Events
A forum for individuals to discuss challenges and successes to inform and inspire medication safety initiatives across the system.
Safer use of time critical medicines
21 May 2025Sharing what has been learnt so far from the national safer use of time critical medicines programme, including improvement interventions. 1 July 2025.
MSATS - Safe Use of DOACs
30 October 2024Discussion of key current medication safety challenges within healthcare with a focus on the safe use of DOACs; inspiring partnership across the system.
Managing complexities of medication use across care boundaries
26 June 2024Exploring the risks for patients on complex or specialist medicines moving across care boundaries with a focus on strategies to reduce harms
MSATS – Safe use of valproate
28 February 2024Discussion of key current medication safety challenges within healthcare with a focus on the safe use of valproate; inspiring partnership across the system
MSATS event: medication safety inequalities
27 September 2023Discussion of key current medication safety challenges within healthcare with a focus on medication inequalities; inspiring partnership across the system.
Medication safety across the system: time critical medicines
28 June 2023Discussion of key current medication safety challenges within healthcare with a focus on time critical medicines; inspiring partnership across the system.
Medication Safety Updates
A summary of recent practice communications reports, publications and safe medication practice research, including emerging issues pertinent to medication safety.
Medication Safety Update
21 June 2024A resource collating the latest medication safety communications and publications to inform, support and inspire medication safety improvements.
Managing the risks of specific medicines
Identifying known risks associated with specific medications and mitigation strategies to prevent harm
Developing insulin safety across a system
1 May 2025Strategies, signposting and initiatives to support safer use of insulin.
Using potassium permanganate for skin conditions or wound care
4 April 2025Potassium permanganate is a chemical product. We review the evidence for using it in wound care and highlight the risk of severe harm associated with wrong use.
Developing opioid safety across a system
26 March 2025Strategies and signposting to support safer use of opioids for chronic, non-cancer pain.
Supporting safe use of adrenal crisis emergency management kits
18 November 2024Treatment of adrenal crisis is time critical and relies on timely use of injectable hydrocortisone to prevent harm.
Managing the risk of confusion between injectable penicillin salts
4 October 2024Minimising the risk of confusion between injectable benzylpenicillin salt formulations may prevent harms.
Managing risks associated with oxytocin infusions during labour
24 September 2024Safety strategies can minimise the risk of harms related to oxytocin infusion overdose and delayed therapy.
Using amphotericin B injections
13 September 20243 formulations exist: 1 conventional; 2 liposomal. Conventional and liposomal formulations are not interchangeable; liposomal formulations are interchangeable.
Assessing injectables for enteral administration
13 August 2024Clinical decisions on the use of injectable formulations for enteral administration should be guided by safety and practicality.
Managing the risks associated with patients prescribed clozapine
28 June 2024Healthcare professionals in non-specialist services managing patients prescribed clozapine should implement safe practice principles to prevent potential harms.
Clinical considerations for patients prescribed clozapine
28 June 2024Healthcare professionals in all settings who interact with patients prescribed clozapine should be aware of clinical considerations related to its use.
Other medication safety material
Time critical medicines quality improvement collaborative
28 May 2025We invite NHS Trusts to express an interest in joining this quality improvement collaborative
Understanding when a check adds value to medication processes
2 May 2025Understanding what a check is, the principles of an effective check and factors to consider if introducing a check to a medication process.
Worked example of assessing the risk of transcribing
28 January 2025Example where medicines are prescribed by both the patient’s GP and specialist clinicians, and are administered in a patient’s home.
Risk assessing transcribing for administration
28 January 2025Various factors affect the risks associated with using transcribing for medicines administration.
Safe management of therapeutic drug monitoring
2 October 2024Organisations must ensure safe management systems are in place to support the management of drugs requiring therapeutic drug monitoring.
