Probe reveals serious failings in drug storage in UK hospitals

Warning after Sky investigation shows medication storage and security flaws

NHS trusts across the country have come under fire after an investigation revealed alarming security failures around the storage of controlled drugs in UK hospitals.

A Sky News probe found a third of the trusts surveyed either had medicines that were not properly locked away, or had drugs that were unaccounted for. There were also problems around temperature control in medication refrigerators.

The standards are absolutely clear. Every hospital should have in place a robust policy for the safe and secure handling of medicines

The findings are particularly worrying as they come just a few months after reports of the saline poisoning incidents at Stepping Hill Hospital in Stockport.

And they have led to warnings from health watchdogs and the supplier community urging hospitals to invest in high-security storage equipment and monitoring technologies.

The Sky investigation has highlighted problems around the storage of controlled drugs

Jim Smith, former chief pharmacist at the Department of Health (DH) and emeritus professor of pharmacy, said: "The controlled drugs issue has been massively important since the Harold Shipman murders and there's been a lot of legislation and regulation around the issue. “The standards are absolutely clear. Every hospital should have in place a robust policy for the safe and secure handling of medicines.”

The DH’s chief pharmaceutical officer, Keith Ridge, said pressure on resources could be partly to blame, adding: “Fridges containing medicines must be locked for security reasons and because medicines will deteriorate if the temperature isn't controlled.

"In fairness to NHS trusts, they're under huge pressure at the moment. These things take time and resources which at the moment are stretched pretty thin."

In fairness to NHS trusts, they're under huge pressure at the moment. These things take time and resources which at the moment are stretched pretty thin

Industry leaders have also commented on the findings, claiming there are a number of solutions on the market that provide security and tracking, helping trusts to ensure supplies are only available to staff with the clearance to access them and to ensure drugs are kept at optimum temperatures.

Carolyn Holland of Lec Medical said: “This report is very disturbing, especially in the wake of the ongoing incident at Stepping Hill Hospital, where six people have died after their saline solution was somehow contaminated with insulin.

“It is crucial that valuable drugs, vaccines and potentially-dangerous substances are stored in professional medical fridges that are specially designed and come complete with a secure lock and warning alarms to restrict unauthorised access. Even the safest drugs can be dangerous when they fall into the wrong hands.”

When choosing storage fridges, she advises hospitals to pick systems that come with dead lock and which comply with BS2281 standards. Audio and visual alarms should also be fitted, or at the very least an open door high-pitch warning system.

It is crucial that valuable drugs, vaccines and potentially-dangerous substances are stored in professional medical fridges that are specially designed and come complete with a secure lock and warning alarms to restrict unauthorised access. Even the safest drugs can be dangerous when they fall into the wrong hands

Holland said action needed to be taken at all premises where medication is stored, adding: “In light of this latest report, it is vital that all hospitals, pharmacies and practices urgently check their medical refrigeration equipment. Without wishing to scaremonger, a simple check and an upgrade to a model that meets MHRA guidelines could save lives.”

During the Sky investigation it was revealed that on a ward in Essex, the access code for a drugs cupboard was written next to the keypad and staff failed to challenge a visitor who accessed a utility room. At Addenbrookes Hospital in Cambridge, 93% of insulin fridges were left unlocked and more than half of the insulin was out of date. And, at Blackpool Fylde and Wyre Hospitals NHS Foundation Trust in 89% of cases the storage area room temperature was not monitored and in 57% of cases the intravenous fluid storage area was not locked.

Overall, of the 94 trusts who gave details of their controlled drugs security audits, 36% revealed failings in at least one area.

In response to the criticisms, a spokesman for Blackpool, Fylde and Wyre said it took patient safety extremely seriously and carried out regular audits to ensure the safe storage and handling of controlled medicines.

Addenbrookes claimed it had driven through ‘significant improvements’ since the investigation and that most fridges were now locked and temperature monitored.

And the Essex trust said it had addressed the security failings identified in the report ‘immediately’.

As part of the Freedom of Information investigation, it was revealed that a handful of trusts are delivering excellent results, with Aintree University Hospitals NHS Foundation Trust among those reporting 100% compliance in its audit in April 2011.

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