Source: The CQC -15th July 2025
The safer management of controlled drugs 2024 report highlights our oversight activity under the Controlled Drugs (Supervision of Management and Use) Regulations 2013.
It includes what we found from our inspection and engagement activity under the Health and Social Care Act as well participating in local controlled drug intelligence networks led by NHS England.
Some key issues that we highlight from 2024 include:
. impending changes to NHS England and the regional and national controlled drugs oversight function
. the need to improve cross-border prescribing datasets on controlled drugs
. access to controlled drugs in care homes for end of life care
. the importance of healthcare professionals working within their scope of practice
. fraudulent activity and diversion of controlled drugs by health and care professionals and support staff, as well as by people impersonating a range of healthcare professionals.
. prescriptions produced fraudulently within electronic systems in primary care to conceal the theft, and ongoing fraud with private prescriptions, often for controlled drugs in lower schedules.
The report also includes a range of themes that we found from a review of Prevention of Future Death Reports, which we share to highlight the risks associated with controlled drugs.
National trends in the prescribing of controlled drugs
In 2024, there were 74,160,671 controlled drug items prescribed by NHS primary care services, a slight increase of 0.4% compared with 2023.
Overall prescribing levels across the different schedules of controlled drug remain stable and prescribing trends in NHS primary care in 2024 are very similar to previous years. Analysis of prescribing data shows:
. increases in prescribing volumes of medicines that are licensed to treat attention deficit hyperactivity disorder (ADHD), such as dexamfetamine, lisdexamfetamine and methylphenidate
. a continued increase in prescribing of testosterone
. a reduction in prescribing of pholcodine, pethidine, co-proxamol, oxazepam, nitrazepam, fentanyl, diamorphine, zopiclone and zolpidem
. an increase in non-medical prescribing:
. prescribing by pharmacists continued to grow, accounting for over half of non-medical prescribing
. paramedic prescribing increased by 704% in 2024 compared with 2023, as changes to the law at the end of 2023 permitted paramedic independent prescribers to prescribe a range of controlled drugs.
Cannabis-based products for medicinal use (CBPMs) are Schedule 2 controlled drugs under the Misuse of Drugs Regulations 2001. As in previous years, almost all prescribing of CBPMs continues to be in the independent sector.
The most current available prescribing data for unlicensed CBPMs in independent services has shown an increase of 130% between the years 2022/23 and 2023/24.
CQC also makes recommendations in the report to raise awareness and address some of the specific issues identified during the last year.
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