Overseeing the safer management of controlled drugs 11 th May 2017 Geraldine Yates Medicines Manager, Central Region Robert Allan Controlled Drugs Officer, National
Our brief Assessing and overseeing how health and social care providers manage controlled drugs Self assessment Maintaining a safe environment for managing controlled drugs Findings from the CQC Annual Report Safer Management of Controlled Drugs How this fits with monitoring adherence to the 2016 NICE Guidance
Our purpose The Care Quality Commission is the independent regulator of health and adult social care in England. We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. 3
Our 5 key questions 4
Part 1: Assessing and overseeing how providers manage CDs CDs are looked at with other medicines within our Safe domain Arrangements for controlled drugs are inspected as part of our inspection processes Intelligence and notifications we receive around poor handling of controlled drugs or patient harm inform our inspection processes What we find feeds into the overall judgement of the service
Key lines of enquiry 6
Key lines of enquiry Define the questions to answer Gather and record evidence from all sources Make judgements and build ratings Write report and publish alongside ratings Key lines of enquiry Ongoing local information from/about the provider Preinspection information gathering Intelligent Monitoring On-site inspection Apply consistent principles, build ratings from the recorded evidence Outstanding Good Requires improvement Inadequate
Part 2: Self-assessment tools To assist, we have both primary care and secondary care self assessment tools on our website. We do not expect to see the results The result is a Red, Amber, Green (RAG) rating We want services to formulate their own action plan
CDAO or nominated lead for controlled drugs. Part 3: How do providers maintain a safe environment for managing CDs Awareness of good practice and legislation: Misuse of Drugs legislation and The Controlled Drugs (Supervision and Management of Use) Regulations 2013 Implementation of relevant guidance - NICE / safety alerts SOPs for all aspects of the controlled drug journey that are kept under review (risk assessed) and followed in practice. Competency and training of staff Monitoring and auditing of arrangements and records Occurrence reporting & investigating if required (non blame culture)
CQC responsibilities to help maintain a safe environment for CDs CQC have national responsibilities under The Controlled Drugs (Supervision of management and use) Regulations 2013: Maintain and publish a CDAO register Work collaboratively with other agencies with a CD remit Oversee CD LINs and how they are working Publish an annual report and make recommendations to government Publish newsletters from the 4 CD sub-groups to the national group (theft and fraud, policy, prescription monitoring and patient safety on the CQC website: http://www.cqc.org.uk/content/use-controlled-drugs
The Safer Management of Controlled Drugs annual report The Controlled Drugs (Supervision of Management and Use) Regulations 2013 came into force in April 2013 Revised and updated the previous (2006) regulations and aligned them with the new structure of the NHS in England We report annually to Government by means of an annual report on the governance arrangements under theses regulations for controlled drugs within England The ninth annual report covers the period between January 2015 to December 2015 Our tenth report looking at 2016 is expected to be published during early summer 2017
The Safer Management of Controlled Drugs annual report Based on activity identified during the previous year, we make recommendations in our annual reports to; Improve the overall safe management and use of controlled drugs Strengthen existing arrangements for the reporting and sharing of controlled drugs concerns Support the work of the Controlled drug accountable officers (CDAOs) Promote good practice Share data on the national prescribing trends in the management of controlled drugs
The Safer Management of Controlled Drugs annual report In our 2015 report we made three recommendations: NHS England CDAOs should agree on and collect consistent information on controlled drug-related issues to provide a national picture. All CDAOs should support the NHS England CDAOs by providing information requested of them in a timely way so that the CD LINs function effectively and productively. Local authorities, through their Public Health and Adult Social Care Directors, should engage with their CD LINs to share concerns about controlled drugs that relate to the services they commission.
The annual reports include an update on: The Safer Management of Controlled Drugs annual report The national register of controlled drug accountable officers (CDAOs) Controlled Drug Local Intelligence Networks (CDLINs) Controlled Drugs National Group and its sub-groups; Vigilance. Patient Safety. Policy; and Prescribing. The CD National Cross-Border Group National trends in the use and management of controlled drugs
The Safer Management of Controlled Drugs annual report Top 10 Schedules 2 and 3 controlled drugs prescribed in NHS primary care in 2014 and 2015 (by millions of items) Top 10 Schedule 4 controlled drugs prescribed in NHS primary care in 2014 and 2015 (by millions of items) During 2015, the total number of controlled drug items prescribed in NHS primary care was 60,577,367, a decrease of 0.48% compared with 2014. Top 10 Schedule 5 controlled drugs prescribed in NHS primary care in 2014 and 2015 (by millions of items) A total of 1,118,884 controlled drug items across Schedules 2 to 5 were prescribed in hospital using an FP10(HNC) or FP10SS form
CD Team Contacts Contacts. Sarah Dennison, National Controlled Drugs Manager: sarah.dennison@cqc.org.uk : 01276 22652 / 07789 876957 Robert Allan, National Controlled Drugs Officer: robert.allan@cqc.org.uk : 0778 9875093 CD LINs Invitations: CDLINs@CQC.org.uk CDAO general queries: medicines.enquiries@cqc.org.uk CDAO Register queries: CDAORegisterData@cqc.org.uk