Purchasing for safety
19 June 2024Using principles of purchasing for safety when making purchasing decisions supports the safe clinical use of medicines and can minimise inadvertent harm
Investigating suspected tampering with medicines
11 June 2024A systematic approach should be taken to responding to reports of possible malicious tampering, securing the evidence, and seeking specialist advice and support
Developing Medication Safety Across The System (MSATS)
15 September 2023Medication Safety Across the System (MSATS) provides resources and networking to inspire and equip individuals in promoting the safe use of medicines.
Giving intermittent intravenous infusions by gravity in adults
12 July 2023Infusion by gravity is not the preferred method of administration, but may be necessary in some circumstances. Ensure a risk assessment is undertaken.
Managing the risks of using effervescent tablets in children
9 March 2023Careful use of effervescent or soluble tablets to deliver part tablet doses for children and neonates can minimise risks of toxicity or suboptimal therapy.
Assessment and storage of medicines for self-administration
25 January 2023Suitable medicines must be stored safely and securely in accordance with organisational policy, while still supporting self-administration
Implementing self-administration of medicines
25 January 2023Individuals receiving healthcare should be supported to continue to self-administer existing/new medications unless there are reasons why they are unable to
Self-administration of medicines
25 January 2023Self-administering medicines in all care settings and at home can benefit both individuals and organisations; it should be encouraged where safely achievable
Collaboration opportunities to improve medication safety
15 December 2022Practical guidance on effective collaboration opportunities to promote medication safety improvements
Communication opportunities to improve medication safety
15 December 2022Effective communication allows for timely responses to new and emerging medication risks and the sharing of potential safety solutions.
Responding to medication safety alerts and notifications
15 December 2022Healthcare professionals responsible for medication safety in their organisation must deliver an appropriate response to safety alerts
Reporting and management of medication incidents and harms
15 December 2022High quality reporting and management of incidents and harms ensures opportunities for learning and improving medication safety
Learning from medication incidents and harms
15 December 2022Practical guidance to ensure opportunities to learn from local intelligence, including patient harm are translated into shared local and national learning
Understanding medication safety policy and frameworks
15 December 2022Healthcare professionals delivering the medication safety agenda in their organisation require an understanding of national policy, frameworks and legislation
Using the Medication Safety Update effectively
15 December 2022Effective use provides assurance that an organisation is aware of the most critical medication safety related information, and acts on this to improve safety
Promoting medication incident reporting
15 December 2022Increased medication incident reporting provides greater opportunities for learning and improving medication safety
Conducting a medication incident investigation
15 December 2022Practical guidance to support those undertaking medication incident investigations
Resources to support learning from medication incidents and harms
15 December 2022Organisations should utilise resources to effectively drive improvement based on the learning from incidents, concerns, disputes and claims
Practice support for the Medication Safety Officer (MSO)
15 December 2022An infrastructure of support opportunities exists that MSOs should utilise to deliver their role most effectively
The Medication Safety Officer (MSO) role
15 December 2022Understanding the role and responsibilities of the MSO in practice will assist organisations in delivering their medication safety agenda
Medication Safety
Resources, guidance and support to assess and improve medication safety culture, strategy and policy within the healthcare system.
Understanding why temperature management is important for medicines storage
10 November 2022Temperature control and monitoring of storage areas to avoid temperature excursions; ensuring medicines are fit for purpose at administration to patients
Preventing parenteral nutrition rapid over-infusion in babies
28 October 2022There is a risk of severe harm or death if PN is unintentionally infused too rapidly in babies. Healthcare professionals need to ensure safe practice.
Including medicines with Risk Minimisation Measures (RMM) in PGDs
16 March 2021Medicines with RMM may not be suitable for inclusion within Patient Group Directions (PGDs). If used, the RMM must be stated within the PGD.
Multiple Use of Injectable Medicines in Clinical Areas V 02 February 2020
19 December 2019This document is intended for multi-professional clinical practitioners to use as a reference and source of information for the prescribing, reconstituting or administering injectable medicines.…