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Disposing of medicines in care homes and care homes with nursing

Categories:
  • Organisations we regulate

All care settings should have a written policy for the safe disposal of surplus, unwanted or expired medicines.

Disposal of waste is subject to legislation and regulated by the Environment Agency. You might need to dispose of medicines when:

  • a person’s treatment changes or stops
    Safely dispose of remaining supplies (with the person’s consent).
  • a person transfers to another care service
    The person should take all of their medicines with them, unless they agree to dispose of any they no longer need.
  • a person dies
    You should keep the person’s medicines until the Coroner completes their investigations.
  • the medicine reaches its expiry date
    Make sure you read about expiry dates in the product information leaflet. Some medicines expire before their ‘use by’ dates because you've opened the packaging. Other expiry dates are shortened if they're removed from controlled temperature storage.

Risk

Care homes must dispose of unwanted medicines appropriately, to avoid placing people who use services at risk.

Examples

A person who is no longer a resident was previously supplied medicine. If you do not dispose of that medicine, it could be administered in error to another person. You must not administer medicine to a person if it was prescribed to another person.

A prescriber has stopped prescribing a medicine. If you continue to administer the medicine, you could place people at risk.

If you administer medicine beyond the expiry date, the product could have chemically changed. This may make it clinically ineffective or could cause actual harm.

Process

Store medicines for disposal in a tamper-proof container until collected or taken to the pharmacy. Disposal of medicines on site through the sewage system is not appropriate.

Care homes without nursing

You should dispose of medicines by returning them to the supplier. This would usually a community pharmacy or dispensing doctor. The supplier should dispose of the medicines in line with current waste regulations.

Nursing homes

You must only return medicines to a licensed waste disposal company. This might include community pharmacies.

Controlled drugs

Controlled drugs in Schedules 2, 3 and 4 (Part I) must be denatured before disposal. This may happen in a community pharmacy or a nursing home.

Care homes without nursing

You should separate unwanted or out-of-date controlled drugs from current stock. Store them in the controlled drugs cupboard.

All medicines, including controlled drugs, should be promptly returned to a community pharmacy.

Best practice involves two staff members recording entries in your controlled drugs register. This helps to verify that the register is accurate. Some pharmacists will sign the register to acknowledge receipt. This is not a legal requirement.

Nursing homes

Patients' own controlled drugs

Patients' own individually-labelled controlled drugs must be denatured before handing to the waste disposal company.

Good practice involves two staff members - one to denature and one to witness.

The Environment Agency classes this as processing waste. The nursing home will need to apply for a T28 waste exemption. This is free of charge.

Stock

Occasionally, the Home Office grants a licence for a nursing home to hold a stock of controlled drugs.

You must denature out-of-date stock in Schedules 2, 3 and 4 (Part I).

You must destroy Schedule 2 stock in the presence of an authorised witness. This includes a police constable or inspectors of the General Pharmaceutical Council. The lead controlled drugs accountable officer of NHS England may also appoint authorised witnesses. You also need to record details of the destruction in your controlled drugs register.

It is good practice for another member of staff to witness the denaturing of stock in Schedules 3 and 4 (Part I).

Keeping records

You must keep records to ensure that medicines are handled properly during disposal. Records could include:

  • date of disposal or return to pharmacy
  • name and strength of medicine
  • quantity removed
  • person for whom medicines were prescribed or purchased
  • signature of the member of staff who arranges disposal of the medicines
  • signature of the person collecting the medicines for disposal

Nursing homes should also keep records of transactions with registered waste disposal companies.

Last updated:
03 August 2018

 


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