Training declaration forms related to Medicines Management internal training can be found on YourSpace.

For a flowchart regarding dealing with missing FP10 prescriptions, see MMP10 Security and Handling of FP10s Procedure.

The following forms can be found in the MMP04 Covert and Overt Administration of Medicines in Food / Drink (Inpatients) procedure

NB - Electronic versions of these forms are available on RiO under Case Record Menu > Medications > Covert Medication > Covert Medication Care Pathway (Initial)

Electonic versions must also be used where available

The following form can be found in the MMP07 Medicine Reconciliation (Inpatients) procedure:

Medicine Reconciliation Form

The following forms can be found in the MMP08 Administration of Medicines procedure. These are to be used for the self-administration of specified medicines only.

They are not to be used for patients under the Self-Administration of Medicines (SAM) Scheme - see MMP05 Self-Administration of Medicines (SAM) Scheme procedure for these forms.

 

SELF-ADMINISTRATION OF SPECIFIED MEDICATION -

Appendix 1 -

Collection and Delivery Record (Transporting Medicines Between Trust Sites) - to be used when transferring medication between sites to provide an accurate audit trail of receipt of the medication. This should be scanned to a team folder and kept for 2 years. This may be used to transport multiple medicines to the same delivery location.

Appendix 2 -

Delivery Record (Transporting Medicines / FP10s to a Patient / Community Pharmacy) For Single Patient Use Only - to be used when delivering medication / FP10s directly to a patient (i.e. not to a Trust site) or a community pharmacy to provide an accurate audit trail of receipt of the medication / FP10. This should be uploaded to the patient's electronic record.

Appendix 3 -

Approved Trust Transport / Taxi Collection Sheet

View Outpatient Depot Prescription 

This is a printable PDF version only

 

The modifiable template can be found on the G: drive at the location below:

G:\11. Medical\11.4 Medicines Operational\11.4.15 Community OP depot prescription

All MMT staff working across Halton, Warrington, St.Helens & Knowsley have access to this folder.

If you require access to this folder, please request this through the IT Self Service Portal.