Assessment of Patient’s Own Drugs (PODs)

Medicines that the individual has brought in from home, another care setting or, if being cared for at home already has in their home, should continue to be used as long as they are appropriate for use.

PODs should be assessed for suitability using the organisation’s assessment tool. The following points should be covered as a minimum to ensure the:

• individual is currently prescribed the medication
• medicines are in date
• labels have the correct personal details
• labels have the full and correct dosing instructions
• formulation is suitable for use by the individual
• individual is able to open containers and read the labels

Where PODs are deemed not suitable for use, they should be disposed of in line with the organisation’s medicines policy and with the consent of the individual.

Infection risk of PODs

Appropriate infection prevention controls must be used where staff are concerned that the PODs may constitute an infection risk.

Depending on the nature and spread of the perceived contamination, the organisation should make available procedures for decontamination if this is deemed more appropriate than destruction.

There must also be an identified protocol to ensure that the PODs follow the individual on their journey through hospitals in transition between care settings, including the management of contamination.

Controlled Drugs

Controlled drugs have additional safe storage requirements which vary depending on their legal schedule.

Organisations should make their own decisions about whether they can support SAM for controlled drugs, based on the clinical setting and the individuals involved.

POD Lockers

Individual POD lockers should be available for the safe, secure storage of medicines and meet the following requirements:

• the medicines must be within reasonable access of the individual (or their carers if carer administration is being undertaken) and in a form that the individual can use
• the POD lockers may be secured by any suitable means including an individual key, digilock or swipe card lock as described in the organisational medicines management policy or equivalent.
• the individual’s responsibility for the secure storage of their medicines is agreed during the consent process for SAM

Exempt from secure storage

Organisations may choose to exempt certain medicines from secure storage to support ease of access to some medicines e.g. reliever inhalers, glyceryl trinitrate (GTN) spray, insulin.

A risk assessment must be undertaken to determine the appropriateness of SAM, where medicines are not to be stored in accordance with the organisation’s medicines policy.

In exceptional circumstances, such as a major incident where it may be impossible to have locked storage, SAM may still be achievable where supported by the outcome of a risk assessment.

Hospital at Home, virtual wards and community services

Organisations must have processes to risk assess the medicines storage requirements for individuals being treated in their own homes. Most medicines will not require secure storage.

Safe storage will depend on the home situation, medicines involved (e.g. controlled drugs) and the potential risk to others.

Special circumstances

The following examples illustrate the rationale for supporting secure storage exemption requirements with certain medicines. Before an organisation introduces exemptions into practice it would be advisable to undertake a local risk assessment.

Insulin

• individuals with diabetes frequently monitor their blood glucose and inject insulin multiple times each day
• individuals will usually manage their diabetes independently whilst at home or in another care setting, linking insulin with meals as required
• individuals should be offered SAM to enable them to link insulin with hospital mealtimes and manage their blood glucose levels as normal
• in-use insulin does not require refrigeration and may be stored in the same secure storage as the rest of the individual’s medicines i.e. POD locker
• organisations should risk assess the need for locked storage of insulin and support alternatives if necessary

Parkinson’s disease

• administration of medications in Parkinson’s disease is time critical and regime timings often fall outside the traditional times for medication administration rounds
• individuals or carers who wish to self-administer these medicines should be assessed in the usual way with particular consideration being given to which medicines may be administered if the individual requires additional care
• Parkinson’s UK have further information on SAM available on their website Self administration of Parkinson’s medication: a guide for hospital staff

Over The Counter (OTC) medicines

Individuals who are self-administering their own medicines should not require healthcare professional administration of OTC medicines.

When in an inpatient or care setting organisations should have an identified process whereby, if required, necessary OTC medicines can be supplied to an individual undertaking SAM following clinical review by authorised healthcare professionals.

Note

• the organisation must have a defined list of such products detailing the circumstances under which they may be supplied and by whom
• General Sales List (GSL) medicines may be supplied by any suitably trained healthcare professional in line with local policy
• a PGD, PSD or prescription will be required for the supply of Pharmacy Only (P) medicines
• separate advice should be included within SAM policies/procedures to account for the recording of any OTC medicines taken by an individual when in their own home.

Further information for OTC medicine supply

SPS advice on P and GSL medicines with PGDs includes a template protocol to support supply. This protocol may be locally adapted where individuals are self-administering their regular medicines and a supply of a GSL medication, as an OTC or homely remedy, is deemed appropriate.

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