For all CDs, in most situations veterinary surgeons should only prescribe 28 days’ worth of treatment. The exception being where there are long term ongoing medical conditions (e.g., when treating epilepsy in dogs). If more than 28 days’ worth of treatment is prescribed, the prescribing veterinary surgeon must be sure the owner is competent to use the medicine safely. Instalment prescriptions Veterinary surgeons supplying Schedule 2 and 3 CDs against another veterinary surgeon’s prescription should: Pharmaceutical companies try to ensure that every bottle of medicine is precisely filled but some small variability may occur. This may result in discrepancies regarding the amount of CD used when taking into consideration the volume remaining in the container. It has been produced in association with the governing organisations for GB Mountain Rescue Teams, the Drug and Firearms Licensing Unit (DFLU) at the Home Office and the Medicines and Healthcare Regulatory Products Agency (MHRA). All thefts, losses or near misses should be reported to the Home Office and the police via your team leader and in turn to the MREW medical director. We recognise the practical challenges posed by administering CDs in a ‘field’ environment and a consequential possibility for a loss there, though these are in practice extremely rate. Adverse incidents with CDs

Schedule 2 CDs (and Schedule 3 and 4 CDs that have been prepared extemporaneously for use under the prescribing Cascade) must be destroyed in the presence of, and instructed by, any of the following: A vet who works for a practice operating under the same franchising or branding (corporate group) as the practice requiring witnessed CD destruction, but the two practices do not belong to the same owner and are separate legal entitiesYou do not need to store controlled drugs in Schedules 4 and 5 in the controlled drugs cupboard or record them in your controlled drugs register. However, you must consider where you store these drugs and ensure that they are stored securely. You must keep accurate records of their receipt, administration and disposal to minimise the opportunity for diversion. Examples include: Prescription stationery for CDs, including printer paper, must be stored securely to prevent theft and misuse to fraudulently obtain controlled drugs. Private prescribing of CDs

a person legally authorised to witness the destruction of CDs such as a Police CD Liaison Officer (CDLO) or footnote which must specify the date on which the correction is made. An * can be used to highlight the line in which there is an error The validity period of a prescription relates to the time in which the prescription can be dispensed, i.e., the CD can be dispensed within 28 days of the prescription being made. Only specific CDs in Schedules 2 and 3 can be included in a PGD and there are stipulations as to who can supply or administer them and under what circumstances:

If a GP makes a domiciliary visit and either administers a CD from the bag or issues a handwritten prescription for a CD, they should make a note of this in the patient’s record as soon as possible after the event. It is good practice to write a prescription for the item administered, endorse it with the word ‘administered’ and date it. Prescribing controlled drugs The person carrying the drugs kit to a casualty does not need to be a current holder of casualty care certificate. Be a computerised system (not including a practice management system) or a bound book (which do not include any form of loose-leaf register or card index). Within the cupboard / safe, it is good practice to separate low strength preparations from high strength ones to minimise the risk of incorrect selection. In Northern Ireland, it is important to note that vets are not approved to witness Schedule 2 CD disposal in any veterinary practice. In Northern Ireland, destruction of Schedule 2 CDs can only be carried out in the presence of a person legally authorised by the Northern Ireland Department of Health, which includes the Northern Ireland Veterinary Inspectors.

This guide is intended to support teams in ensuring they comply with the law and regulatory expectations set out by the Home Office. Every team must have the following: Schedule 4 CDs are divided into 2 parts. Part 1 contains most of the benzodiazepines and Part 2 contains the anabolic and androgenic steroids. There are no additional special controls for Schedule 4 CDs.The member of staff making the entry should sign and date it. Whenever possible, all entries should also be witnessed by a suitably trained member of care home staff who should also sign the entry.

Where individual ampoules are in the building and signing them out during a rescue are matters for the team. These details do not need to be in the CDR, indeed they can complicate the CDR so much it becomes hard to understand. If these details are kept, it is often best to keep them separate.Only team members that may, for operational reasons, need access should have a key or know the code to open the safe. Keeping a record of key holders or intermittently changing codes would be appropriate. Schedule 2 CDs have therapeutic value, are highly addictive, and may be subject to abuse. Their use is strictly controlled, including special prescription, storage, destruction, and record keeping requirements. Where the witness is an independent veterinary surgeon, they should record their RCVS number and confirm their independence in writing in the CDR, and for all destruction and disposal, the following further information should also be recorded and signed by the witness: