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Content ArticleThe objective of the national Medicines Safety Improvement Programme is to help patients get the maximum benefit from their medicines and reduce waste with an overarching aim to reduce medication related harm in health and social care, focusing on high risk drugs, situations and vulnerable patients. Each area of work in this programme intends to make medicines safety part of routine practice, ensure medicines use is as safe as possible and understand the patients’ experience. The national Medicines Safety Improvement Programme (MedSIP) is led by NHS England and Improvement’s patient safety team. The programme is delivered by the West of England Patient Safety Collaborative. Learn more about the West of England's MedSIP.
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Content ArticleWould you like to help our healthcare professionals understand how they can continue to use a new approach for prescribing safety in general practices? This research is looking at making prescribing safer in general practices in England and is jointly conducted by the Universities of Nottingham, Manchester, Edinburgh & Dundee. GP surgeries are working with pharmacists to use a computer programme to help find patients who may need their medicines reviewing. People from patient and public groups are invited to say what they think about continuing this service across the country in the longer term. If you choose to take part, this will involve being part of a group discussion on issues relating to continuing the service for medicines safety. You do not need to know about the service before taking part as this will be explained to you. If interested, please contact: azwa.shamsuddin@ed.ac.uk
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Content ArticleAntimicrobial resistance (AMR) is a global problem that impacts all countries and all people, regardless of their wealth or status. The scale of the AMR threat, and the need to contain and control it, is widely acknowledged by country governments, international agencies, researchers and private companies alike. This document sets out the UK’s 2019–2024 national action plan to tackle AMR within and beyond our own borders. Developed in consultation with a broad range of stakeholders across different sectors, it builds on the achievements of our last strategy (2013–2018), and is aligned with global plans and frameworks for action. The plan has ultimately been designed to ensure progress towards our 20-year vision on AMR, in which resistance is effectively contained and controlled. It focuses on three key ways of tackling AMR: reducing need for, and unintentional exposure to, antimicrobials; optimising use of antimicrobials investing in innovation, supply and access.
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Content ArticleMost primary care clinicians are well aware that the climate crisis is a health crisis and of the immediate and significant health co-benefits of climate action, such as through reduced air pollution. However, when it comes to taking action, in our experience many clinicians do not make the link with clinical practice. This is perhaps a result of extrapolating from actions to reduce one’s personal carbon footprint in areas like energy, waste, and transport. Yet, the majority of general practice’s carbon footprint results from clinical activity. In this article, Aarti Bansal and Grant Blashki focus on clinical practice and outline six practical steps that primary care can take towards sustainable healthcare that align with evidence-informed and person-centred practice.
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Content ArticleThis project includes the design of templates for controlled drugs, Hypnotics/Z-drugs, DMARDs (each orally administered drug has individualized template), NOACs, Warfarin, Lithium and Amiodarone. These templates prompt the user to add compulsory details before the drug can be issued for the first time or for a repeat issue. This has led to better and safer prescribing and potential to identify group of patients who either have not been reviewed or have missed essential monitoring. To avoid visual fatigue templates are short and to the point and a clinician can navigate away by one click if the required fields have been captured recently. Audits of prescribing such drugs has shown better prescribing and more patient involvement in decision making. Read more about this case study on the NICE shared learning database, via the link below.
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Content ArticlePharmacy teams should understand how to minimise the risk and likelihood of dispensing errors, including methods that can be used to evaluate existing processes, as well as how to deal with errors if they happen. This article from Phipps et al., in the Pharmaceutical Journal, builds upon the ideas proposed in ‘Understanding dispensing errors and risk’, and also proposes strategies and methods that should be considered for use in the pharmacy to manage the risk of dispensing errors.
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Content ArticleAs prescription numbers continue to increase, it is necessary to understand the dispensing errors that can occur and how they may happen. This article is the first of two articles from Phipps et al. on dispensing errors and risk. Reducing risk and managing dispensing errors will build on the ideas proposed in this article.
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Content ArticlePatient safety is vital to well-functioning health systems. A key component is safe prescribing, particularly in primary care where most medications are prescribed. Previous research has demonstrated that the number of patients exposed to potentially hazardous prescribing can be reduced by interrogating the electronic health record (EHR) database of general practices and providing feedback to general practitioners (GPs) in a pharmacist-led intervention. This study aimed to develop and roll out an online dashboard application that delivers this audit and feedback intervention in a continuous fashion.
