Vulnerable people’s drug prescriptions to be reviewed following Ombudsman investigation

Hundreds of people across England with drug and alcohol dependencies who have been prescribed Valium long-term will have their cases reviewed following an investigation by the Local Government and Social Care Ombudsman (LGO).

The LGO has found that Change Grow Live (CGL), on behalf of Cambridgeshire County Council, has been prescribing benzodiazepines to people long-term against national guidance. The company also provides drug and alcohol services for 50 other councils.

Benzodiazepines – including diazepam (Valium) – are a class of medicines that can relieve nervousness, tension and other symptoms of anxiety and should usually only be prescribed short-term.

CGL’s policy explains people use them for anxiety, insomnia, to enhance opiate effects, to deal with mental health issues, improve confidence and to reduce psychotic symptoms like hearing voices. However, if they are prescribed for too long, they can have significant negative effects including dependence, withdrawal symptoms and drug-seeking behaviour.

People on these medicines should have their prescriptions reviewed regularly, and those reviews should consider the benefits and risks of continuing with the current dose, reducing or stopping it, with a management plan put in place after each review.

However, the LGO’s investigation found CGL was either not reviewing people’s prescriptions regularly enough or not keeping proper records of those reviews.

Across the country, CGL has 343 clients who are on long-term prescriptions. Its medical director has since started a national clinical audit focusing on benzodiazepine prescribing across the country.

LGO chief executive, Nigel Ellis, said: ‘Clinicians need to weigh up the benefits and risks for patients who are taking these medicines long-term and should have a clear rationale for continuing to prescribe.

‘I am pleased that patients in these vulnerable groups will now have their cases reviewed more regularly and comprehensively following my investigation.

‘Both CGL and the council have co-operated fully with our investigation, and I welcome their ready acceptance of our recommendations.’

CGL and the council have agreed to provide the LGO with a report of the national clinical audit CGL is currently undertaking.

The council has also agreed to ensure CGL improves record keeping, updates its policy to include recent guidance from NHS England and completes yearly audits of Cambridgeshire CGL clients who are on long-term prescriptions of benzodiazepines.

Image: Mika Baumeister