July 2016 July 2016 Prescription Form Security LSMS NHS England - - PowerPoint PPT Presentation

July 2016

NHS England (South East) Controlled Drugs Local Intelligence Network www.tiaa.co.uk

Prescription Form Security

LSMS

July 2016

Aim

Our aim is to provide NHS staff that handle prescription forms with guidance and advice to ensure as far is reasonably practicable, prescription forms are kept safe and secure, so that losses to the NHS are minimised.

July 2016

Working in Partnership with Key Stakeholders

NHS Protect NHS England (Regional Teams)

July 2016

Life cycle of a prescription form

• Ordered through Capita by NHS England regional teams
• Regional teams securely deliver forms to GP practice
• GP practice stores and uses prescription forms
• Patient handed completed and authorised prescription form
• Patient takes it to Community Pharmacy for dispensing
• Community Pharmacy returns the completed forms to NHS BSA

(PPD) During each stage of its life a prescription form should be secure and NHS staff should be able to locate the form.

July 2016

Why is security regarding prescription forms important?

• Prescription forms are “blank cheques” and

are open to misuse

• They can be used to obtain controlled drugs

illegally, which could lead to a clinical incident

• They are easy to conceal and move as they are

small items

• They often are not securely stored

!! Include prescription forms in your risk assessment !!

July 2016

Secure management and use of prescription forms by:

• Prevent theft and misuse by secure

storage

• Develop

procedures for secure management and storage - inclusive roles and responsibilities

• Develop local protocols to address

losses, theft or missing prescription forms

• Control

and record prescription movement, including the recording of serial numbers

July 2016

Delivery of prescription forms to a GP

Delivery is arranged by NHS England regional teams, via a secure delivery service Upon delivery:

• A time slot needs to be arranged
• Delivery should not be made in a public area
• Dedicated staff (2) should be available to accept delivery
• Prescription forms should be delivered in bulk packaging, to avoid individual

forms going missing

• Boxes should be fully checked to ensure correct quantity and forms were

delivered

• Packaging should be sealed and the seals unbroken
• The forms should be signed for on the delivery note
• Delivery quantity and serial numbers should be recorded
• Forms should be securely stored as soon as possible

If there are irregularities at the point of delivery, this must be reported.

July 2016

Stock control system

• Stock control systems should contain following data:
• Date of delivery
• Name of person accepting delivery
• What quantity has been received (and serial numbers)
• Where it is being stored
• When it was issued
• Who issued the prescription forms
• To whom they were issued
• The number of prescriptions issued
• Serial numbers of prescriptions issued
• Details of the prescriber
• Details of any prescription forms that have been destroyed
• Records should be retained for a minimum of 3 years

July 2016

Storage prescription forms

By shredding or by the use of confidential waste services, securely destroy personalised forms which are no longer in use. This to be witnessed. Limit access to prescription forms to authorised personnel only Consider physical security measures

• CCTV
• Alarms
• Access control systems
• Secured by Design

July 2016

Security prescription forms when in use

Manual systems

• Ensure forms or pads used manually

(handwritten) are kept secure at all times

• keep as few prescriptions as possible

July 2016

Security of prescription forms when in use

IT systems

• Electronic alternatives reduce number of lost/stolen prescriptions
• Do not leave forms in printer trays when not in use (or overnight)
• Fit a security device on a printer or place the printer in a secure part of the

building (away from patient and public areas)

• Limit access to functions that generate prescriptions
• All prescribers to have an individual

passwords (no sharing) and these to be changed

• n a regular basis
• Screensaver facility to avoid information being read

when the prescriber is away from their desk, and password re-entry should be required

July 2016

Security of prescription forms when in use

• Record serial numbers (see above)
• Blank prescriptions should never be pre-signed
• Un-used forms to be returned to stock at the end of each session/day
• Completed prescription forms to be stored in a locked drawer/cupboard
• Do not leave patients, temporary staff and visitors alone with prescription

forms, or allow access to prescription forms storage areas

• GP stamps should be kept in a secure location, separate from the forms
• Pre-personalised prescription forms are preferred over hand-stamped

prescription forms

• Comply with legal requirements when prescribing CD’s
• Prescribers are responsible for the security of forms once issued

July 2016

Duplicate and spoiled prescriptions

Securely destroy duplicate prescriptions and record appropriately If an error is made either:

• Put a line through the script and write

“spoiled” on the form

• Cross out the error, initial and date the error,

then write the correct information

• Destroy the form and start a new prescription

(and record appropriately)

July 2016

Home visits

Keep prescription pads in a lockable carrying case Do not leave prescription pads in your vehicle, but if you have to:

• Do not leave them on view
• Store in a locked compartment (in the boot)
• Fit/use car alarm
• Record the numbers you are taking at the GP surgery
• Take only a small number of prescription forms with you

July 2016

Care home visits

• Do not leave blank or pre-signed prescription forms lying around
• Do not use the home’s CD cupboard for storing prescription pads
• Carry your own supply

July 2016

Locums

When issuing prescriptions on behalf of a senior partner, note your name on the prescription, ensure it matches the signature Record serial numbers of the pads used GP surgeries should record serial numbers of prescriptions issued to locums, and have a record of care homes where they will be used

• Carry your own supply
• Ensure surplus prescriptions and pads

are returned to the GP practice

July 2016

Reporting and audit

• Prevention of theft and loss of prescription forms is the responsibility of

everyone! Treat prescription forms as a valuable asset.

• Implement procedures and systems to ensure prescription stationery is

secure

• Focus on potential weaknesses (risk assessment)
• Ensure staff know how to report concerns
• Ensure separation of duties (whenever possible) between ordering, receipt

and checking of prescription forms

• Appoint an appropriate member of staff to oversee the whole process

(from ordering, receipt, storage and recording), and appoint a contingency in case of absence

• Undertake stock checks on a regular basis (minimum quarterly)

July 2016

Audit Trail

All systems should be auditable i.e. the history of a prescription can be traced from receipt of the blank form to when it is prescribed and issued.

July 2016

Reporting missing/lost prescription forms

Ensure processes are in place for staff to report incidents Ensure you have following information where possible:

• Date and time of loss/theft
• Date and time of reporting the loss/theft
• Place where loss/theft occurred
• Type of prescription stationery
• Serial numbers
• Quantity

July 2016

Reporting missing/lost prescription forms (cont.)

Report to NHS Protect: 0800 028 40 60 (8am-6pm Monday-Friday) Or online: https://www.reportnhsfraud.nhs.uk

July 2016

Actions after lost/stolen/missing prescription forms

• Ensure the affected prescriber issues “different” prescription forms in the

next two months (different colour ink etc.)

• Consider sending script electronically to an agreed pharmacy
• Ensure specimen signatures can be provided to pharmacies so that signatures

can be checked

• Review risk assessment regarding prescription forms
• Review security measures in place within the surgery that could affect

prescription form security

July 2016

Questions

July 2016