Supporting safe medicines use
The Drugs and Therapeutics Committee (DTC) helps make sure medicines are used safely, effectively and fairly across South West London and St George’s Mental Health NHS Trust. Its work supports patients, carers and people who use our services to receive treatment that is based on good evidence, national guidance and local learning.
The Committee reviews clinical effectiveness, medicines safety, approves medicines-related policies and guidelines, considers requests for medicines that are not routinely available on the formulary, and uses audits, quality improvement projects and feedback to improve care. Patient and carer representatives are part of the Committee, helping ensure that decisions are informed by lived experience as well as clinical expertise.
The committee works closely with the SWL Mental Health Interface Prescribing forum, SWL Joint formulary committee and the SWL Integrated Medicines Optimisation Committee, to ensure consistent and safe practices across primary and secondary care with regards to mental health medicines.
How the committee supports patients and carers
The DTC brings together consultants, patient and carer representatives, doctors, nurses, pharmacists and other Healthcare Professionals specialising in different areas. Together, they review how medicines are used and agree changes that improve effectiveness, safety, consistency and access to treatment.
A key part of the DTC’s role is overseeing the formulary of mental health medicines and recommending additions or changes to the SWL Joint Formulary. A formulary is the list of medicines approved for routine use after careful review of their safety, benefits and suitability for NHS care. Where a medicine is not routinely available, the Committee considers the evidence and individual clinical need before a decision is made.
Progress in 2025 — 2026
During 2025 — 2026, the Committee reviewed 186 requests for medicines that were not routinely available on formulary of which 143 were approved for use, they approved the updates to 17 medicines-related policies, procedures and clinical guidelines. These decisions helped support safe prescribing, clearer guidance for staff, and more consistent care for patients whilst ensuring the most up to date evidence and safety information is used to inform decisions.
Important developments included adding bupropion as a treatment option for people with treatment-resistant depression and supporting the introduction of take-home naloxone, a medicine that can be used in an emergency to reverse the effects of opioid overdose, subject to guidance and staff training, and use of guanfacine in adults with ADHD to name a few.
Improving safety, information and shared decisions
The Committee strengthened guidance to help clinicians work more closely with patients, carers and families where people may find it difficult to take medicines as intended. This includes identifying barriers, offering support, and agreeing clear follow-up plans. Guidance on valproate was also updated to improve consent processes, support decision-making, and provide clearer information for people with additional communication or learning needs. This helps people make informed decisions about their treatment and understand the benefits and risks of medicines. Following audit learning, a pilot of an antidepressant review clinic was commenced and a quality improvement project was initiated on supporting children and young people improve their confidence with medicines. The work of the DTC aligns with the Trust Medicines Optimisation Strategy.
Using learning to improve care
The DTC reviewed audits and quality improvement work on areas such as medicines safety, treatment monitoring, medicines adherence, clozapine treatment, medicines-related falls, and medicines use in children and young people. Learning from this work has led to improvements in policies, staff training, patient information and clinical practice.
The Committee also strengthened its focus on reducing health inequalities. This included work to improve information and support for people with learning disabilities who receive valproate, and updates to clozapine guidance to support fairer access to treatment for people from different ethnic backgrounds.
Looking ahead, the DTC will continue to focus on clinical effectiveness, medicines safety, improving educing inequalities, improving access to medicines information, supporting shared decision-making, and ensuring that learning from audits leads to lasting improvements in care.
