Libertas Member secures acquittal on all charges
Allegations dismissed by Tribunal before the Nursing & Midwifery Council
Darren Snow, instructed by Angela Graham at the Royal College of Nurses, represented senior nurse SG before a fitness to practice hearing.
Allegations were made that Darren’s client had prescribed methadone outside national guidelines and outside his competence to a historic heroin user who had come off a methadone script 10 days earlier and was not testing positive for opiates.
In evidence, it became clear that Darren’s client was a highly respected specialist working with drug users, one of the leading specialist nurse practitioners in this field and the private health care company employing him had policies for treatment that were 10 years out of date and did not reflect nor even understand what national standards were for this specialist approach to treatment known as “retox”.
As a matter of law, Darren’s client was authorised to prescribe methadone as a specialist nurse prescriber and was working well within his scope of practice and area of expertise at the time.
Darren’s client had decided to prescribe a low dose of methadone to reintroduce the patient to that medication in the hope that it prevented a relapse back onto heroin.
Evidence revealed that the nurse’s employer had subsequently cancelled the prescription as it was not recognised by their policy and discharged the patient, who was at high risk of heroin relapse and death, back into the community with no further treatment or review.
As part of the defence case, Darren called Dame Clare Gerada, President of the Royal College of GPs – herself an expert in this area – and Professor Sir John Strang, of Kings College London, a leading specialist in drug treatment work with expertise in reintroducing methadone to historic heroin users at risk of relapse.
Professor Strang is responsible for the Orange Book, the national guidance on drug treatment work, which supported the use of “retox”.
The nurse’s actions were supported by expert and practitioner evidence as clinically appropriate and in the patient’s best interests.
Allegations of prescribing methadone when it was not clinically appropriate, not best practice and without seeking authorisation were all dismissed by the Tribunal.