You are here

CQC carried out a period of listening activity at Brighton and Sussex University Hospitals NHS Trust in December 2013 and January 2014. The report from that exercise, which informed our inspection in May 2014, is available below.

All reports

Inspection report

Date of Inspection: 5 July 2011
Date of Publication: 26 July 2011
Inspection Report published 26 July 2011 PDF | 154.43 KB

People should be given the medicines they need when they need them, and in a safe way (outcome 9)

Meeting this standard

We checked that people who use this service

  • Will have their medicines at the times they need them, and in a safe way.
  • Wherever possible will have information about the medicine being prescribed made available to them or others acting on their behalf.

How this check was done

We reviewed all the information we hold about this provider, carried out a visit on 05/07/2011, checked the provider's records, observed how people were being cared for, looked at records of people who use services, reviewed information from people who use the service, talked to staff and talked to people who use services.

Our judgement

We found that the hospital had appropriate arrangements in place to ensure that medicines were safely handled and administered.

On the basis of the evidence provided and the views of people using the services we found the hospital compliant with this outcome.

User experience

People told us they were felt their medicines were well managed and were able to ask nurses if they had any concerns with pain being well managed and that analgesia was given whenever they needed it.

One person told us that they liked the nurses putting their eye drops in for them as that made it easier. We spoke with a person who was waiting to go home who told us that their new medicines had been explained to them, including the blood tests that they would need whilst taking them and they had been given a booklet about it to read. Another person told us how the hospital had arranged for their medicines to be in a special pack which would help them remember to take them when they got home.

In the A&E assessment area we observed the consultant discussing medication with a patient and assessing possible side effects and how the patient might manage these, whilst constantly checking the patient’s understanding. The patient told us how wonderful and patient he found the consultant and staff.

Other evidence

The trust has written policies and procedures regarding the handling, storage and administration of medication. Nurses all receive training in medication procedures and the safe handling of medicines before administering any medicines in the hospital. This includes a workbook, test, competency assessment and further training days. We saw that the records of these are kept on the wards and competency is re-assessed at intervals. Further training in specialised techniques was given regularly.

We saw medicines being given to people on one ward. Three nurses used the same trolley to give medicines to the people in their section of the ward. This meant that the trolley could not easily be moved close to the patient and medicines had to be carried across the ward. The trolley was locked between each use, but with only one set of keys this was not easy for the nurses to manage. On some other wards we went to we saw that most of the patients’ medicines were kept in individual lockers by their beds. Pharmacy staff told us that that this system was to be extended to other areas of the hospital. The prescription charts we viewed were all completed correctly, if someone refused their medicines or they were not given, the reason was recorded.

When patients were admitted to hospital the medicines that they were taking were checked so that they received their correct medicines during their stay. We saw that the pharmacy staff often did this check, using information from patients and their GP. New medicines are recorded on the prescription chart and on a printed discharge summary which the patient and their respective GP receive. We saw that patients also receive a card advertising a telephone medicines helpline that they can access when they leave hospital.

We heard from some ward staff and patients that there was sometimes a delay in receiving medicines for discharge. The pharmacy told us of the changes they were making to improve this process, which included some near patient dispensing, a tracker system for wards to know when the medicines would be ready and extra delivery rounds. Some nurses had seen that progress had been made, and on one ward a meeting was set up to improve the timely prescribing of discharge medicines.

The hospital has a discharge lounge where people can wait for their medicines and transport. We heard that some people could wait here for up to four hours. The staff in this unit said that medicine delays were still an issue for their patients. A recently opened ‘Step Down’ unit supported people with more complex discharge needs and in this unit the medicines are prepared in advance as part of their discharge plan.

We saw evidence of regular audits of missed doses and controlled drugs on the wards. Pharmacists are involved in a multidisciplinary forum to investigate and provide learning from any medication incidents and the trust has a robust governance structure in place to review policy and practice and address areas of risk.