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Diamorphine dilemma

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A quantity of the drug diamorphine is found to be missing from the ward. What procedure should follow and how serious is this situation for the registered practitioner responsible for the drug going missing?

DIAMORPHINE is a Schedule 2 controlled drug and as such is subject to stringent rules on its storage, control and administration. That the records show the drug is missing is serious and if there is no satisfactory explanation the police must be brought in.

Controlled drugs are of particular concern to the Department of Health, especially since the murders committed by Dr Harold Shipman. The fourth enquiry that followed his conviction dealt with controlled drugs in the community and recommended greater controls.

As a result, the Health Act 2006 sections 17 to 25 tightened rules on the storage and administration of medicines, and enabled new regulations to be drawn up by the DH and the Royal Pharmaceutical Society of Great Britain, strengthening governance and monitoring arrangements. In May 2007 they published The Safer Management of Controlled Drugs.

Trusts must now appoint an accountable officer with responsibilities for the safe and appropriate management and use of controlled drugs. In addition, amendments to The Misuse of Drugs Regulations enable all details on prescriptions for controlled drugs, except the signature, to be computer-generated and the computerisation of registers for drugs listed in Schedule 2 and 3.
Details of the changes can be found in Safer Management of Controlled Drugs (CDs): Changes to Record Keeping Requirements (DH Gateway Ref. 7187, October 2006). A constable or other authorised person has the power to enter premises and inspect stocks and records. Guidance for nurses is also provided in the NMC's Guidelines for the Administration of Medicines (2004).

For the registered practitioner responsible, a missing controlled drug could lead to criminal and professional conduct proceedings and the loss of her or his post.

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