerns surrounding the management and use of CDs with other designated and responsible bodies such as Police Scotland, NHS Counter Fraud Services, local authorities and regulatory bodies.

Local Intelligence Networks (LINs) led by the Health Board CDAO have been established to provide a forum for information sharing. The LIN involves members from the Health Board, independent CDAOs, Police Scotland, NHS Counter Fraud Services and the General Pharmaceutical Council.

CDAOs from other organisations report CD incidents to Healthcare Improvement Scotland (HIS). The Care Inspectorate has a similar system for care home reporting. Both organisations collate reports and forward quarterly reports to the NHS Tayside CDAO who ensures the intelligence is shared appropriately across the LIN.

All information sharing must comply with Data Protection Legislation and NHS Codes of Confidentiality. If patient safety is at risk then this takes precedence over Data Protection Legislation.

8.16.2. Suspicious Substances

NHS Tayside does not permit the use, possession or supply of illegal substances on its premises. For this purpose, a substance is suspicious if the person in possession cannot reasonably explain why they have it, or if there is any doubt about its nature.

Some psychoactive substances, formerly known as “legal highs” are not illegal to possess, but are known to cause adverse effects in some cases and have no therapeutic benefit. As such NHS Tayside would support this being removed from a patient as a “suspicious substance” if felt to be appropriate.

Schedule 1 Controlled Drugs include hallucinogenic drugs, for example, cannabis. The class of persons who may lawfully possess them is strictly limited and does not include Pharmacists or other Clinicians, except under a licence granted by the Home Office.

A nurse may only take possession of a Schedule 1 drug for the purpose of handing it to a police officer, or to a person authorised to destroy it. The nurse is not authorised to supply, therefore it is illegal for the nurse to return it to the patient or patient representative.

A pharmacist is authorised to take possession of a Schedule 1 drug in order to destroy it, in the presence of an Authorised Witness or to hand it to a police officer or to another person authorised to destroy it. Please refer to: 'Misuse of Drugs Regulations 2001'.

Therefore, when a member of staff takes possession of a suspicious substance, it is important that all actions related to the taking into safe custody or destruction of such substances are fully and correctly documented and witnessed. Also, accurate records maybe required for evidence if matters proceed to a court case.

If a patient is found in possession of a suspicious substance, the nurse or other member of staff, should inform the patient that the substance is to be removed for destruction. The nurse or other member of staff may involve the police at this stage if he or she is uncomfortable in approaching the patient. Also, if the patient refuses to hand over the suspicious substance, the police should be informed. The police will remove the suspicious substance when they attend in these circumstances. Otherwise, the procedure below must be followed.

A senior manager or consultant clinician must decide whether patient details are made available to the police in the interests of patient safety. Details must be made available to the police if the quantity of the suspicious substance is greater than what could be considered for the patient’s own personal use. In this situation police advice regarding further handling of the product must be followed.

Please refer to the ‘Policy on the Management of Substance Misuse on NHS Tayside Premises’ (Staffnet Link).

The member of staff who has found the illicit substance or has it handed to them by a patient must immediately inform Senior Charge Nurse/Midwife/Operating Department Practitioner in charge of the Ward/Department/Theatre.

The senior member of the team and the member of staff identifying the illicit substances must place these into a valuables envelope, which then must be sealed and signed by both members of staff. The envelope must also document the patients CHI, what the patient has stated the substance is and must describe the contents of the envelope, for example, 10 white tablets. This envelope should then be placed into the CD Cabinet.

The Senior Charge Nurse/Midwife/Operating Department Practitioner in Charge must complete a DATIX and inform the Ward/Department Consultant.

The Senior Charge Nurse/Midwife/Operating Department Practitioner in Charge should contact the Police and request the drugs are uplifted, and where appropriate (if a large quantity of drugs could purely not be for personal use) identify the individual.

Any member of staff finding a substance thought not to belong to an identified patient should report it to the Senior Charge Nurse/Midwife/Operating Department Practitioner in Charge, who should then contact the Police to organise removal of the substance. The senior member of the team and the member of staff identifying the illicit substances must place these into a valuables envelope, which then must be sealed and signed by both members of staff. The envelope must also document the patients CHI, what the patient has stated the substance is and must describe the contents of the envelope, for example, 10 white tablets. This envelope should then be placed into the CD Cabinet.

If a patient is unwilling to hand over a substance to a member of staff which is believed to be illicit, it must be explained to the patient that the Police will be notified and their details given as an offence may have been committed. The patient should be observed until the Police arrive.