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Content Article
Explore England's prescribing data
Patient Safety Learning posted an article in Medication administration
Every month, the NHS in England publishes anonymised data about the drugs prescribed by GPs. But the raw data files are large and unwieldy, with more than 700 million rows. OpenPrescribing.net are making it easier for GPs, managers and everyone to explore - supporting safer, more efficient prescribing. Source: OpenPrescribing.net, EBM DataLab, University of Oxford, 2020 -
News Article
Leaked government review plans new law to push data sharing
Patient Safety Learning posted a news article in News
An official review carried out for the health secretary, leaked to HSJ, reveals plans to bolster the law to require greater sharing of patient data, saying it would help improve safety for those wrongly prescribed drugs. A draft of the report on overprescribing, carried out for Matt Hancock by NHS England, says a major problem is that clinicians in different parts of the system can’t see what’s been prescribed and dispensed elsewhere. It says “wider access” should be given, which would also ensure “many eyes” are looking at the data to detect patterns or problems. This should include making it a requirement that prescribing apps make their data openly available, according to the report by chief pharmaceutical officer Keith Ridge. Read full story (paywalled) Source: HSJ, 16 November 2020 -
News Article
Royal College review warned trust of ‘very significant risk for patient care’
Patient Safety Learning posted a news article in News
A community trust was told to urgently review prescribing of stimulant medications for children after concern that some were posted to families but never arrived. Bridgewater Community Healthcare Foundation Trust was told that sending prescriptions through the post may be a potentially unsafe practice by the Royal College of Paediatrics and Child Health. The warning came in a report from the college after it was invited by the trust to review its community paediatrics service The trust was urged to work with primary care and clinical commissioning groups to establish shared care for children who needed these medications. Stimulant medicines are often used for children with attention deficit hyperactivity disorder. The review also found there was a “a very significant risk for patient care” with letters, reports and prescriptions being delayed or going missing due to “recurrent issues” with the post in the building used by the team covering St Helen’s. It highlighted issues with the safeguarding procedures at the trust, with each locality team having its own processes and handling a small number of cases, and called for urgent work to streamline services. Read full story (paywalled) Source: HSJ, 11 November 2020 -
Content ArticleSocial prescribing, also sometimes known as community referral, is a means of enabling health professionals to refer people to a range of local, non-clinical services. The referrals generally, but not exclusively, come from professionals working in primary care settings, for example, GPs or practice nurses. Recognising that people’s health and wellbeing are determined mostly by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health. Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and wellbeing. But does it work? And how does it fit in with wider health and care policy?
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News ArticleA pharmacist-led, new digital intervention that improves patient safety when prescribing medication in general practice reduced rates of hazardous prescribing by more than 40%, 12 months after it had been introduced to 43 GP practices in Salford, finds a new study. Due to its success, plans are underway to roll it out across Greater Manchester. Prescribing and medication are one of the biggest causes of patient safety incidents and the third WHO Global Patient Safety Challenge is focussed on Medication without Harm. The SMASH intervention addresses this. It was developed by researchers at the National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC), which is a partnership between The University of Manchester and Salford Royal hospital in collaboration with The University of Nottingham. Pharmacists working in general practice use the SMASH dashboard to identify patients who are exposed to potentially hazardous prescribing. For example, patients with a history of internal bleeding may be prescribed medications such as aspirin which could increase the risk of further internal bleeds without prescribing other treatments to protect them. SMASH identifies this and warns healthcare professionals about it, who can then decide on a possible course of action. The intervention is unique due to its ability to provide near real time feedback to prescribers as it updates every evening. Professor Darren Ashcroft, Research Lead for the Medication Safety theme at the GM PSTRC, said: "We worked with the Safety Informatics theme at the GM PSTRC to develop then test SMASH. It is designed to improve patient safety in general practice by reducing potential problems made when prescribing medication and inadequate blood-test monitoring. It brings together people and data to reduce these common medication safety problems that all too often can cause serious harm." Read full story Source: EurekAlert, 14 October 2020
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Content ArticlePeek et al. evaluated the impact of the pharmacist-led Safety Medication dASHboard (SMASH) intervention on medication safety in primary care. SMASH was developed by researchers at the National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC), which is a partnership between The University of Manchester and Salford Royal hospital in collaboration with The University of Nottingham. Pharmacists working in general practice use the SMASH dashboard to identify patients who are exposed to potentially hazardous prescribing. The study found that the SMASH intervention was associated with reduced rates of potentially hazardous prescribing and inadequate blood-test monitoring in general practices. This reduction was sustained over 12 months after the start of the intervention for prescribing but not for monitoring of medication. There was a marked reduction in the variation in rates of hazardous prescribing between practices.
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Content ArticleThis resource, written by the Royal College of Nursing, is intended for any registered nurse working with medicines as part of their role. The principles of medicines management however, apply across all health care settings and for non-registered staff.
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EventuntilThis high profile conference will be attended by GPs, Social Prescribing Link Workers, Social Prescribing programmes, Community, Health and Social Care industry leaders, Primary Care Networks, Clinical Directors, Practice Managers and Line Managers from across sectors in the United Kingdom. Celebrate, network, discover the latest updates and learn best practices to power up community wellbeing through social prescribing. Further information and registration
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News Article
Seven NHS hospital trusts to receive share of £8.7m for e-prescribing
Patient Safety Learning posted a news article in News
A further £8.7million is to be dished out to seven NHS hospital trusts to introduce digital records and e-prescribing. The money is part of a £78million investment which was announced in February 2018 and aims to accelerate the roll out of electronic prescribing systems across the NHS. The latest funding is part of the third wave of the investment, which will be handed out over three years. In 2018/ 19, £16.2 million was awarded, £29.4 million was given in 2019/20 and another £12 million will be invested later this year. The seven trusts which will benefit from this latest round of finding are: Portsmouth Hospitals NHS Trust (£1.7m) Solent NHS Trust (£988,000) Sussex Community NHS Foundation Trust (£637,000) United Lincolnshire Hospitals NHS Trust (£1.26m) North Cumbria Integrated Care NHS Trust (£2m) East Lancashire Hospitals NHS Trust (£1.6m) Birmingham Community NHS Trust (£531,000) National director of patient safety, Dr Aidan Fowler, said: “Patient safety is of paramount importance and is something we are continuously looking at ways to improve, whether through new technology, such as the introduction of electronic prescribing, or by building a safety culture where all NHS staff feel supported and safe to speak up.” Read full story Source: Digital Health, 1 October 2020 -
News Article
Need for tech to reduce medication error and improve patient safety
Patient Safety Learning posted a news article in News
Omnicell UK & Ireland, a leading provider of automated healthcare and medication adherence solutions, hosted a health summit on the eve of World Patient Safety Day, to discuss the impact of medication errors on patients and the NHS. The session focussed on the role technology can play in preventing such issues. The summit, this year held via webinar, comes off the backdrop of the Department of Health and Social Care disclosing that in England 237 million mistakes occur every year at some point in the medication process. These errors cause serious issues for patient safety, but also place a significant cost burden on an already stretched NHS. The 2019 Patient Safety Strategy published by NHS England and NHS Improvement also found the NHS failed to save 11,000 lives a year due to safety concerns with the cost of extra treatment needed following incidents being over £1bn. A number of high-profile panel members answered a series of questions from the audience on solutions and best practice to improve patient safety with the aim of debating and sharing ideas on how to meet challenges and the impact of COVID-19. One of the panelists, Patient Safety Learning's Chief Digital Office Clive Flashman, agreed with the other panel members that the NHS had become more collaborative and familiar with technology since Covid: “We’ve seen a definite increase in telehealth and telemeds. Covid has forced cultural blockers that were there before to be removed out of necessity. There has been a growth in robotic pharmacy automation to free up staff time from high volume administration tasks to do more complex work that adds value for patients.” But with the second-wave of COVID-19 still a very real threat he advised: “We don’t want to wait until the next wave to learn a lesson – we need to learn lessons now. Quality Improvement Leads should be focussed on what went right and what went wrong over that period between March and May. They need to be looking at what we can learn from that now and what we can do differently next time. If we don’t do that, we won’t succeed in the second wave where we might fail.” Ed Platt, Automation Director, Omnicell UK & Ireland, added: “Challenges within the NHS throughout Covid has forced them to embrace technology and drive innovation." "It’s important that when things go back to normal, we don’t go back to the same status quo. We need to invest in the right infrastructure in hospitals so unnecessary demands and stress are not put on pharmacy, supply managers and nurses so they are free to focus on patient care not administration tasks." Read full story Source: NHE, 17 September 2020 You can watch the webinar on demand here -
Content Article
NHS England: Support for prescribers
Patient Safety Learning posted an article in Medication administration
NHS England has commissioned the Specialist Pharmacy Service to provide prescribers with all the support they need to: Stop prescribing medicines which are not clinically-effective or cost-effective Provide clear information to patients to help them make meaningful choices and decisions about their treatment Help people to get the benefits they want from their prescribed medicines Encourage people to ‘self-care’ and choose not to take a medicine if they don’t really need one Take positive action to reduce waste so we stop throwing away so many medicines. -
