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A decision made (17/01/2007) regarding: Misuse of Drugs (Jersey) Law 1978 – The Safer Management of Controlled Drugs in the Community

Subject:	Misuse of Drugs (Jersey) Law 1978 – The Safer Management of Controlled Drugs in the Community
Decision Reference:	MD-HSS-2007-0001		Exempt clause(s):
Type of Report: (oral or written)	Written		Person Giving Report (if oral):
Telephone or e-mail Meeting?			Report File ref:
Written report – Title	Misuse of Drugs (Jersey) Law 1978 – The Safer Management of Controlled Drugs in the Community
Written report – Author (name and job title)	Paul McCabe – Chief Pharmacist
Decision(s): Minister approved the recommendations of the Misuse of Drugs Advisory Council as detailed in the accompanying report.
Reason(s) for decision: The Shipman Inquiry was an independent public inquiry into the issues arising from the case of Harold Shipman. The Inquiry’s fourth report was published on 14th July 2004. It focussed on the methods used by Shipman to divert large quantities of potentially lethal controlled drugs and the reasons it was possible for him to do so for so long without detection. The Shipman Inquiry concluded that there were shortcomings in the systems used for the safe management of controlled drugs and made a number of recommendations to improve their management. The current provisions of The Misuse of Drugs (Jersey) Law 1978 do not adequately meet the recommendations of the fourth report of the Shipman Inquiry. The Misuse of Drugs Advisory Council has consequently made a number of recommendations for changes to the Misuse of Drugs (Jersey) Law 1978.
Action required: Minister to approve the recommendations of the Misuse of Drugs Advisory Council and authorise the Chief Pharmacist to prepare a brief for consideration by the Law Draftsman.
Signature: Signed by Senator Stuart Syvret (Minister/ Assistant Minister)		Date of Decision: 17 January 2007

Misuse of Drugs (Jersey) Law 1978 – The Safer Management of Controlled Drugs in the Community

STATES OF JERSEY

HEALTH AND SOCIAL SERVICES

Misuse of Drugs ( Jersey ) Law 1978

The Safer Management of Controlled Drugs in the Community

1. Introduction

The Misuse of Drugs Advisory Council (MDAC) is established in accordance with Article 2 of the Misuse of Drugs (Jersey) Law 1978 and has a duty to advise the Minister on measures, which in its opinion, should be taken to prevent the misuse of drugs and/or deal with the social problems connected with drug abuse.

2. Background

The MDAC, at its meeting on 20th November 2006, gave consideration to a number of proposals relating to the safer management of controlled drugs in the community arising from recommendations of the Shipman Inquiry.

The Shipman Inquiry was set up on 31st January 2001 and was chaired by Dame Janet Smith as an independent public inquiry into the issues arising from the case of Harold Shipman. The Inquiry’s fourth report was published on 14th July 2004. It focussed on the methods used by Shipman to divert large quantities of potentially lethal controlled drugs and the reasons it was possible for him to do so for so long without detection.

The Shipman Inquiry concluded that there were shortcomings in the systems used for the safe management of controlled drugs and made a number of recommendations to improve their management.

3. Recommendations of the Misuse of Drugs Advisory Council

After careful consideration of the proposals, the MDAC recommends the following changes to the Misuse of Drugs (Jersey) Law 1978:

3.1. The removal of handwriting requirements for Schedule 1, 2 and 3 controlled drug prescriptions

Currently, Article 14(1)(b) of the Misuse of Drugs (General Provisions) (Jersey) Order 1989 provides that all prescriptions for Schedule 2 and 3 controlled drugs must be in the prescribers own handwriting, This change will allow for computer generated prescriptions. These prescriptions will still have to be signed by the prescribing doctor.

3.2. To restrict the validity of Schedule 4 controlled drug prescriptions to 28 days from the appropriate date on the prescription

Currently, Article 15(1)(b) of the Misuse of Drugs (General Provisions) (Jersey) Order 1989 provides that prescriptions for Schedule 1, 2 and 3 controlled drugs must be supplied no later than four weeks after the date specified in the prescription. This change will extend this provision to Schedule 4 controlled drugs.

3.3. A requirement that standardised private prescription forms be used for the private prescribing of all Schedule 1, 2 and 3 controlled drugs for human use that will be dispensed in registered community pharmacies.

Currently prescribers may use any private prescription form of their choice.

3.4. A requirement that private prescriptions for all controlled drugs for human use that will be dispensed in registered community pharmacies must contain the prescriber identification number.

This is a number unique to an individual prescriber and is currently issued by the Social Security department and not the prescriber’s professional registration number.

3.5. A requirement that private prescriptions for Schedule 1, 2 or 3 controlled drugs must be sent to the Chief Pharmacist at the end of each month for collection and analysis purposes.

Currently there is no central record of private prescriptions dispensed by community pharmacies. This requirement will enable information about the prescriber, the dispenser and medication dispensed, including the quantity prescribed, to be readily available and will compliment the data currently available for health prescriptions.

3.6. A requirement that pharmacists must ascertain whether the person collecting a Schedule 1 or 2 controlled drug is the patient, the patient’s representative or a health care professional acting in their capacity as such and record this information in the controlled drug register.

The Shipman Inquiry highlighted the ease by which Shipman was able to collect controlled drugs on behalf of patients for whom he had prescribed them and then divert them for his own improper use. It is intended that this provision will act as a deterrent to unlawful collection and provide a valuable link in the audit trail.

3.7. A requirement that pharmacists request individuals collecting prescriptions for Schedule 1, 2 or 3 controlled drugs for human use to sign the back of the prescription form to confirm that they have done so.

Provision will be made to enable pharmacists to supply controlled drugs in the absence of a signature in order that unnecessary barriers are not placed in the way of a patient’s legitimate access to medicines they need that have been prescribed for them.

3.8. A provision that controlled drug registers may be kept electronically

Currently, controlled drug registers must be in the form of a bound book and comply with the requirements of the Misuse of Drugs (General Provisions) (Jersey) Order 1989. This provision will allow registers to be kept electronically as long as they comply with the requirements of the General Provisions Order.

3.9. A provision that the controlled drug register can be used to record additional information to that required or allowed under the provisions of the Misuse of Drugs (General Provisions) (Jersey) Order 1989.

The record keeping requirements specified in the General Provisions Order are the minimum fields of information that must be recorded. This provision will allow the recording of additional information where it is felt to be appropriate.

3.10. A requirement that records should be made for all patient returned Schedule 1 and 2 controlled drugs and their subsequent destruction.

Currently, there is no requirement for doctors or pharmacists to keep a record of Schedule 1 and 2 controlled drugs returned to them for the purposes of destruction. This provision will provide a clear audit trail of the return of such controlled drugs and their subsequent destruction.

4. Recommendation

The Minister is requested to consider and approve the above recommendations of the Misuse of Drugs Advisory Council and authorise the Chief Pharmacist to prepare a brief for consideration by the Law Draftsman.

Paul McCabe

Chief Pharmacist

9th January 2007