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Medicines Safety Assurance Tool

The Medicines Safety Assurance Tool (MSAT) is provided as a PDF document for reference. To request the spreadsheet solution of this safety tool, or for more information about this tool, to make a comment, or share a safety issue please contact

The MSAT was developed to improve the management of medicines related risk to patients. It is intended to provide commissioners with a systematic way of identifying and analysing emerging medicines safety issues and engage with providers to reduce medicines related harm.

Transition of Commissioning Policies

On 1st July 2022 NHS Cheshire and Merseyside Integrated Care Board (ICB) became the new statutory body responsible for ensuring health care services are available to meet the reasonable needs of the people of Cheshire & Merseyside.

Until such time as a single suite of commissioning policies can be developed and adopted, NHS Cheshire and Merseyside will continue to adopt and operate the CCG policies it has inherited at Place/borough level, which means that there will be no immediate change in commissioning policy for local people resident in those Places/boroughs from what was in place prior to 1st July 2022.

NHS Cheshire and Merseyside Commissioning Policies



Date Added: 10 - Jun - 2018

The NHS campaign to improve the care of people at risk of, or with, acute kidney injury.

Body System:
Date Added: 27 - Jan - 2022

The Pan Mersey Area Prescribing Committee recommends that patients or carers, or both, are trained and understand optimal use of their adrenaline auto injector device and are advised to carry two adrenaline auto injectors at all times.

Body System:
Date Added: 29 - Aug - 2023

Everyone involved in the support or care of people receiving clozapine is reminded of the importance of awareness and management of common side effects that may lead to life threatening conditions.

  • Constipation must be actively monitored and actively treated. Clozapine carries a serious risk of intestinal obstruction including faecal impaction and paralytic ileu.
  • Be cautious with signs or symptoms of a low white cell count. Clinical or haematological neutropenia or agranulocytosis can lead to an acute life threatening condition.
  • Monitor closely for tachycardia. Clozapine also carries a serious risk of myocarditis and cardiomyopathy particularly in the first two months of treatment.

NHS Cheshire and Merseyside APPROVED

Body System:
Date Added: 29 - Nov - 2017

Codeine is contraindicated in all children aged 0-18 years who undergo tonsillectomy or adenoidectomy (or both) for obstructive sleep apnoea. Codeine is restricted to children over 12 years of age and only if the benefit outweighs the risks.


Body System:
Date Added: 29 - Nov - 2017

Domperidone is restricted to short term use in the relief of nausea and vomiting. The maximum recommended dose is 30 milligrams daily for one week. Contraindications include cardiac disorders, hepatic impairment, and concomitant QT prolonging or CYP3A4 inhibiting drugs.


Date Added: 18 - Sep - 2020

A Drug Safety Supplement from MLCSU

Date Added: 24 - Jun - 2022

Although emollients are not flammable in themselves or when on the skin, when dried on to fabric they act as an accelerant, increasing the speed of ignition and intensity of the fire. This accelerant effect significantly reduces the time available to act to put out a clothing or bedding fire before serious and fatal burns are sustained.

MHRA and NFCC emollients leaflet A5

MHRA and NFCC emollients A4 information sheet for healthcare professionals

Body System:
Date Added: 24 - Oct - 2019
Body System:
Date Added: 26 - Jun - 2018

Overdose of methotrexate can lead to serious adverse effects such as haematopoietic disorders (leukopenia, thrombocytopenia, anaemia, and pancytopenia) and  gastrointestinal reactions (mucositis, stomatitis, oral ulceration, gastrointestinal ulceration, and gastrointestinal bleeding). Some reports of overdose have been fatal. In  these fatal cases, events such as sepsis or septic shock, renal failure, and aplastic anaemia were reported. 

Date Added: 24 - Feb - 2021

This document brings together a number of resources clinicians can use to support the appropriate use and review of opioids used for chronic pain.

Body System:
Date Added: 24 - Sep - 2021


Adrenal insufficiency and adrenal crisis-who is at risk and how should they be managed safely
Adopted from the Society for Endocrinology and the British Association of Dermatologists

Body System:
Date Added: 24 - Mar - 2022

The Pan Mersey Area Prescribing Committee recommends that ALL clinicians provide GPs with adequate information about changes to patients’ medication regimes to ensure the accuracy of the Summary Care Record. 

Date Added: 23 - Sep - 2021

The Pan Mersey Area Prescribing Committee recommends that valproate is initiated and supervised by an experienced specialist and only when other treatments are ineffective or not tolerated.

Body System: