Standard Operating Procedure

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Standard Operating Procedure Title of Standard Operation Procedure (SOP): Disposal of Medicines No: SS4 Version No:3 Issue Date: June 2017 Review Date: June 2020 Purpose and Background Increasing numbers of children and young people are prescribed medication that needs to be taken at school. The reasons for this include increasing numbers of children with chronic health conditions such as diabetes and asthma, therapeutic advances and rising numbers of children attending school with complex health needs. The administration of medication in Special Schools is crucial to some children and young people s health and well-being to ensure maximum educational, physical and emotional development. The Department of Health requires that NHS Trusts establish effective systems to ensure that medicines are prescribed, stored, administered and handled in a safe manner in line with Risk Management Frameworks and Clinical Governance requirements. This SOP is one of four to be used in conjunction with the policies Medicines Policy for use in Special Schools with On Site Nursing Provision and Simple Medicine Policy for Administration of Paracetamol in Special Schools. This aims to establish best practice and ensure patient and staff safety. It is designed to be used in conjunction with the East Cheshire NHS Trust Medicine Policy and provide a framework for the correct procedures for the safe disposal of medicines in the Special School setting. Scope (i.e. organisational responsibility) Vital functions affected by this SOP: This policy has been developed for East Cheshire NHS Trust Special Needs School Nursing staff for use in Park Lane School, Macclesfield, SK11 8JR It is a School for pupils with a Learning Disability, Physical disability or Complex medical needs. The vital function affected by this SOP is the disposal of medicines held in the Special School listed above.

Monitoring Compliance Requirement to be monitored. Process to be used for eg. audit Audit carrying out Co-ordinator Frequency of Annually reviewing the results Co-ordinator / Manager developing an action plan Co-ordinator / Manager individual / the action plan Co-ordinator Escalations (if you require any further clarification re the process outlined please contact): Author: Co-ordinator Co-ordinator/Team Leaders Approval Record: Committee/Group Date Women s and Children s SQS Committee March 2015 Received for information

Operating Procedure 1. Items that require disposal are to be identified. Most common reasons are: Medicine has passed the manufacturers expiry date Medicine has expired due to a short shelf life once it has been opened e.g eye drops, antibiotic suspensions Medicines which the pharmacist has dispensed loose into a bottle and has been dispensed 6 months ago or longer. Medicine has been discontinued or changed Medicine has become contaminated, part used or ruined Medicine has been dispensed for administration and is no longer required A pupil has transferred to another Educational Establishment or left school. 2. Medication that is no longer required or has passed its expiry date must be returned to the pupil s parent/carer for disposal. A note should accompany the medicine explaining the reason for its return and a record made of this in the pupil s health records (APPENDIX 1). Medicine should NEVER be returned via the pupil, it should be handed to the Transport personnel at the end of the school day. 3. Any dose of medicine prepared for administration and subsequently not used must be disposed of in the Yellow Clinical Waste stream i.e. sharps bin/orange clinical waste bag. 4. Syringes used to measure/administer medicine and part used vials are disposed of into the Yellow Clinical Waste Stream i.e. sharps bin/orange clinical waste bag. 5. Medicine awaiting return to the parents for disposal must be stored securely in a locked cupboard in line with Trust Policy. 6. Medicine, however small in volume, must NOT be disposed of in domestic or commercial refuse, or via the sewerage system. 7. Loss of medicines and / or medicine keys If there is any loss of medicines, the Nurse in Charge must investigate and notify appropriate personnel. Every effort must be made to retrieve the keys. If they cannot be located, a decision must be made as to whether the locks on the cupboards should be changed. A DATIX report should be completed. 8. Any empty containers of flammable medicines including aerosols must be returned home or to the pharmacy. Additional Information Disposal of medicinal waste and sharps will be in compliance with the Trust Clinical Waste Policy (available on the Internet) Healthcare waste includes medicinal and sharps waste Surplus, unwanted or expired medicines should not be stored in the Special School setting.

Responsibilities Heads of Service, Divisional Heads and Community Service Managers are responsible for ensuring the services they manage are aware of these Standard Operating Procedures for Medicines in Special Schools and that amendments are cascaded in a timely manner. Lead Pharmacist Community Services is responsible for supporting the School Nurse Co-ordinator with the review of SOPs periodically. In conjunction with Risk Management, Medicines Management will be responsible for investigating failures in procedures when advised of them. Co-ordinator is responsible for ensuring that all team members are fully aware of the SOPs. Also responsible for ensuring that all new starters to the School Nursing Team are made aware of their existence and the intranet site where the most up to date version will be available. Registered Nurses All professionals are personally and professionally accountable for their actions and omissions in their practice and must always be able to justify their decisions and ensure compliance to East Cheshire NHS Trust operating procedures/policies and NMC Standards for Medicines Management. Individual professionals are personally responsible for reporting any skill deficit or training requirements to their line manager or service manager. Any incidents, errors or issues arising from this policy should initially be discussed with the line manager and referred to or discussed with Medicines Management or Risk Management Team when appropriate. Parents/Carers have overall responsibility for their child s medicines which may be transferred to the Special with appropriate authorisation. It is the responsibility of the parent/carer to inform the of any medicine prescribed for their child by completion of a parental information form. This should be completed at least annually and each time a medicine is changed or added. References Department for Education (2014). Supporting Pupils at School with Medical Conditions. Retrieved from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/ 349435/Statutoryguidance_on_supporting_pupils_at_school_with_medical_conditions.pdf East Cheshire NHS Trust. (2012). Medicines Policy. East Cheshire NHS Trust. Nursing and Midwifery Council. (2007). Standards for Medicines Management. London, United Kingdom: NMC. Royal Pharmaceutical Society of Great Britain. (2007). The Handling of Medicines in Social Care. Retrieved from: http://www.rpharms.com/unsecure-support-resources/pharmaceutical-servicesto-social-care-settings-resources.asp Audit & Reconciliation Appropriate administration records will enable auditing of medicine administration. These should take place annually and more frequently if the need is identified Medicine stock sheets will provide an accurate record of medicine held within schools and provide an audit trail in the event of any discrepancy. Stock sheets will include a record of medicines returned home.

APPENDIX 1 School Nursing Team School Address School nurse telephone Date / / Dear Parent/Carer RETURN OF MEDICATION FOR DISPOSAL Child s Name.. NHS Number Date of Birth.. Address.... Please find enclosed the following medication 1 2 3 4 Reason for return - Medication has been discontinued is out of date Under the Control of Pollution Regulations 1980, it is illegal to dispose of medication through the school or household waste systems. We would be grateful therefore if you would return the medication to your local Pharmacy, where it will be disposed of safely. Please contact the s should you wish to discuss this Yours faithfully School Nursing Team