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Coronavirus: Home secretary urged to do more to relax drug rules to help ease end-of-life suffering

Drug shortages causing ‘significant and unnecessary distress and pain to patients at the end of their lives and their families’

Shaun Lintern
Health Correspondent
Wednesday 29 April 2020 23:54 BST
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The government has been urged to relax rules on controlled drugs during Covid-19
The government has been urged to relax rules on controlled drugs during Covid-19

The government is under pressure to go further on measures to relax rules on powerful painkillers such as morphine to prevent patients suffering “unnecessary pain and distress in the last days of their lives”.

On Tuesday the health secretary, Matt Hancock, announced staff in care homes and hospices would be allowed to “re-use” controlled drugs such as morphine and midazolam, with medication prescribed for one patient used for another where there is an immediate need.

But the Home Office today confirmed to The Independent that it had no plans to extend the rules to the care of patients in their own homes – a restriction experts and charities have warned could leave people suffering at the end of their lives.

The government announced the changes following concerns over the supply of drugs. Controlled drug rules were extended to commonly used painkillers after serial killer GP Harold Shipman was able to divert drugs he used to murder patients for years without detection.

The Royal College of GPs (RCGP) welcomed the changes announced by Mr Hancock, calling them “a significant step forward”, but added: “This only applies to patients living in care home and hospice settings, so there is still work to be done to ensure patients living in their own homes have appropriate access to necessary medication in a timely way.”

Professor Martin Marshall, chair of the RCGP​, added: “It’s vital that patients at or nearing the end of their lives receive the care they need – and having the right medication when they need it is key to this.”

Last week the RCGP wrote to home secretary Priti Patel warning that people were suffering unnecessarily due to problems accessing drugs.

While Prof Marshall accepted the rules were necessary in normal times, the coronavirus pandemic had led to an increase in patients, which meant “delays in administering drugs to patients whose Covid-19 symptoms develop rapidly”, he said.

“We are aware of incidences where this has caused significant and unnecessary distress and pain to patients at the end of their lives, and their families.

“We are hearing that the requirement for these named prescriptions, combined with localised shortages of drugs and the pressure on clinical staff, means that in some cases patients who are sadly near the end of their lives can wait hours before receiving these medications.”

He added that rules on only using drugs for named patients meant there was “unnecessary wastage” that could leave people without “essential drugs to relieve suffering from end-of-life symptoms”.

Drug shortages during the coronavirus pandemic have hit hospitals too. Anaesthetic drugs needed to ventilate patients have been in short supply, while earlier this week hospitals were warned doses of lorazepam, a drug used for sedation, was expected to run out in May.

Separately, the home secretary today laid emergency regulations in the House of Commons to relax rules for the supply of medicines during the coronavirus pandemic. The rules come into effect on April 30 and allow pharmacists to supply medicines without a prescription where a patient has been receiving a controlled drug as part of their treatment.

The regulations also allow pharmacists to change the intervals on a prescription for controlled drugs without the need for a new prescription.

Ian Hamilton from the University of York, a senior lecturer in substance abuse and mental health welcomed the changes but said the delay to implementation left people at risk.

He said: “It is frustrating for prescribers and pharmacists to have the ability to treat patients with Covid-19 but due to unnecessary bureaucracy are unable to intervene in a timely way.

“The Home Office could make the necessary changes immediately by executive action but has chosen to delay these changes. This issue has been going on for over a month now. My fear is the ... delay is likely leading to patients staying in hospital for longer, or worse elevating the risk of heart attacks or death due to respiratory failure.”

The Home Office and Department of Health and Social Care were approached for comment.

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