This weeks leadership message comes from Deputy Medical Director Dr Tom Davis

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I would like to begin this week’s leadership message by reflecting on the weekend’s terrorist attack in London. Our emergency service colleagues, especially at the London Ambulance Service, once again showed what a tremendous asset they are to the community and my thoughts are with them, as well as all the victims and those affected by the attack.

I was also saddened to hear of the passing of a long standing colleague, Martin Manning, and wish to express my condolences to his family and friends at this difficult time. It is at times like these that it is important to reiterate to you, our staff, that you have the full support of your management teams should you ever need it, as well as access to the confidential Employee Assistance Programme.

Turning to medicines management, it has been well documented and communicated over the last year that this has been an area of focus for the Trust. We have made good progress and this is thanks to the hard work being done by staff in this area.

In January, a new Medicines Management team was established. The team includes new members Amy Godfrey, a senior pharmacy technician, and Dean Ayres, a medicines management auditor. They join Head of Medicines Management Anna Zamczyk. The team is currently engaging with local leads to establish effective medicine management functions.

We have also begun using the AuditR system for auditing and have seen great success with it. Since April there has been a 100% usage of the system across the Trust. Huge thanks to everyone for their hard work, without it we wouldn’t be able to have greater visibility of monitoring and assurance of drugs.

There is now an Operational Medicines Management group within the Trust as well. It consists of operational representatives from each SLM area, Area Clinical Leads and the Medicines Management team. The group has been working together as a forum for sharing good practice, discussing operational issues and proposing solutions to the Medicines Management Board.

We are currently focusing on controlled drugs. A large audit was carried out at the beginning of the year which identified the need to improve overall assurances around controlled drug supply, security and management.

As a result, since May we have been reviewing how we manage and use controlled drugs, for example, how these drugs are stored. These reviews will enable us to establish new processes where required to lower the overall risk associated with controlled drugs.

There is a clear and obvious risk associated with paramedics having personal possession of controlled drugs. Therefore the Trust will soon be moving towards a daily shift/vehicle possession system instead. Paramedics will still have an individual responsibility for the safe carriage and usage of controlled drugs, so we ask that you ensure that you are fully up to date with any changes that are made.

The Medicines Management team will be working closely with Operations teams locally before they make final decisions on process changes. These changes will all be overseen by myself (as the Deputy Medical Director) and the Director of Nursing, who is the Controlled Drug Accountable Officer for the Trust.

Other forthcoming changes around controlled drugs will address the way we manage Diazepam, and the removal of Oramorph from the drugs list. The Medicines Management Board have reviewed the available data around Oramorph usage in the Trust; including the clinical indications for use, the volumes ordered versus amounts used for patient care and the volumes that are denatured through partial usage or expiry (due to a short shelf life). Alternatives are being looked at to ensure all our patients still receive the analgesia they require, for example, liquid ibuprofen for paediatrics. As we have further updates we will share them with you.

Finally, is it really important to remember that that the Medicines Management team are available to help and assist you and your teams whenever required; no decisions should have to be made in isolation. The first point of contact for the team is through the central email address MedicineManagement@eastamb.nhs.uk, an email address we will also use to confirm any decisions made about medicines management.

Published 8th June, 2017

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