SAFE AND SECURE HANDLING OF MEDICINES
Introduction
Medicines are powerful tools of modern therapeutics.  They are all potentially dangerous if used improperly and some are liable to misuse and to drug related crime.  The safety in handling and security of medicines within the managed health service was the subject of the Duthie Report, published in 1988, and The Safe and Secure Handling of Medicines: A Team Approach.  A revision of the Duthie Report (1988) led by he Hospital Pharmacists' Group of the Royal Pharmaceutical Society. March 2005.   It is the content and spirit of these reports in conjunction with current legislation that has formed the framework for this review of procedures for the safe and secure handling of medicines.

The general principles associated with the safe and secure handling of medicines have been set out.  These relate to the three R's - Responsibility, Record-keeping, and Reconciliation, which forms the basis of the 'Medicine Trail', or the ability to account for a medicine from the time of ordering through to the administration to a patient. 

As well as the general principles, more specific guidance has been given on the handling of medicines within  all NHS Tayside care settings, which, together with professional standards of practice, will ensure safe and secure management of all medicines. 

There may be some small areas of clinical practice, or new developments in clinical practice, not directly covered in this document.  This manual gives guidance on good and acceptable practice, but the responsibility for devising, implementing, and maintaining a system of medicine security to meet such occasions rests with the Director of Pharmacy.

Medicines are products which are administered by mouth, applied to the body, or introduced to the body for the purpose of treating or preventing disease, diagnosing disease or ascertaining the existence, degree or extent of a physiological condition, contraception, inducing anaesthesia, or otherwise preventing or interfering with the normal operation of a physiological function. Medicines, therefore, include infusions or injections of sodium chloride 0.9% and water for injection, which are included as medicinal products covered by the European Directive on Medicines (Ref. The Safe and Secure Handling of Medicines: A Team Approach.  A revision of the Duthie Report (1988) led by the Hospital Pharmacists' Group of the Royal Pharmaceutical Society. March 2005. Some devices, which are categorised within the Medical Devices Regulations, such as some dressings, eye drop systems, inhalations etc., are included in the application of the Code of Practice.

All health professionals are equally accountable for their own practice. They may only accept tasks and responsibilities that they are confident and can demonstrate they possess the competence to undertake.  Staff must take account both of clinical and corporate governance and in dealing with medical representatives must follow Section C of the Standards of Business Conduct for NHS Staff: Annex 3 to 6.

During the review of the Safe and Secure Handling of Medicines information, contributions from staff from various disciplines throughout NHS Tayside were collated.  To assist with future updating, we would welcome your comments.  These should be forwarded to  the Medicines Policy Group Chairperson via Carol Walkinshaw, Business Manager, Pharmacy Service, e-mail carol.walkinshaw@nhs.scot.  

Director of Pharmacy
NHS Tayside

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