Written Statement - Opiate use and guidance within NHS Wales

The independent panel report into the deaths of patients at Gosport War Memorial Hospital in Hampshire found at least 456 patients had their lives shortened through the use of opioids without justification, between 1989 and 2000.  Whilst the report looked specifically at concerns regarding the standards of care at Gosport, it serves as an important reminder to all care providers about the importance of robust systems and processes to support the safe use of opioids and other controlled drugs. It also highlights the need to ensure the concerns of staff, patients and their loved ones are listened to and acted upon.

It is essential that we have robust arrangements in place for the management and use of Controlled Drugs to minimise patient harm, misuse and criminality.  The tragic deaths of patients at Gosport War Memorial Hospital occurred many years ago.  In the intervening years a great deal has been done to improve the management and supervision of the use of controlled drugs within the NHS. Measures to enable and require NHS and independent healthcare providers to monitor their use of controlled drugs and assure themselves of the quality and safety of the care they provide have been put in place.  The Controlled Drugs (Supervision of Management and Use) (Wales) Regulations 2008 require that all local health boards, NHS Trusts and independent hospitals in Wales appoint a Controlled Drugs Accountable Officer. The Accountable Officer, who must be a fit and proper suitably experienced person, has a range of responsibilities relating to the safe management and use of controlled drugs. The responsibilities include ensuring  there are appropriate arrangements in place for monitoring and auditing the management and use of controlled drugs and for the investigation of any concerns raised in regards to improper management or use of controlled drugs.  Regulations provide powers for the Accountable Officer to act upon well-founded concerns to protect patients, or members of the public, in cases of concern relating to the management or use of controlled drugs.

Regulations also provide for local health boards to establish Controlled Drugs Local Intelligence Networks (LINs) with representatives from across health, social care, health and care regulators and the police, to facilitate sharing and discussion of concerns.

Our policy is to take an evidence based approach to the prescribing and administration of all medicines. To provide assurance that organisations adhere to the evidence based approach we routinely measure performance in key areas through national prescribing indicators. These include a number relating to opioids use.

In NHS Wales we are committed to a culture of openness and transparency.  Patients and staff are able to report concerns with the care or treatment provided through the ‘Putting Things Right’ process. This process promotes a culture of openness through the principles of ‘Being Open’.  In addition, there is an all Wales whistleblowing policy which enables staff to raise concerns where they believe there has been malpractice/wrongdoing.  The purpose of this policy is to provide an internal mechanism for reporting, investigating and remedying any wrongdoing/inappropriate practice in the workplace.

This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Assembly returns I would be happy to do so.