The High Risk Medicines Framework specifies some medicines and medicines groups and at the current time this does not include Parkinson’s medication. There is also a High Risk Medicines Discussion template that is not medicine specific and can be adapted and used by local teams to meet their needs. Parkinson’s medication can be reviewed and discussed within this framework to support local teams to discuss and prioritise improvement activities. All resources are reviewed regularly and the Scottish Patient Safety Programme (SPSP) welcomes further suggestions to add to or develop resources.

The Scottish Patient Safety Programme (SPSP) Medicines Collaborative was hibernated in 2020. Since then, the following elements have restarted:

• Non-Steroidal Anti-Inflammatory Drugs (NSAID) Safer Care Bundle
• NSAID Communication Care Bundle
• Medicines Sick Day Rule Cards
• High Risk Medicines Framework
• High Risk Medicines Discussion Framework

Two elements which have ceased are:

• Omitted medicines, which has moved to the Excellence in Care team
• Reducing Medicines Harm Across Transitions

Medicines safety continues to be a priority across Healthcare Improvement Scotland (HIS) and their current focus is on supporting the implementation of primary care pharmacotherapy services. This includes quality improvement work to ensure safe and timely access to medicines using resources from the acute prescribing and serial prescriptions toolkits. These toolkits have been developed in collaboration with primary care teams to ensure people have safe and timely access to medicines including regular, person-centred medication reviews. HIS also provides hands on implementation support to teams who can apply to join a seven week sprint programme. During this programme teams are supported to understand their local system and implement the tools and resources within the pharmacotherapy toolkits.

All Healthcare Improvement Scotland’s resources are reviewed regularly by the clinical team supporting HIS. The high risk medicines framework has been reviewed and has been identified as a useful resource for teams to use within their local settings. These are live resources and the Scottish Patient Safety Programme team welcomes feedback or suggestions for further developments.

Reducing harm due to high-risk medicines has been identified as a priority by health boards across Scotland and the Scottish Patient Safety Programme (SPSP) has focussed on supporting teams to discuss and prioritise improvement activities related to high-risk medicines and high-risk situations around medicines.

The SPSP programme within HIS has developed a number of tools and resources which are publicly available via the Healthcare Improvement Scotland (HIS) website. These resources include the Non-Steroidal Anti-Inflammatory Drugs (NSAID) Safer Care Bundle, NSAID Communication Care Bundle, Medicines Sick Day Rule Cards, High Risk Medicines Framework and the High Risk Medicines Discussion Framework. All resources available on the HIS website are reviewed by the clinical team supporting HIS to ensure they remain up to date and beneficial, and are available for staff to use within their local settings.

Hospital Electronic Prescribing and Medicines Administration (HEPMA) has been rolled out in in seven Health boards including NHS Ayrshire & Arran, NHS Dumfries & Galloway, NHS Forth Valley, NHS Greater Glasgow and Clyde, NHS Lanarkshire, NHS Lothian and The State Hospital.

The six North of Scotland Boards have worked collaboratively together to develop a regional HEPMA and have implemented capability for the region. NHS Grampian, NHS Highland, NHS Tayside and NHS Orkney have gone live and are now planning for a wider roll out across each of their estate. Both NHS Shetland and NHS Western Isles are finalising preparations for go live in the coming weeks.

Work is underway to rollout HEPMA systems in the remaining Health Boards of NHS Borders, NHS Fife and the Golden Jubilee National Hospital. We expect these implementations to begin in 2024.

The Scottish Patient Safety Programme (SPSP) has developed a number of tools and resources to improve medicines safety. One area of focus has been on developing resources around the use of high risk medicines, and within high risk situations. The high risk medicines framework and discussion tool has been reviewed by the clinical team supporting Healthcare Improvement Scotland (HIS) to ensure they remain up to date and beneficial. There are also some more in-depth evaluations and updates of specific resources. The sick day rule cards are being updated in collaboration with the Quality Prescribing and Therapeutics Division of the Scottish Government and will be included in polypharmacy guidance, and HIS has commissioned the University of Strathclyde to complete a national evaluation of the Non-Steroidal Anti-Inflammatory Drugs (NSAID) safety bundles. This evaluation will be completed in the coming months and a report will be issued outlining the findings.

The medicines reconciliation process is set out at a national level, and the responsibility lies within each Health Board to enact and monitor adherence.

Board specific policies detail the roles and responsibilities of healthcare professionals when completing and updating medicines reconciliation forms during admission, transfer, and discharge.

Arrangements may vary, therefore specific details could be obtained directly from the Health Boards.

People living with Parkinson’s should be responsible for the administration of all their medicines, including during a stay in any health or care setting, unless a risk assessment indicates otherwise. There are several tools to help people to remember to take their medication, including using alarms on a digital watch, or setting a reminder on a smartphone, using medication reminder charts, using pill timer boxes and multi-compartment compliance aids. In health and care settings, including hospitals, organisational policies will define who can administer medicines, or the appropriate delegation of the administration of medicines, within that setting. This should include a policy for self-administration of medicines.

All registered healthcare professionals who administer medicines, or - when appropriate - delegate the administration of medicines, are accountable for their actions, and this includes recording when a dose of medication may have been missed. This is in line with professional and regulatory standards and guidance. Non-registered healthcare professionals are appropriately trained, assessed as competent and meet relevant organisational guidance on medicines administration.

The administration of Parkinson’s medications vary from person to person and does not always correspond with hospital ward medicine administration rounds for people who are not able to self-administer, and so the roll-out of a Hospital Electronic Prescribing and Medicine Administration (HEPMA) system across Scottish hospitals will help to reduce any missed doses, as well as providing a record of any omissions which provides data to support improvement in the administration of medicines. In addition, there are additional tools in use in some hospitals which can provide alerts as reminders to administer Parkinson’s medicines.

I refer the member to the answer to question S6W-17540 on 11 May 2023. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .