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Specialist Pharmacy Service
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Medicines Use and Safety
Suggested Template for CQUIN for Green Bags to be used by Ambulance
Trusts when transferring patients
Transfer of medicines (using a “Green Bag”) with patients transported from
home to A&E departments by ambulance service
Indicator number
Indicator name
Transfer of medicines (using a “Green Bag”) with
patients transported from home to A&E departments
by ambulance service
Indicator weighting
(% of CQUIN scheme available)
Description of indicator
Numerator
Denominator
Rationale for inclusion
Data source
Frequency of data collection
Organisation responsible for data
collection
Frequency of reporting to commissioner
Transfer of medicines with the patient (using a
“Green Bag”)
Number of patients taken by ambulance service to
acute trusts from own home accompanied by a
“green bag” of medicines
Total number of patients taken by ambulance service
from their own home to A&E departments
Transferring medicines with patients improves
patient care:
 Aids identification of medicine-related
admissions
 Facilitates accurate and timely medicines
reconciliation on admission
 Reduces delayed and omitted doses of
medicines during inpatient care
 Reduces waste
 Facilitates accurate discharge information
Additional required field on patient clinical record
form may be needed.
(May need changes to current data collection)
On-going
Ambulance provider
Quarterly
Baseline period/date
Baseline value
Final indicator period/date (on which
payment is based)
40%1 of patients admitted from home to the accident
and emergency department of an acute provider will
be accompanied by their current medicines stored in
a “green bag” designated for this purpose
Final indicator value (payment threshold)
Final indicator reporting date
Are there rules for any agreed in-year
milestones that result in payment?
e.g. agreed changes to data collection may be an inyear milestone
Are there any rules for partial
achievement of the indicator at the final
indicator period/date?
1
This figure is based on that used in South East Coast Ambulance Trust. It was based on a pre-CQUIN ambulance crew survey which
found the use of “green bags” to transport medicines with patients admitted from their own home to emergency services to be 0-50%.
Winner: Dressings, PrescQIPP Innovation awards 2013; Winner: RPS Pharmaceutical Care Award 2013
Finalist: HSJ Patient safety in primary care award 2013; Winner: UKCPA/Guild Conference Best Poster award 2013
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Medicines Use and Safety
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Milestones
Date/period
milestone
relates to
Rules for achievement of milestones
(including evidence to be supplied to
commissioner)
Quarter 1
e.g. agreed changes for data collection
Date milestone
to be reported
Milestone
weighting
(% of CQUIN
scheme
available)
Quarter 2
Quarter 3
Quarter 4
40%1 of patients admitted from home to the
accident and emergency department of an acute
provider will be accompanied by their current
medicines stored in a “green bag” designated
for this purpose
Rules for partial achievement at final indicator period/date
Final indicator value for the partial
achievement threshold
% of CQUIN scheme available for meeting final
indicator value
Further reading and references on rationale
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Pirmohamed et al found that 6% of emergency admissions were as a direct result of medicines.2 If
patients bring in their own medicines then identification of medicine-related admissions is aided.
Pharmacist-led reconciliation has been shown to prevent medication errors and reduce the costs
associated with errors.3 Medicines reconciliation is improved if patients bring their current medication
into hospital.
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Having current medicines readily available reduces delayed and omitted medicines.
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Using patients’ own drugs reduces waste.
© Specialist Pharmacy Service
2
Pirmohamed M, James S, Meakin S, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 82 0
patients. British Medical Journal 2004; 329:15-19
3
Campbell F, Karnon J, Czoski-Murray C et al. A systematic review of the effectiveness and cost-effectiveness of interventions aimed at
preventing medication error (medicines reconciliation) at hospital admission. The University of Sheffield, School of Health and Related
Research (ScHARR). September 2007. www.nice.org.uk (Accessed 30 March 2015).
4
National Patient Safety Agency. Reducing harm from omitted and delayed medicines in hospital NPSA/2010/RRR009
http://www.nrls.npsa.nhs.uk/alerts/?entryid45=66720 (accessed 30 March 2015)
5
DH (2012) Improving the use of medicines for better outcomes and reduced waste – An Action Plan
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212837/Improving-the-use-of-medicines-for-betteroutcomes-and-reduced-waste-An-action-plan.pdf (accessed 30/3/15)
Green Bag CQUIN Ambulance Service – Apr 15 (TR)
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