Deadline approaches for new steroid emergency card measures

GP practices have until 13 May 2021 to update their systems to ensure that prescribers issue a steroid emergency card to all eligible patients.

The steroid emergency card should be given to all patients with primary adrenal insufficiency and those who are steroid dependent.
The steroid emergency card should be given to all patients with primary adrenal insufficiency and those who are steroid dependent.

The steroid emergency card, introduced in August 2020, helps healthcare staff to identify patients who are steroid-dependent and gives information on the emergency treatment needed to prevent adrenal crisis if the patient is acutely ill or experiences trauma, surgery or other major stressors. The card should be carried in addition to the existing steroid treatment card.

A national patient safety alert was issued alongside the new card, advising that by 13 May 2021 at the latest:

  • All organisations that initiate steroid prescriptions should review their processes/policies and their digital systems/software and prompts to ensure that prescribers issue a steroid emergency card to all eligible patients
  • Prescribers undertaking standard/scheduled reviews (eg, in clinics or when authorising repeat prescriptions) should review their processes/policies and their digital systems/software and prompts to ensure all eligible patients prescribed steroids have been assessed, and where necessary issue a steroid emergency card.

Community and hospital pharmacies are required to have a supply of cards to replace those that are lost or damaged. They may also be required to issue cards whilst GP and hospital appointments are being carried out over the phone.

Safety review

The steroid emergency card should be given to all patients with primary adrenal insufficiency and those who are steroid
dependent (ie, on a long-term oral steroid). It may be issued at the prescriber's or pharmacist's discretion for patients with other medical conditions and those at risk of secondary adrenal insufficiency.

The alert was issued following a review of patient safety incident data for a recent two-year period, which identified four deaths, four patients admitted to critical care, and around 320 other incidents involving issues with steroid replacement therapy for patients with adrenal insufficiency or emergency treatment for adrenal crisis.

The Society for Endocrinology, the Specialist Pharmacy Service, and the British Association of Dermatology have produced detailed guidance for implementing the national patient safety alert.

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