Introduction to Medicines

This first presentation is going to give you a brief introduction to medicines. There are many laws and regulations that apply to medicine supply and administration, we will talk about some now and some later in step four. care home regulations set the minimum standards that should be expected in a care setting. Standard eight relates to the promotion of and maintaining resident’s health and providing access to health care needs so this has a direct implication on medicine supply and administration. The Care Quality Commission ensure that these standards are enforced helping to keep standards high. The Health and Social Care Act 2012 was implemented to safeguard the future of the NHS and to improve the quality and choice for patients.

People living in care homes have the same rights and responsibilities as those who do not

live in care homes in relation to their NHS care, this is set out in the

NHS Constitution for England. Treatment and care should take into account an individual’s needs and preferences. Care home residents should have the same opportunity to make informed decisions about their care and treatment in partnership with their health professionals and social care practitioners. Furthermore amongst the guidance is the requirement that employers should ensure that they have suitably trained staff to safeguard the health, safety and well-being of service users. Health and Social Care Act 2008 (regulated activities), regulations 11 and 12 are considered relevant the supply and administration of medicine. Regulation 12 states medicines must be supplied in sufficient quantities, managed safely and administered appropriately to make sure people are safe. Regulation 11 talks about the need for consent.

Medicines health regulations outlines the legal classification of medicines and details when medicines can be supplied. The misuse of drugs regulations divides controlled drugs into five schedules, medicines that are liable for misuse are classified as control drugs (CDs) some CDs require safe storage and a more detailed audit trail. So that’s all the legal stuff for now so let’s move on to medicines, what is a medicine? A medicine is any substance or combination of substances that prevent or treat disease. There are two classes of medicines, those that need a prescription from an authorized prescriber (these are POM medicines) and those medicines that can be bought over-the-counter (OTC), first we’ll have a look at prescription only medicines.

Prescription only medicines require a written authorisation which is

a prescription from an authorised prescriber, this is usually a GP but can also be from hospital consultants, dentists and other health care professionals such as nurses, pharmacists, physiotherapists who have undergone further training. Prescriptions must be dispensed from a pharmacy, the only exception will be when you are a rural community and there isn’t a pharmacy in close proximity and the surgery are a registered dispensing doctor practice. Eligible patients can then be dispensed from the surgery. Some prescription only medicines require extra levels of controls as mentioned earlier and they’re called controlled drugs, so let’s have a look at

controlled drugs in a bit more detail. As I’ve already mentioned there are five levels of control, schedule 1 these are CD license examples would include LCD and cannabis and you should never be in possession of these medicines and if one of your residents is found to have these then they should be handed in to the police. If you have a look at schedules 2, 3, 4 and 5 medicines you will be surprised how many of those you will have in your care setting. Schedules 2 and 3 are required to have additional safe storage. So let’s move on to medicines that do not need a prescription over-the-counter or OTC medicines.

These are divided into two categories, pharmacy only medicines (sometimes called P medicines) where the sale is supervised by a pharmacist from a registered pharmacy. General sales medicines (GSL) can be bought from a pharmacy or from another retail outlet for example a supermarket. Residents may also use herbal or homeopathic medicines, they can be purchased by the patient as self selection or following a consultation with an alternative practitioner such as a herbalist or homeopath. When a residence uses over-the-counter or herbal medicines it is vital that you check with a pharmacist to ensure that they are compatible with their prescribed medicines. This can sometimes be a challenge as friends or family would bring medicines in for the residents.

Check your local policy to see how you should deal with this situation.