This report shows what we found about the common areas of risk when using medicines across health and social care in England.
We know that people’s physical and mental health outcomes improve when medicines are used in the best or optimal way. When they are not prescribed or administered correctly they can cause harm.
We want to encourage improvement by sharing what we have found through our regulatory work and giving examples of how some providers have reduced these risks.
What we did
over 200 inspection reports
100 enforcement notices
1,500 National Reporting and Learning System (NRLS) and statutory notifications from providers.
What we found
There are many examples of how good use of medicines can lead to person-centred care and better patient outcomes. Yet many medication errors happen and we identified common areas of risk where there is a need for improvement across different types of health and care services:
prescribing, monitoring and reviewing medicines
at transfer of care between services
reporting and learning from incidents
storing, supplying and disposal
staff competence and workforce capacity