Medicines administration legal framework

Norma Barrow made this Rhyddid Gwybodaeth request to North West Ambulance Service NHS Trust

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Dear North West Ambulance Service NHS Trust,

I am looking for information with regards to the legal frameworks relied upon in your service to carry, dispense and administer POMs.
In a CQC report "British Red Cross Society, British Red Cross, Birmingham" Date of inspection visit: 26 March and 5 June 2019, Date of publication: 25/10/2019 the CQC stated that. --" non-healthcare professionals carried prescription only medication, including salbutamol inhalers, salbutamol nebulisers and glycerol trinitrate (GTN) spray” and “The Human Medicines Regulations 2012 state that prescription only medication (POM) can be administered by any person providing that medication has been specifically prescribed for the individual."

1. Do your non-prescriber staff routinely carry, dispense and administer POMs.

2. For each administration of a POM by your non-prescriber staff has that medication has been specifically prescribed for the individual.

3. Has the CQC previously raised the issue of POM medication being administered having not been “specifically prescribed for the individual” to you in any previous inspection?

a. Can you provide any details of this, time frame, report title, response etc.

4. Do you have non-healthcare professionals whom respond on behalf of your service whom carry, dispense and administer POMs?

a. Can you clarify what medication these non-healthcare professionals carry?
b. Can you confirm the legal framework replied upon for these medicines to be administered (by medication name, class, GSL, P, POM and form parenteral / non- parenteral)?

Yours faithfully,

Norma Barrow

FOI Enquiries, North West Ambulance Service NHS Trust

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FOI Enquiries, North West Ambulance Service NHS Trust

FOI2285

 

Dear Norma

 

Further to your freedom of information request, please find below
responses to your questions:

 

1.           Do your non-prescriber staff routinely carry, dispense and
administer POMs?

 

Our registered health-care professionals routinely carry and administer
POMs.   Prescription Only Medicines are administered under schedule 17 and
19 exemptions or using Patient Group Directions (PGDs).

 

The trust supports the use of certain medicines by certain unregistered
healthcare workers employed by the trust, if they have been trained and
deemed competent in their use.

 

Some emergency medical technicians can administer parenteral medicines
(injections) in accordance with schedule 19 of the Human Medicines
Regulations 2012 in an emergency for the conditions listed. The trust
takes responsibility for the safe treatment of patients and agrees the
practitioner groups who can administer each schedule 19 medicine.

 

There is no current provision in law for emergency medical technicians to
make a decision to treat (prescribe for) a person with non-parenteral
prescription only medicines. However, this practice is considered
necessary for the urgent and timely treatment of people using ambulance
services. The trust provides assurance on the delivery of safe and
effective care through considering the risks and having governance
arrangements to mitigate and manage this risk. This is a restricted and
monitored practice.

 

This includes the provision of scope of practice, clinical guidelines,
education and training and audit of use.

 

2.           For each administration of a POM by your non-prescriber
staff, has that medication has been specifically prescribed for the
individual?

 

No

 

3.           Has the CQC previously raised the issue of POM medication
being administered having not been “specifically prescribed for the
individual” to you in any previous inspection?

 

The issue of the use of POMs by non-registered healthcare professionals
has been raised during discussion and assurances provided.  There is only
one medicine used by the trained healthcare professional, emergency
medical technician. 

 

a.                   Can you provide any details of this, time frame,
report title, response etc.

 

There was a verbal discussion during  an inspection in 2020, followed up
with evidence of the governance process in place.  The CQC report
(published in June 2020) stated:

‘Ambulance technicians treated patients with non-injected
prescription-only medicines. Although current legislation does not support
this, the service assessed and managed the risk, trained staff and
assessed them as competent. This ensured patients had timely access to
safe and effective treatment.’

 

 

4.           Do you have non-healthcare professionals whom respond on
behalf of your service whom carry, dispense and administer POMs?

 

No

 

a.                   Can you clarify what medication these non-healthcare
professionals carry?

 

Only pharmacy only or general sales list medicines.

 

b.                  Can you confirm the legal framework replied upon for
these medicines to be administered (by medication name, class, GSL, P, POM
and form parenteral / non- parenteral)?

 

Human Medicines Act 2012

The Human Medicines Regulations 2012 (legislation.gov.uk)

 

I hope the above information is of assistance.

 

Kind regards

 

Sarah Morley

Freedom of Information

North West Ambulance Service NHS Trust

Tel: 01204 498400

[1]www.nwas.nhs.uk

 

 

[2]NWAS Logo
This message (and any associated files) is intended only for the use of
the individual or entity to which it is addressed and may contain
information that is confidential, subject to copyright or constitutes a
trade secret. If you are not the intended recipient you are hereby
notified that any dissemination, copying or distribution of this message,
or files associated with this message, is strictly prohibited. If you have
received this message in error, please notify us immediately by replying
to the message and deleting it from your computer. Messages sent to and
from us may be monitored.
Internet communications cannot be guaranteed to be secure or error-free as
information could be intercepted, corrupted, lost, destroyed, arrive late
or incomplete, or contain viruses. Therefore, we do not accept
responsibility for any errors or omissions that are present in this
message, or any attachment, that have arisen as a result of e-mail
transmission. If verification is required, please request a hard-copy
version. Any views or opinions presented are solely those of the author
and do not necessarily represent those of the company.
Please note that North West Ambulance Service may monitor email traffic
data and also the content of email for the purposes of security and staff
training.
Please consider the environment before printing this email.

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1. http://www.nwas.nhs.uk/