News ArticleMore patients and healthcare staff will benefit from single electronic patient records as 7 hospital trusts receive a share of £8.7 million to introduce digital records and e-prescribing, Minister for Patient Safety Nadine Dorries announced today on World Patient Safety Day. The roll-out has already been introduced to over 130 NHS trusts, and is part of a £78 million investment to deliver the ambition set out in the NHS Long Term Plan to introduce electronic prescribing systems across the NHS. NHS trusts will now be able to more quickly access potentially lifesaving information on prescribed medicines and patient history, and build a more complete, single electronic patient record, which reduces duplication of information-gathering, saves staff time and can reduce medication errors by up to 30%. The funding was announced at a virtual conference organised by Imperial College London to mark World Patient Safety Day. Read press release Source: Gov.uk, 17 September 2020
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News ArticleThe emergence of antimicrobial resistance (AMR), including drug-resistant bacteria, or “superbugs”, pose far greater risks to human health than Covid-19, threatening to put modern medicine “back into the dark ages”, an Australian scientist has warned, ahead of a three-year study into drug-resistant bacteria in Fiji. “If you thought Covid was bad, you don’t want anti-microbial resistance,” Dr Paul De Barro, biosecurity research director at Australia’s national science agency, the CSIRO, told The Guardian. “I don’t think I’m exaggerating to say it’s the biggest human health threat, bar none. Covid is not anywhere near the potential impact of AMR. We would go back into the dark ages of health.” WHO warns overuse of antibiotics for COVID-19 will cause more deaths While AMR is an emerging public health threat across the globe, in the Pacific, where the risk of the problem is acute, drug-resistant bacteria could stretch the region’s fragile health systems beyond breaking point. An article in the BMJ Global Health journal reported there was little official health data – and low levels of public knowledge - around antimicrobial resistance in the Pacific, and that high rates of infectious disease and antibiotic prescription were driving up risks. “A challenge for Pacific island countries and territories is trying to curtail antimicrobial excess, without jeopardising antimicrobial access for those who need them,” the paper argued. Read full story Source: The Guardian, 10 September 2020
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Content ArticleThe National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) is an independent body composed of 27 national organisations. In 1995, the United States Pharmacopeial Convention (USP) spearheaded the formation of the National Coordinating Council for Medication Error Reporting and Prevention: Leading national health care organizations are meeting, collaborating, and cooperating to address the interdisciplinary causes of errors and to promote the safe use of medications.
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News ArticleFollowing four deaths and more than 300 incidents with steroid replacement therapy involving patients with adrenal insufficiency in the past two years, patients at risk of adrenal crisis will be issued with a steroid emergency card. All adults with primary adrenal insufficiency (AI) will be issued an NHS steroid emergency card to support early recognition and treatment of adrenal crisis, a National Patient Safety Alert has said. The cards will be issued by prescribers — including community pharmacists — from 18 August 2020. AI is an endocrine disorder, such as Addison’s disease, which can lead to adrenal crisis and death if not identified and treated. Omission of steroids in patients with AI, particularly during physiological stress such as an additional illness or surgery, can also lead to an adrenal crisis. The alert has requested that “all organisations that initiate steroid prescriptions should review their processes/policies and their digital systems/software and prompts to ensure that prescribers issue a steroid emergency card to all eligible patients” by 13 May 2021. Read full story Source: The Pharmaceutical Journal, 17 August 2020
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Content ArticleA joint National Patient Safety Alert has been issued by NHS Improvement and NHS England national patient safety team, Royal College of General Practitioners, Royal College of Physicians and Society for Endocrinology, regarding the introduction of a new Steroid Emergency Card to support the early recognition and treatment of adrenal crisis in adults.
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News Article
Coroner warns about poor drug reviews after patient dies from tramadol overdose
Patient Safety Learning posted a news article in News
A senior coroner has demanded action by Simon Stevens, chief executive of NHS England, to ensure that GPs monitor repeat prescriptions properly, after an 84 year old man with dementia died from an overdose of tramadol. Peter Cole, who was found collapsed at his home in Welwyn in Hertfordshire by a neighbour, had amassed a large quantity of unused prescription drugs at his house. He had numerous drugs on repeat prescription, said Geoffrey Sullivan, chief coroner for Hertfordshire. Read full story (paywalled) Source: BMJ, 5 August 2020
