Diabetes UK, Epilepsy Action, National Aids Trust, Parkinson's UK, Rethink Mental Illness and The Richmond Group of Charities with the support of the Royal College of Emergency Medicine and the Royal Pharmaceutical Society, are calling on the UK government to keep patients safe in hospital by making sure no one misses a dose of medication again. Every minute counts. As charities representing 5.46 million patients across the UK, we are concerned at the amount of people missing crucial doses of medication in hospital.

People with conditions like Parkinson’s, diabetes, HIV and epilepsy have to take medication when they need it and often at a specific time (time critical medication). If a dose is missed or taken late they risk becoming more unwell, sometimes irreversibly.

There are simple solutions to delivering medication on time, even in an over-stretched and under-resourced NHS:

• Have self-administration of medication policies in every hospital across each ward (where it is safe) so that patients who are able to take their own medication on time can do so.
• Boost the rollout of e-prescribing in hospitals and use it to monitor and report on missed or delayed doses. 
• Train all hospital ward staff responsible for prescribing and administering medication so that they know what time critical medication is and who needs it.

Despite these simple solutions, the scale and impact of the problem is huge:

• When people with Parkinson’s miss a dose of medication, even by just 30 minutes, they can have their ability to walk, talk or swallow changed irrevocably. Shockingly, only 42% of people with Parkinson’s admitted to hospitals in England last year always got their medication on time every time.
• One in six people in hospital have diabetes, and 35% of them need to be treated with insulin. The most recent data found that 37% had at least one insulin error on their drug chart. Having very high blood glucose levels as a result of insufficient insulin is a potentially life-threatening emergency.
• 48% of people with epilepsy struggle to control their seizures with medication. Not getting their medication on time can impact their seizure control and lead to breakthrough seizures, which could have a huge impact on their ability to drive or, in extreme cases, increase their risk of Sudden Unexpected Death (SUDEP).
• For people living with HIV, the standard advice for most HIV drugs is to take the dose as close to the same time every day. Missed or late doses of the treatment while in hospital could result in the level of virus increasing and developing resistance to drugs, meaning the drugs are not as effective.

Just 52% of NHS trusts in England require staff responsible for prescribing and administering medication to have training on time critical medication.

Given the serious risk of harm, and the number of people affected, this should be a priority patient safety issue for the NHS. Yet time critical medication in hospitals is often forgotten.

It’s time the UK government took action to ensure that NHS England and partners are supported to create self-administration of medication policies; implement robust electronic prescribing systems to monitor and report if medication is given on time; and provide training on time critical medication for relevant ward staff. Every minute counts.

Deborah Gold, Chief Executive of National AIDS Trust said: “Receiving medication late can cause a myriad of concerns for people living with HIV. Spending time in hospital can be anxiety inducing enough, without the added worry that you might have difficulty accessing the treatment which keeps your HIV under control. It is fundamental to effective care that pre-existing conditions are not worsened by a hospital stay.

“HIV medicines stop the virus from replicating in the body, allowing the immune system to repair itself. People living with HIV who take their medication correctly have a fully suppressed viral load, which prevents them from getting sicker, and stops them from transmitting the virus to their sexual partners.

“The standard advice for most HIV drugs is to take the dose as close to the same time every day. Missed or late doses of the treatment while in hospital could result in the level of virus increasing and developing resistance to drugs, meaning the drugs are not as effective.

“The government must not delay in working with NHS England to ensure people living with HIV, and other conditions that require time-critical medication, get their treatment when they need it while staying in hospital.”

Signed

• Diabetes UK
• Epilepsy Action
• National Aids Trust
• Parkinson’s UK
• Rethink Mental Illness
• The Richmond Group of Charities
• Royal College of Emergency Medicine
• Royal Pharmaceutical Society