Resolution: Access to controlled drugs in care homes
Submitted by the Pain and Palliative Care Forum
03 Jun 2024, 08:00 - 06 Jun, 17:00
This resolution was passed by voting members at Congress 2024.
Care homes without nursing cannot store controlled drugs unless they are prescribed for individual residents as per the Misuse of Drugs Act 1971. This means there are challenges with access to controlled drugs in residential homes which can impact negatively on the ability of staff to provide the best care possible at the end of life. It is important to acknowledge the challenge is due to the legal position of storage of controlled drugs in these homes.
Care homes with nursing are permitted to hold stocks of controlled drugs in schedules 3, 4 and 5 without a Home Office license (CQC, 2023).
Stock of controlled drugs in schedule 2 can be held in care homes with nursing where the home is wholly or mainly maintained (50% or more) by a public authority, out of public funds, by charity, or voluntary subscriptions (Home Office, 2014). Otherwise care homes with nursing must apply for a UK Home Office Controlled Drugs license (Jones, 2023). However, this is a prolonged process with associated costs and in itself is prohibitive. Awareness and uptake levels of the license are unknown but likely to be low.
This is a system problem as opposed to any criticism of staff providing clinical care. The consequence of the current situation is a delay in alleviation of symptoms posing a risk of unnecessary suffering by the resident and distress to families and staff.
There are approximately 441,000 people in about 16,700 care homes in the UK (Berg, 2024). Approximately 70% are residential (without nursing) and 30% are care homes with nursing (Berg, 2024). While UK-wide statistics on deaths in care homes are problematic because of definitional differences between the nations, it is estimated that between 17% and 21% of all deaths registered in the UK in 2022 were registered in care homes (ONS 2023). Accessi