The Department of Health (DH) has now published guidance about the mixing of medicines before administration, following the recent legislative changes (see here for guidance and here for more information).
The National Prescribing Centre (NPC) has produced a resource with tools and advice about how to implement the guidance points (here).
The DH guidance points out that, “These changes apply not only to palliative care, but to all clinical areas where the mixing of medicines prior to administration is accepted practice and supported by the employer’s policies for the delivery of healthcare.” It reiterates the advice from the Medicines and Healthcare products Regulatory Agency – that it would not consider ‘enforcement action against those prescribing and administering mixtures of licensed medicines in clinical practice, unless it would be in the public interest to do.’ So, for controlled drugs (where the legislative changes do not yet apply) existing good practice arrangements should continue.
The NPC resource provides advice on when medicines should be mixed, emphasising that this should only happen when it is essential to meet the needs of the patient, what issues the prescriber and the person doing the mixing should consider, what counts as instructions ‘in writing’ and much else. It suggests that organisations and practitioners should review systematically their current practice in the light of the new guidance, using this resource.