Medicines

Medication Delays Putting Hospital Patients’ Lives ‘at Risk’

A coalition of health charities has called on the Government to do more to ensure that patients in hospital taking time-critical medications actually receive them on time. In a joint statement, the group, which said it represented 5.46 million patients across the UK, said that it was “concerned” at the number of hospitalized patients who were “missing crucial doses of medication”.

The statement was signed by: Diabetes UK, Epilepsy Action, the National Aids Trust, Parkinson’s UK, Rethink Mental Illness, and the Richmond Group of Charities, as well as supporters the Royal College of Emergency Medicine and the Royal Pharmaceutical Society (RPS).

Medication Delays “Wholly Avoidable”

To coincide with the call, and to mark World Patient Safety Day, Parkinson’s UK re-launched its ‘Get It On Time’ campaign , originally started in 2006. A new report from the charity, Every Minute Counts, demonstrated that a majority of patients with Parkinson’s disease experienced delays receiving medication while in hospital, which was a “wholly avoidable problem”, it stressed.

The UK Parkinson’s Audit 2022 showed that 58% of people with Parkinson’s disease did not always get their medication on time, every time, when admitted to hospitals in England. This was a similar proportion to previous years (50% in 2015, 58% in 2017, and 53% in 2019), showing that “scant progress has been made over the best part of the last decade”, the charity said.

In May this year, Parkinson’s UK sent freedom of information requests to every NHS Trust in England, asking what steps they were taking to address the problem. Responses were received from 91% of trusts.

Findings showed that a quarter of NHS trusts had no policies to allow people with Parkinson’s disease to take their own medication while in hospital. Just over half (52%) required staff training about time-critical medications, and although 81% of trusts had e-prescribing, only 58% used it to report whether people with Parkinson’s disease were receiving their medication on time or not.

“A Priority Patient Safety Issue for the NHS”

Given the “serious risk of harm”, and the number of people affected, this should be “a priority patient safety issue for the NHS”, the charity said. “Yet time-critical medication in hospitals fails to register on the health policy landscape.”

It pointed out that for Parkinson’s disease patients, a medication delay for as little as 30 minutes could mean the difference between functioning well and being unable to get out of bed, walk, talk, eat, or swallow. Missing medication altogether could lead to “severe and irreversible harm”, including potentially fatal Parkinsonism-hyperpyrexia syndrome.

Similar issues also affected patients with diabetes, epilepsy, HIV, and some mental health issues. Of the one in six people in hospital with diabetes, 35% are on 

Insulin, and 37% of them had at least one insulin error on their drug chart, according to latest figures. Similarly, for the 48% of patients whose epilepsy is poorly-controlled, medication delay could lead to breakthrough seizures and, in extreme cases, prove fatal. Missed or late doses of HIV drugs could result in higher viral loads and increased resistance.

Patients Who Can Should Keep and Administer Their Own Medications

Yet, the group said, there were “simple solutions” to delivering medications on time: 

  • Enable self-administration of medication by patients, where appropriate
  • Boost the roll out of e-prescribing and use it to monitor delayed or missed doses
  • Train all ward staff responsible for prescribing and administering medication about time-critical medication and who needs it

Asked to comment by Medscape News UK, an NHS spokesperson said: “While local NHS trusts are each responsible for their own medicines policy, NHS England has commissioned a range of support, information and resources for organisations on this issue, which have been used by hundreds of health professionals. We will continue to encourage their use so patients in hospital can get their medication in a timely way.”

Also commenting to Medscape News UK, Laura Wilson, RPS director for Scotland, said: “Patient safety is paramount and ensuring no one misses a dose of their in hospitals is vital. Every minute counts when it comes to time-critical medication. 

“By implementing self-administration policies, expanding the use of e-prescribing and providing essential training for hospital ward staff, we can significantly reduce the risks faced by patients with conditions like Parkinson’s, diabetes, HIV, and epilepsy.”

Parkinson’s UK said it was currently recruiting people with Parkinson’s disease to assess whether missed or delayed medication in hospital unnecessarily extended stays or led to health problems.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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