Operating department practitioners (ODP) are specialist clinicians responsible for planning and delivering perioperative care. ODPs are 1 of 14 Allied Health Professions that are professionally autonomous practitioners and hold a protected title within the UK. ODPs are regulated by the Health and Care Professions Council (HCPC). ODPs must first meet the high standards of proficiency mandated by HCPC. Consent is a major ethical and legal component, ensuring that the patient has given full agreement. There is the Equality Act of 2010, which prevents discrimination, critical that ODPs work with diverse populations in public NHS. There is also the concept of negligence, which legally can be evaluated with the ’Bolam test’ as a benchmark to determine if standards of practice were followed. As broad practitioners in surgical departments ODPs are subject to a range of policies regarding duty to treat, confidentiality, specimen treatment, and human rights, among others (Abbot & Booth, 2014). The regulations are important because ODPs work with high-risk and vulnerable patients. There should be a strong understanding of the responsibility, accountability, and legal parameters of the role, with ODPs being up to date on the latest policies, which can impact their practice.
Medication errors and reactions are extremely common, with an estimated over 237 million errors made in England alone annually. This costs the NHS over £98 million and leads to at least 1700 deaths each year (Elliot et al., 2020). Errors are made at each stage of the process, with 54% made during administration, 21% when prescribing, and 16% for dispensing. Primary care accounts for the largest sample, but because of the sector size has the lowest rate of error at 38%. Hospitals account for 1 in 5 medication errors. While 72% of errors or reactions are minor, 26% could cause moderate harm and 2% create severe consequences (Elliot et al., 2020). The reason for these errors is primarily human error, the majority due to lack of attention or mix-ups. A small percentage of the errors can be attributed to negligence or lack of knowledge. There is also the fact that ubiquitous medications used for health lead to a higher number of errors.
The legislation regarding medicine for medicinal purposes is complicated. All marketing, licensing, and production are overseen by the Medicines Act 1968 and the Human Medicines Regulations 2012. Compliance for this is overseen by MHRA. Legislation on controlled drugs, including in healthcare settings on their storage, administration, and prescription is based on the Misuse of Drugs Regulations 2001, led by the Home Office. All controlled drugs are organized in schedules according to therapeutic application, risk of abuse, and the necessity for control (National Institute for Health and Care Excellence, 2016).
Recently a new Information Standard was published by the NHS, allowing easier access to medication information and also sharing of information, to improve safety for patients and ease for a prescription for clinicians, all while monitoring medications that may cause harm. ODPs cannot legally prescribe medications, but they can prepare and administer them in surgical settings. Otherwise, an ODP can use patient-specific directions (PSDs) to administer or supply medication to a patient who has been assessed by an authorized prescriber. However, that may change in the future as a UK-wide consultation is discussing whether ODPs can directly supply and administer medication to patients in the context of their practice.
References
Abbott, H., & Booth, H. (2014). Foundations for operating department practice: Essential theory for practice. McGraw-Hill Education (UK).
Elliott, R. A., Camacho, E., Jankovic, D., Sculpher, M. J., & Faria, R. (2020). Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety, 30(2).
National Institute for Health and Care Excellence. (2016). NICE guideline NG46.