The SHBN Endorses First UK Coalition Position Paper on Safer Handling of Hazardous Medicinal Products
The Safer Healthcare Biosafety Network (SHBN) today welcomes Safe Management of Hazardous Medicinal Products in UK Healthcare Settings, a joint position paper published by a multidisciplinary group, including the UK Oncology Nursing Society (UKONS), the British Oncology Pharmacy Association (BOPA), the Royal College of Nursing (RCN), the Pharmaceutical Aseptic Services Group (PASG) and the Association of Pharmacy Technicians UK (APTUK). While the paper was drafted and published independently by the clinical group, the SHBN is acknowledged for its role in convening the group under its UK HMP Safety Campaign.
Hazardous medicinal products (HMPs) are widely used across healthcare, most notably in cancer treatment, but also in the management of conditions such as multiple sclerosis, HIV, psoriasis, and organ transplantation. These medicines include cytotoxic agents, antivirals, monoclonal antibodies, immunosuppressants, hormones, and certain antibiotics.
While lifesaving for patients, many hazardous medicinal products pose recognised health risks if healthcare workers are unintentionally exposed during preparation, administration, transport or disposal. Many HMPs contain substances classified under the Classification, Labelling and Packaging (CLP) Regulation as carcinogenic, mutagenic or reprotoxic (CMR). As a result, occupational exposure requires stringent control measures due to the potential for serious adverse health effects, including cancer and effects on fertility, reproduction and pregnancy.
The UK has no legal definition or published list of hazardous medicinal products, and no standardised requirement for the engineering controls that reduce exposure. The UK’s wider legislative framework for hazardous substances is well established, but its interpretation and implementation vary between organisations and clinical settings, leaving the level of protection afforded to staff inconsistent.
The position paper responds to the need for a nationally consistent, evidence-informed guidance and sets out five recommendations for a more consistent national approach to protecting healthcare workers from occupational exposure to hazardous medicinal products (HMPs):
- Establishing a UK framework for hazardous medicinal products
- Encouraging safer product design
- Developing national PPE standards
- Improving access to occupational health and safety risk information
- Improving consistent implementation through education and collaboration
Luke Akehurst, MP for North Durham, says: “NHS staff who prepare and administer these medicines every day should not have to rely on where they happen to work for the level of protection they receive. Four professional bodies have now set out what good practice looks like, and that gives us something concrete to put to ministers. I am hosting the roundtable on 3 September so that the people who do this work can make that case directly to parliamentarians.”
Louise Church, Head of Health, Safety and Wellbeing, Royal College of Nursing, says: “Hazardous Medicinal Products (HMPs) are absolutely essential to patient care, but the lack of clear definitions or even a full list of HMPs is an unacceptable situation that is leaving nursing staff at risk. This consensus statement must lead to the establishing of a national framework across all healthcare settings on HMPs, ending inconsistent levels of protection being applied across different health settings.
“This national framework must come hand in hand with better access for nursing staff to occupational health and risk information, as well as education and training on how to handle these products safely. There needs to be clear guidance as part of the framework on the lifecycle of HMPs to support consistent health and safety controls across the health sector. The UK Government, Health and Safety Executive and employers should welcome this framework and support our coalition’s calls.”
Ruth Hammond, Chair of the UK SACT Board, and Board Member, UK Oncology Nursing Society, says: “Nurses are at the heart of delivering safe systemic anti-cancer therapy, and the voices of UKONS members have been central to shaping these five strategic recommendations. By continuing to work collaboratively with pharmacy colleagues, health and safety advisers, industry experts and professional societies, we can turn the strategy’s vision into meaningful change at the frontline. Education is fundamental to UKONS, and remains key to ensuring hazardous medicinal products are handled safely, consistently and appropriately across the UK, tailored to the medicine and task.”
Louisa Knowles, Advanced Pharmacist for Technical Services, University Hospitals Birmingham NHS Foundation Trust on behalf of PASG, says: “This work shows the power of collaboration. By bringing a multidisciplinary team together, we can break down professional boundaries, share knowledge and create a safer approach for everyone. Ultimately, this is about one thing: making sure that every healthcare worker who handles hazardous medicinal products has the knowledge, protection and support they need to do their job safely.”
Joseph Williams, Past Chair and Vice Chair of the British Oncology Pharmacy Association (BOPA), says: “Pharmacy teams play a vital role in ensuring hazardous medicinal products are handled safely throughout their lifecycle. BOPA welcomes this multidisciplinary position paper and its focus on reducing variation through consistent risk assessment and appropriate controls.”
Netty Cracknell, Past President of International Society of Oncology Pharmacy Practitioners (ISOPP), says: “Clear information and education are essential to turning these recommendations into everyday practice. This will help organisations provide robust and consistent protection for everyone who works with hazardous medicinal products.”
Dr Paul Robert, Chair of the Safer Healthcare Biosafety Network, says: “The SHBN is proud to endorse this position paper. The UK is overdue a national framework for HMPs and protections against exposure to HMPs varies across individual NHS trusts, putting healthcare workers at risk. Without a clearly defined list of hazardous medicinal products, we simply cannot ensure all staff who may be exposed are properly trained and adequately protected.”
Publication comes ahead of a parliamentary roundtable on HMP safety at the House of Commons on 3 September, convened by SHBN, at which MPs, peers, clinicians and the document’s endorsing organisations will consider the recommendations and the case for national guidance.
