No news is bad news on CD changes

After hopes were raised in the autumn (see here), the Home Office said on 9 January that it is still unable to provide a date for the long-awaited amendments to the Misuse of Drugs Act about independent prescribers and controlled drugs. The statement was made in correspondence with pharmacist prescriber Mark Hutton, who specialises in the management of chronic pain, in the East Midlands, and who has been pursuing the Home Office since 2008 about these amendments. He said,’It is ridiculous that I cannot prescribe a drug such as co-codamol yet a patient can purchase it in a pharmacy, and that as a qualified independent prescriber, I have to use supplementary prescribing to prescribe controlled drugs for patients. There is a shortage of pain consultants compared with the number of people with chronic pain, and the Home Office has given no reason for the delays in allowing non-medical prescribers to provide a better service to patients in pain.’

Matt Griffiths, visiting professor of prescribing and medicines management at the University of the West of England, who has also been urging the Home Office to act and highlighting the consequence of delay for some years, had this to say:

‘We have been promised these changes since 2008. As well as non-medical prescribers and their patients, this also affects nurses who want to mix medicines that include a controlled drug, as these amendments will be made at the same time. There are daily restrictions on my practice, where legislation has not kept up with the needs of the modern day health service. I can work as a visiting clinician on a daily basis. I can prescribe certain controlled drugs for palliative care patients, but I can’t carry them out to their homes unless it is on a named patient basis. Despite correspondence with Lord Henley, the Home Office minister responsible, and earlier promises from the Home Office, no date has been given, and the reasons behind the delays of nearly four years do not justify them. I believe that Secretary of State for Health Andrew Lansley, or Prime Minister David Cameron need to intervene as patient care is being affected on a daily basis’.

The statutory instrument was most recently promised for the end of October 2011 (see here) and will allow nurse and pharmacist prescribers to prescribe controlled drugs, within their competence, as well as making the promised changes on mixing medicines, where one or more is a controlled drug (see here).

ANP Chair Barbara Stuttle, who wrote to David Cameron about this issue last year, points out the anomaly involved in this long delay: ‘We keep being told about the £20 billion that needs to be saved in the NHS but something that could so easily address some efficiency concerns – but relies on Ministers – is constantly delayed! All the relevant bodies agree about these legislative changes: all it needs is the statutory instrument. If the government is serious about supporting clinicians to work efficiently and effectively, then I urge the Home Office to make these legislative changes urgently. This will enable nurses to do their job and look after patients by providing the right care at the right time.’