The Pharmaceutical Journal
Vol 269 No 7206 p44
13 July 2002

This article
Reprint
Photocopy

News summary

Related websites
CHI investigation at Gosport War Memorial Hospital (more)

CHI says pharmacists failed to stop excessive prescribing

A complaint from Hampshire police to the Commission for Health Improvement has resulted in a finding that pharmacists failed to challenge excessive prescribing of diamorphine, haloperidol and midazolam at the GP-led Gosport War Memorial Hospital. Medicines were also found to have been prescribed before patients had been assessed or even arrived on the wards.

Publishing its report last week, CHI said: "There was no effective monitoring of the levels of prescription of medicines. Some patients were prescribed strong pain relief on admission, before a total individual assessment of their needs was made. There was also a lack of adequate supervision for individuals working at the trust. CHI is unable to confirm whether any patients died as a direct result but can confirm that patients were regularly put at risk. ... Portsmouth Healthcare NHS Trust, which managed Gosport War Memorial Hospital, failed to undertake an immediate review of prescribing practice in 1998, despite a number of triggers. Police investigations, a pattern of patient complaints and pharmacy data should have alerted the trust to a potential problem with the prescription of pain relief."

The report says that pharmacy support to wards at the hospital was inadequate in 1998. Prescribing data were available and there should have been systems to monitor these data at ward level.

Pharmacists interviewed by CHI's investigation team spoke of a "remote relationship" between community hospitals, such as Gosport War Memorial Hospital, and the main pharmacy department at Queen Alexandra Hospital, together with an increasing workload.

The commission says that Fareham and Gosport Primary Care Trust, which now has responsibility for the hospital, must ensure that a system is in place routinely to review and monitor all prescribing on wards caring for older people. Pharmacy input into regular ward rounds should be considered.

It adds that pharmacists are now confident that ward pharmacists will challenge large doses prescribed by junior doctors and that adequate policies and guidelines governing the prescribing and administration of pain relief to older patients are in place and are being followed.

Ian Piper, chief executive of Fareham and Gosport PCT said that services were now of a standard that should reassure local people.

"We welcome and accept fully the findings of the report and are pleased that CHI recognised the improvements which have been made in services since the complaints it investigated were made," Mr Piper said. "CHI has made a number of recommendations to further improve services and these will be implemented in full."