The Medication Safety Officer (MSO) role

About the role

An MSO is the named individual within an organisation responsible for encouraging medication incident reporting and learning. The NHS England National Patient Safety Alert “Improving medication error incident reporting and learning” published in 2014 recommended that all organisations have a named MSO who is part of the national MSO network.

Since 2023, the NHS standard contract has mandated that provider organisations must appoint an MSO and ensure that the MSO network are kept informed of the person or persons holding these positions.

The MSO can offer medication safety specialist expertise. They can be a centralised individual within the organisation, working collaboratively on improving medication safety by communicating medication risks and introducing associated mitigation strategies. The MSO can offer a leadership role to the medication safety agenda.

Responsibilities of an MSO

The overarching responsibility for ensuring medicines are used safely within an organisation may sit within a number of roles. The responsibility for safe use of medicines is multidisciplinary and healthcare professionals (HCPs) need to work collaboratively to minimise harm from medicines. Collaboration opportunities to improve medication safety (SPS page) provides further advice.

MSO responsibilities include, but are not limited to:

• Being an active member of the national medication safety officer network and any local or regional medication safety groups
• Acting as the organisational link with the MHRA, NHSE and MSO network to receive essential communications and escalate concerns related to the safe use of medicines
• Implementing local actions to improve medication safety which align with national safety initiatives, including national patient safety alerts
• Managing medication incident reporting in the organisation (including improving the reporting and learning from incidents)
• Being an active member of the medication safety committee (or equivalent) within the organisation
• Leading medication safety improvement work within the organisation

Responsibilities of an MSO vary between organisations and depend on the needs of the organisation and the experience of the named MSO. Often additional MSO responsibilities will be associated with delivering the medication safety agenda for the organisation and system, ensuring they align with the NHS England national patient safety strategy.

Medication safety team

The success of MSOs delivering the medication safety agenda has led to some organisations developing medication safety teams. These include a variety of healthcare professionals including pharmacists, pharmacy technicians, nurses, medics and also administration staff. Teams with clinical link staff or medicines champions are an excellent way to ensure multidisciplinary involvement and communication.

Examples of medication safety team organograms are available on the MSO workspace on Future NHS Platform (login required).

Benefits of a team

Having a multidisciplinary team promotes engagement with frontline staff across all professions, thereby creating a more holistic understanding of medication safety issues.

Junior membership develops a future medication safety focused workforce.

Job descriptions

Job descriptions for an MSO role and their associated team members will have variation dependent on the organisational structure and service delivery requirements. There is no nationally agreed job description for either MSOs or members of the medication safety team within an organisation. The MSO workspace on NHS futures contains some example job descriptions that have been shared by existing MSOs and their teams.

Organisational oversight

A named board director or equivalent has responsibility for medication safety within an organisation. The MSO will need to work closely with this person to escalate all medication safety issues and provide organisational assurances related to medication safety.

Organisations require governance systems that support the effectiveness of the role of the MSO and provide opportunities to escalate medicines concerns effectively. The medicines safety committee (or equivalent) plays an important part in this. Things to consider:

• how all specialities and divisions inform and escalate issues to the committee
• how the committee reports up to the executive board
• how the committee links with other relevant groups such as medical devices group
• input from other related teams such as Patient Advice and Liaison Services, quality improvement and learning and development teams

Getting started in the role

MSOs new to post may find the following actions helpful:

• register with the network as the named MSO for the organisation – download the registration form from the MHRA and email to the network lead on lnwh-tr.sps-mso@nhs.net
• ensure access to the organisational generic MSO email account by contacting your local IT department
• join the MSO workspace on the Future NHS platform (login required) (to request access to this workspace email the national MSO network lead via lnwh-tr.sps-mso@nhs.net)
• contact the chair of the local or regional MSO network for an introduction to the group (these details can be found on the MSO workspace on the Future NHS platform (login required))
• make initial contact with key individuals or groups within your organisation to ensure future effective collaboration
• contact with your organisation’s incident reporting system manager or lead and ensure access your local incident reporting system
• join the NHS Patient Safety workspace on Future NHS platform (login required)
• join the Medicines Safety Improvement Programme (MedSIP) workspace on Future NHS Platform (login required)
• join the Medication Safety Across the System workspace on Future NHS Platform (login required)

Leaving the role

When a postholder leaves it is essential that a seamless handover is made to ensure that the roles and responsibilities of the MSO are continued. Handover must include continued access to the generic MSO email account to ensure essential communications are still received and acted on appropriately.

The new MSO details need to be updated on the national MSO register by emailing the MSO network lead on lnwh-tr.sps-mso@nhs.net to request a change of details form.

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