Abstract

The secure storage of controlled drugs (CDs) is defined in the Misuse of Drugs (Safe Custody) Regulations 1973. The 2007 Amendment specified its application to care homes which includes hospices. Compliant storage involves use of receptacles compliant with British Standard 2881.

The Home Office has confirmed that there are no exemptions to these safe custody storage requirements in care homes (personal communication 2011) although some approved local discretion is allowed in NHS trusts.

Spontaneous breakthrough cancer pain (BCP) is severe with a rapid onset and relatively short duration in most patients requiring prompt treatment with potent opioid analgesics. Treatment is with immediate release oral morphine or oxycodone or the newer faster acting oral transmucosal and nasal fentanyl preparations. Except oral morphine solution 10 mg/5 ml, these preparations must comply with safe custody CD regulations storage.

Healthcare professionals frequently cite treatment delay due to central retrieval of CDs, often distant from the patient, key locating, unlocking cupboards and completing administration audit. This results in patients in pain longer.

By employing self administration of medicines policies plus the development of a BS2881 compliant near-patient biometric storage cabinet, we have set out to empower patients in their own BCP treatment and reduce treatment delays. There is no legal requirement to witness CD self-administration.

Biometric cabinets are keyless with secure access by means of a thumbprint. IT cabinet link provides access authorisation and an audit trail. Lock-out times are programmable to govern frequency of access and repeat access. There are different cabinets for central ward or individual bed side location.

Pilot sites are being recruited for a trial and evaluation of the development. Organisationally agreed Standard Operating Procedures will govern the entire process in line with official requirements.

The outcomes of the pilot will be evaluated and published.

Development in association with Flynn Pharma.