CQC strategies for the safe disposal of medicines

When medicines reach the end of the road, what are the most safe and effective disposal strategies?

CREDIT: This is an edited version of an article that originally appeared on Quality Care Commission

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 any investigations are completed.

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 items have been removed from controlled temperature storage.

Risk

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

• 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

You should record the process for disposing of medicines in your medicines policy. Store medicines for disposal securely and separately from in use medicines. Control access until they are collected or taken to the pharmacy. Do not dispose of medicines on site through the sewage system. NICE SC1 says ‘Medicines for disposal should be stored securely in a tamper-proof container within a cupboard until they are collected or taken to the pharmacy.’

Care homes without nursing

You should dispose of medicines by returning them to the supplier. This would usually be 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.

When social care providers are responsible for disposing of any unwanted, damaged, out-of-date or part-used medicines, you must have robust processes in place. These should include details of how the medicines will be disposed of, what records need to be kept, and obtaining agreement.  

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.