POLICY FOR ASSESSMENT OF UN-USED PRESCRIBED MEDICINES FOR THE POTENTIAL TO RE-USE IN CARE HOMES (NURSING AND RESIDENTIAL CARE HOMES) AND HOSPICES –STOOD DOWN WITH EFFECT FROM 18TH MAY 2020
We are continually assessing the regional arrangements for medicines in care homes (nursing and residential care homes) and hospices during the COVID-19 pandemic. As you will be aware, a number of regional arrangements were put in place to facilitate access to medicines for these settings; this includes the provision of urgent pandemic packs, an expansion of the palliative care network of pharmacies and a policy for the re-use of medicines.
Further to our letter on 20th April 2020, we wish to advise that the Policy for Assessment of Un-used prescribed Medicines for the potential to Re-use in Care Homes (Nursing and Residential Care Homes) AND Hospices is STOOD DOWN from Monday 18th May 2020. Initial reports suggest that homes and hospices have had limited need to re-use medicines in line with this policy, given the number of other measures that have been put in place.
We will keep these arrangements under review and write to you should there be a need to reinstate this policy as the COVID-19 pandemic unfolds. It is also planned to evaluate the implementation of the policy and refine for any future use. 2
ACTIONS
1. Community pharmacies
should facilitate the return of residents’ medication from residential care homes and supported living including controlled drugs as part of contracted core services. HSCB have advised Rentokil Initial who hold the current waste management contract accordingly. Since advice is constantly being updated during the pandemic, healthcare workers in various sectors should ensure that they are accessing the most recent advice via FAQs at link below:
http://www.hscbusiness.hscni.net/services/3150.htm
2. Care facilities
(i) Ensure this change in policy is communicated to all relevant staff.
(ii) Ensure processes for waste management revert to normal practice with immediate effect. This should include a review of all medicines that had been stored for potential re-use to ensure appropriate disposal
(iii) Nursing Homes and hospices should arrange for uplift of clinical waste in line with their usual arrangements:
RQIA has issued guidance to nursing homes in relation to the disposal of medicines in the following document:
Supported living/Residential care homes should liaise with their community pharmacy to agree mutually convenient timelines for acceptance of medicines waste for disposal.
(iv) Only those medicines returned from a suspected, or confirmed, COVID positive patient which were stored in their room need to be quarantined. These medicines should be sealed (double bagged) and quarantined for three days (72 hours) prior to returning to a pharmacy.
Refer to most recent advice via link below.
http://www.hscbusiness.hscni.net/services/3150.html
(v) Assurance Proforma for care facilities
Complete and return the attached proforma (Appendix 1) to RQIA via email by 18th June 2020, thus providing an assurance that any controlled drugs retained in line with this policy have now been destroyed as per the individual setting’s normal operating procedures. 3
(vi ) Record Keeping for care facilities
In accordance with The Nursing Homes Regulations (Northern Ireland) 2005, Regulation 19(4) the records pertaining to this policy must be kept for six years.
Care Homes should contact RQIA pharmacy team if they have any queries 028 9536 1111. Further information can also be obtained by contacting a Pharmacy Adviser in your local HSCB office
Thank you for your ongoing support during these challenging times.
Yours sincerely
Joe Brogan
Assistant Director of Integrated Care Assistant Director of Integrated Care
Dr Margaret O’Brien,
Head of Pharmacy and Medicines Head of General Medical Services Management
