Managing complexities of medication use across care boundaries

Event 26 June 2024Location Online via WebEx at 12:30-14:00

Exploring the risks for patients on complex or specialist medicines moving across care boundaries with a focus on strategies to reduce harms


26 June 2024


Online via WebEx at 12:30-14:00

About the event

This interactive session is part of the ‘Medication Safety Across the System’ (MSATS) series aimed at healthcare professionals, working in any sector with a role or passion for medication safety and/or involved in medicines use.

Our speakers will share innovative practices addressing the safe use of medicines across care boundaries, to inspire and equip the audience ready for translation and replication in their locality.

Why it’s important

There are known risks when medicines use crosses boundaries of care. Additional risks are introduced with complexities related to medicines formulation, licensing, availability and, use in specialist populations and conditions.

Measures aimed at reducing the risk of harm related to these complexities, such as standardisation and targeted communications require a collaborative and system wide approach to ensure sustainable safety improvements.

What will be covered/what you’ll learn

  • A discussion of factors that add complexities to the prescribing and supply of medicines, with a focus on liquid medicines.
  • A ‘lived experience’ to understand the impact of these complexities when individuals cross care boundaries and continue their medicines.
  • Shared exemplar practices where standardisation or communication tools have been used along the patient pathway to improve safety, enabling reflection and consideration for implementation at a local and system level.
  • Opportunities to network with peers to inform the development of appropriate local and system wide responses, to enhance the safe use of complex and specialist medicines.

Learning outcomes:

  • Articulate key safety issues related to the prescribing or supply of complex or specialist medicines when patients cross all care boundaries
  • Define key safety considerations when prescribing , supplying and advising on administration of complex and specialist medicines, particularly when patients transfer across care boundaries
  • Understand how standardising strengths and formulations of medicines can enhance safety at the prescribing interface
  • Understand the impact of good written and verbal communication to other healthcare professionals, patients and carers along the patient pathway
  • Reflect on examples shared and identify actions or responses to recommend locally, in order to improve safe practice.


A range of speakers from SPS and other organisations will run this event.

Non-SPS Speakers

Stephen Tomlin

Director of the Children’s Medicines Research & Innovation Centre -CMRIC (Great Ormond Street Hospital)
Vice Chair – Joint Medicines Committee – RCPCH/NPPG

Keynote speaker – James Melville Ross

Dad to disabled twins Tommy and Alice, managing a complex combination of medicines at home

Dr Yincent Tse

Consultant Paediatric Nephrologist, Newcastle Upon Tyne

Nikki Smith

Head of Medicines Safety, Surrey Heartlands ICS

Ashifa Trivedi

Chief Pharmaceutical Officer’s Clinical Fellow, NHS London Procurement Partnership

More speakers to be confirmed soon.

SPS Speakers


Registration is now open. Once registered you will receive confirmation and a link for your diary.

Note: Our webinars are provided for colleagues providing NHS services so please register with your NHS or work-based email address. If you don’t provide NHS services or are a charity, please drop us a line to clarify your interest in this webinar.

Check your access before the event

Check that you are able to access WebEx prior to the event.

We recommend installing the Cisco WebEx app, or, alternatively, accessing the meeting via Google Chrome. If you are still having difficulty, you may need to contact your IT department to assist you in opening the application (you’ll only have to do this once).

Joining on the day

Listen through your computer or mobile phone.
The webinar will start promptly at 12:30 so join at least 10 minutes earlier so you don’t miss important information.

Dial in

If you experience trouble accessing the meeting from your computer, you can always dial in and listen through your phone.

Call: 0203 478 5289 (Standard UK rates apply)
Access code: 2371 596 4279
Passcode: 288363



The event will be recorded and this will be available on the SPS website a few days later.

Associated Resources

The need for standardisation

Mandy Wan introduces her project looking at dosing instructions on dispensed medicines labels. The results of this project are shared to act as a catalyst for healthcare professionals to reflect and take action towards safety improvements in their care setting and across the system.

Ensuring the safe prescribing of complex medicines across the interface in South East London

A presentation by Helen Cooper and Sheatha Abumehdi describing work to rationalise, optimise and, where possible, standardise prescribing of unlicensed specials across a system.

MSATS: Digital solutions to support transition between care settings

Andy Fox, Chair of the ‘Medicines for Children’ programme, explains how they have created an app to support parents, particularly those looking after children with complex medicines regimes, safely manage their child’s medications.

Supporting clinical decision making where excipients in liquid medicines pose potential harm

Mohammed Abou Daya, Service Lead Pharmacist Women and Children at Barts Health NHS Trust, describes some of the potential risks that excipients may pose and signposts to resources to support clinical decision making.

Supporting healthcare professionals, in non-specialist locations, delivering care to patients on specialist medication’ – Innovative solutions to support the safe use of specialist mental health medicines

Jennifer Southern shares her innovative role as a mental health in-reach pharmacist, supporting pharmacy staff in an acute trust to manage complex medication issues across their local care boundaries.

Using a system wide approach to develop resources supporting the safe management of patients on complex medicines

Jo McMillan, Head of Medicines Optimisation, for North and Mid Hampshire within Hampshire and Isle of Wight ICB, is discussing how her ICB took a system wide approach to developing resources which would raise awareness of the potential risks associated with clozapine. Although this example is specific to clozapine the learning can be applied to any complex medicine. For more information visit

Empowering generalists and care-givers to ensure safer use of medicines in children across systems

Anna Bischler speaks to Nanna Christiansen, Chief Childrens Pharmacist Evelina, Guys and St Thomas’s NHS trust, Chair NPPG and Nicola Husain, Education & Training Lead, Neonatal & Paediatric Pharmacy Group. Together they explore strategies which may help to prevent harms associated with the use of specialist medicines, particularly in situations where patients are transitioning from one care setting to another.

Contact us

Please contact the Admin Team if you have any questions.

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