Research has shown time and again that there is a significant risk that patients’ medicines will be unintentionally altered when they move care providers. The NHS outcomes framework has already recognised the significance of this to patient safety. All NHS providers, and commissioners of those services, are now charged with reducing harm to patients caused through medication errors.
Having safe systems in place for managing information and supply of medicines across care providers is also seen as central to safe, high quality care by the Care Quality Commission.

The development of this guidance was led by the Royal Pharmaceutical Society, in collaboration with other royal colleges, patients, health and social care professionals, and is closely mapped to a range of related national initiatives and guidance. It gives organisations tools to develop their systems, and to help effect the culture change necessary in their organisations to raise this important patient safety issue higher up everyone’s agenda.

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