Background to Medicines Governance

The Northern Ireland Medicines Governance Team was established in August 2002 and comprises of 6 senior pharmacists and an administrator dedicated to medicines risk management in acute Trusts in Northern Ireland.

The Team have made excellent progress in addressing the following medicines safety areas:

• Promotion of medication incident reporting which includes actual, prevented and potential incidents;

• Development of the risk management process itself, including identification, analysis and evaluation of risk;

• Development and implementation of regional best practice policies, safety policies and recommendations; and

• Risk education.

In November 2004, the Team was awarded the Health Service Journal Award for Patient Safety.

Although much has been achieved in the secondary care setting, the same resources have not been available to support medication safety in primary care despite it being the area where the bulk of medicines are prescribed and dispensed. The DHSSPS document ‘Making it Better- A Strategy for Pharmacy in the Community’ 2003 states ‘there is an urgent need for the development of a formal medicines risk management system in the primary care setting, which is analogous to that established in secondary care.’

The ‘Safety First - A framework for sustainable improvement in the HPSS’, March 2006, sets an action plan to improve quality of care which takes account of progress and local and national developments. One of the actions included in this document is the extension of the Medicines Governance Team into primary care.

Medicines Governance in Primary Care

The extension of Medicines Governance into primary care aims to build a safety culture, which promotes medication incident reporting, learns and shares safety lessons and implements and disseminates solutions to prevent harm. The primary care section of the Team will have the following key tasks;

• Promote medication incident reporting amongst all primary and community care clinical staff;

• Analysis of medication incident reports to identify and prioritise areas of risk for action, paying particular attention to high risk medicines such as warfarin, methotrexate, insulins and opiates;

• Development of good practice policies (regionally and locally) to support the safe use of medicines;

• Facilitation of the adoption of existing relevant Northern Ireland Medicines Governance Team initiatives in Primary Care;

• Participation in investigation and root cause analysis of major medication incidents at local level;

• Sharing the learning from medication incident reports through staff education initiatives;

• Identify medication risks across the primary / secondary care interface and work collaboratively with the secondary care section of the Team to address theses;

• Network with other local and national primary care organizations, healthcare Trusts and academic institutions with respect to the safe use of medicines; and

• Measures of outcomes.

Five Medicines Governance pharmacists will be appointed in 2008 to implement the medicines governance agenda in Primary Care.