Hospital Pharmacist
Vol 10 No 5 p189
May 2003

News summary

Related websites
The Children's National Service Framework (more)

Give children the right start: new NSF published

Child-centred care, delivered seamlessly by the various professions involved, including pharmacists, is the over-riding theme of the new "Getting the right start: National Service Framework (NSF) for children". To date, only the "Hospital standard" section, together with the "Emerging findings"consultation document has been published, with the rest being expected this winter.

The hospital standard is divided into three main subsections, with that focusing on the quality and safety of care generally being the most relevant to hospital pharmacists. The need for clinical governance and for evidence-based care is stressed.

A major issue identified in the hospital standard is the use of "unlicensed" and "off-label" medicines in children. This is recognised as being an unsatisfactory state of affairs, but the standard recognises that it will take time for measures increasing the range of products and formulations licensed for use in children to work. Meanwhile, it recommends that hospitals have policies in place about the use of manufacturer's patient information leaflets (PILs), which have been designed for adults and may not cover the medicine's use in children. It asks pharmacists to reassure parents and children about the contents of any such PILs they hand out. Other recommended policies and procedures on the safe use of medicines in children include:

• Making available pharmacy staff to ensure that medicines are managed safely and effectively

• Preparing intravenous injections and infusions for children centrally under controlled conditions

• Reporting and monitoring medication errors

• Ensuring that formulations of medicines are appropriate to the age and ability of the child

• Having control assurance standards relating to the specific needs of children, such as weighing all children accurately to allow drug doses to be calculated

Other parts of the hospital standard focus on the design and delivery of hospital services around the needs of children and their families, and the suitability of hospital settings for the care children receive.

The "Emerging findings" document continues the medicines management theme, recognising medication reviews as a method to ensure optimal use of medicines, and suggesting that "the introduction of supplementary prescribing by pharmacists and nurses will provide greater flexibility, improved access, and overcome some of the barriers that currently exist in the provision of holistic care to children." The use of "unlicensed" and "off-label" medicines in children is again highlighted as being a problem. Comments on the "Emerging findings" report can be made to Claire Phillips the children's NSF project manager until mid-July.