1

1.1

Principles of Medicines Security:
Medicine Security Management System
NHS Tayside shall establish, document and maintain effective and economical systems to ensure and demonstrate that medicines are prescribed, dispensed, stored and administered in a safe and secure manner. The Director of Pharmacy is responsible for organising, monitoring and reporting on a system for ensuring the safe and secure handling of medicines on behalf of the NHS Tayside Chief Executive. At each step where a medicine changes hands there shall be clear laid-down procedures explaining:

Responsibility	-	where this lies, whether it may be delegated, how far it extends, to clarify the level of authority.
Record keeping	-	what must be recorded, where, by whom, and for how long records must be kept?
Reconciliation	-	how often this must take place, who must do it.

The Appointed Nurse in Charge (the senior nursing appointment for the ward or department) has the responsibility for ensuring that the system is followed and that the security of medicines is maintained.

1.2

Principles of Medicines Security:
Procurement

The designated hospital pharmacies OR community pharmacy are the sole procurement point for medicines.

1.3

Principles of Medicines Security:
Distribution

Pharmaceutical supplies will be provided from the hospital pharmacies to wards, departments, clinics and healthcare professionals in line with agreed stock lists, requisitioned and signed by an authorised signatory, in accordance with local policies and procedures. Further storage will be required before/during patient use, although some items for immediate use may be issued.

1.4

Principles of Medicines Security:
Issue to Point of Use/Dispensing or Supply Dispensing and Issue

Definition: The activities undertaken, in response to formal orders, when medicines are issued to the place where they will be used or supplied directly to the patient.

Medicines at this stage may be supplied to ward/department as stock; as items for specific patients or issued in bulk for supply/administration by suitably qualified practitioners (e.g. contraceptive pills, vaccines etc.). In addition, direct issues to patients being discharged from hospital or to out-patients may be made on the authority of a prescription signed by a prescriber.

“One-stop” dispensing combines the inpatient supply to individual patients with the discharge medication.

All medicines issued to patients must be labelled in accordance with the Medicines Act 1968.

The majority of issues/dispensing/supply/transactions for groups of patients or individual patients will be undertaken in the Pharmacy Department.

1.5

Principles of Medicines Security:
Prescribing

All dispensed medicines must be prescribed in written form on the medicine prescription chart or discharge prescription/letter or other authorised documentation.

1.6

Principles of Medicines Security:
Patient Group Directions

Patient Group Directions enable certain approved practitioners in an approved setting to be authorised to supply and administer certain medicinal products.
All Patient Group Directions must be approved by NHS Tayside on the advice of the Drug and Therapeutics Committee.

1.7

Principles of Medicines Security:
Administration

The administration of a medicine to an individual patient may be accomplished in a number of ways in accordance with a written prescription:

Administration by Registered Nurse or Midwife.
Administration by a Suitably Qualified Practitioner.
Self-administration by a patient/carer in accordance with NHS Tayside Patient/Carer Self Administration Policy.

1.8

Principles of Medicines Security:
Disposal

Medicines no longer suitable for use must be disposed of under the direction of the pharmacist and in accordance with the NHS Tayside Waste Disposal Procedures. In the case of Patient’s Own Medicines – see also Section 6. There are additional restrictions in relation to Controlled Drugs (see Section 8.9)

1.9

Principles of Medicines Security:
Retention of Records

Medicine records must be retained in accordance with the NHS Tayside Policy for the Retention of Records. The policy recognises the importance of availability of information for audit purposes, the implications of the Consumer Protection Act 1987 as it applies to public liability, the Medicines Act 1968, and the Misuse of Drugs Act 1971.