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Q & A - Clinical Matters
Index
CL502 - Disposal of sharps
CL501 - Signing anaphylaxis treatment form
Q CL502 - Disposal of sharps – Can you shed some light on the current situation where pharmacists will no longer accept patient's old sharps
boxes for disposal, but insist that they should be handing them in at GP surgeries for disposal with the practice sharps? New 02/06
Answer - In April 2004 the Clinical Governance Support Team of the NHS Modernisation Agency issued a National Diabetes Support Team Factsheet (No 2) Disposing Of Used Syringes and Other Sharp Clinical Waste
This includes the following:
“As a general rule waste produced by the householder, including clinical and sharps waste, is the waste of that householder and
is therefore collected, on request, by the local authority. However, if the householder is being treated by a healthcare practitioner, then waste produced as a result of that treatment is deemed to be the waste of
the healthcare professional and is removed by them for disposal”.
GPs may prescribe sharps bins for diabetic patients on an FP10 to enable them to dispose of their needles safely.
Since diabetic treatment would normally be self administered by patients they should ask the local authority to arrange for safe collection and disposal of
their needles.
Further Information:
Hazardous waste
Hazardous Waste Regulations – interim guidance on premises notification
Hazardous Waste Changes
GPC
Guidance note for GP practices on the introduction of the new Hazardous Waste regulations, to be introduced on 16 July 2005
See also:
Q&A PR526 -
Hazardous Waste Regulations
CED
Q CL501 - Signing anaphylaxis treatment form - I have been asked by the mother of a child who has suffered from an anaphylactic
reaction in the past to sign a treatment form giving advice on treating a serious allergy to peanuts. This is for use by the child’s school who insist that it is essential if emergency treatment is to be
given. The form appears to be an official hospital form with accurate advice on emergency treatment. However, it has been filled in by the mother and includes the use of a homeopathic
preparation (Apis) that I am unfamiliar with. The child no longer attends the hospital clinic, although treatment was initiated there. Should I sign the form ? New 10/01
Answer – If you sign the form you would effectively be authorising and
taking professional responsibility for treatment that you do not understand and that may not accord with the hospital doctor’s recommendations. We would advise you to sign the form with a simple
statement confirming that the child does indeed suffer from a severe allergy and that the use of adrenaline as described on the form would be
appropriate in an emergency situation. Most schools insist on similar procedures to ensure that the child does indeed suffer from a serious
allergy and that emergency treatment could be life saving. It is, therefore, essential to comply with the school protocol which permits
prompt treatment in an emergency, as this is in the best interests of your patient and in line with your responsibilities as the child’s doctor.
You should not authorise alternative medications with which you are unfamiliar, and which would almost certainly not be authorised by the
hospital, as you would be legally and professionally responsible for any adverse consequences
We have in fact checked with the local specialist hospital department that would have initiated this child’s treatment. They have confirmed
categorically that they would never prescribe or authorise the inclusion of Apis on an emergency treatment form.
The specialist clinic undertakes regular training of families and school nurses in the emergency treatment of anaphylaxis. They use an
emergency advice sheet, which the clinic doctors sign for use by patients currently under their care. They have agreed to share their currently revised and approved allergy and anaphylaxis advice sheet
with you and with any other GPs who may require it at this time. Obviously you should satisfy yourself that it is still correct when you issue it to a patient and that you would be prepared to authorise the
treatment described.
We are very grateful to Professor John Warner and Dr John Hourihane from the Infection, Inflammation and Repair Division of the Wellcome
Trust Clinical Research Facility at Southampton University Hospitals NHS Trust for sharing this
Anaphylaxis Advice Sheet with us.
CED
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