So, what does it mean to be “Accountable” within the legislation?
According to the English Oxford dictionary “Accountable” is to be responsible, required to account for one’s conduct; explicable.
It is true to say that the latest NHS re-organisation has been one of the biggest and most disruptive that it’s staff have gone through in recent years. Much of the experience and organisational memory has been lost due to management cuts, with long standing employees leaving the service.
But what is this to you, the current, statutory Controlled Drugs Accountable Officer (CDAO)? Would this make a good defence if your organisation was caught not complying with the law?
A paper was released in February 2013 (from the Department of Health’s policy team) outlining an operating model for NHS England Local Area Teams with regards to The Controlled Drugs (Supervision of Management and Use) Regulations 2013.
The regulations make clear that NHS England must ensure that systems are in place for the safe and effective management and use of CDs and that these systems are working effectively.
Local Intelligence Networks
NHSEngland must formally determine how many Local Intelligence Networks (LINs) there are to be and how many lead CD Accountable Officers, based in the Local Area Teams (LAT), are required to cover them
Regulation 8(4) places a requirement on each LAT to nominate or appoint a fit, proper and suitably experienced person to be its CDAO in respect of each of its LIN areas. It is NOT possible for the LAT CDAO to “contract out” their primary roles and functions to another organisation such as a
Commissioning Support Unit.
The LAT CDAOs are responsible for establishing and leading LINs drawn from the representatives of designated and responsible bodies.
The LIN should also consider how to engage Professional Regulators including the General Pharmaceutical Council along with Local Medical Committees, Local Pharmaceutical Committees and NHS Protect (formerly NHS Counter Fraud). They should also have links to the Business Services Authority
It is important to highlight that as well as having a responsibility for the system wide arrangements for the supervision of management and use of controlled drugs, the LAT is also a commissioner and as such will wish to ensure that any person, or those organisations commissioned with providing relevant services on their behalf, must establish and operate appropriate arrangements for securing safe management and use of CDs and that those systems are reviewed as appropriate as described in regulation 11.
Clinical Commissioning Groups
Clinical Commissioning Groups (CCGs) are not required to appoint a CDAO but are required to assist the relevant LAT CDAO. It is good practice for the CCG to nominate a relevant individual within the CCG who will act as a focal point for liaison with the LAT CDAO, bringing in others as appropriate
Clinical Commissioning Groups (CCGs) are required to assist their lead CDAO in the following ways;
- Provide full support to the CDAO (LAT) in any investigation.
- Report all complaints involving controlled drugs
- Report all incidents or concerns involving the safe use and management of CDs to the CDAO
- Share all standard operating procedures in relation to the management of CDs.
- Analyse the prescribing ePACTdata
- Supply periodic self–declaration and self-assessment to the LAT CDAO as requested.
Destruction of CDs
The LAT CDAO, will be responsible for overseeing CD arrangements in community pharmacies and dispensing practices. The CDAO will need to ensure there are sufficient, fully trained witnesses to avoid build-up of expired or unwanted stock of CDs. Any person authorised to witness destruction by a lead CDAO should continue to be subject to a professional code of ethics, have received appropriate training and be independent of the day to day use or management of CDs.
The regulations state that the organisation employing the CDAO must provide the necessary funds and other resources for the CDAO to discharge their responsibilities in accordance with the Regulations.
To this end, NHS England has made available £1.6 million per year.
This will provide the following
- The equivalent of one WTE 8a post to support the LAT CDAO in managing the LIN, gathering and chasing CD quarterly reports from organisations, ensuring that there are sufficient trained witnesses for CD destruction and assisting with the production of the CDAO Area Team annual report.
- The equivalent of 0.2 WTE pharmaceutical expertise at 8d. This person is likely to be the LAT CDAO and will provide the clinical expertise around the Supervision of management and use of controlled drugs.
The Controlled Drug (Supervision of Management and Use) Regulations have been in place since January 2007. The updated Regulations became formal on 1st April 2013, six months on, where are you up to???
You are responsible and required to account for your conduct with regards to the implementation of these Regulations. Can you explain what you have put in place and your plans going forward?
Gail Curphey is one of the presenters of the Sancus Accountable Officer Training Course. The next course is running at Kings College London on the 7th & 8th October 2014. To book your place follow this link