Freedom of Information (FOI) / Garden House
New Scapa Road
Kirkwall
Orkney KW15 1BQ

Peter J Gordon
/ Date: 04/12/2014
Tel: 01856 888 220
Fax: 01856 888 211
Email:

Dear Mr. Gordon,

RE: Freedom of Information Request 201415 / 308 - Prescribing of Haloperidol

Your Query / Date of Request / 12th November 2014
I am writing as part of a Freedom of Information request regarding statistical details of the prescribing of the antipsychotic medication generically called HALOPERIDOL. It may be that the all of the information that I request is already available through a publicly accessible database and if so could you please direct me to this.
The reason I write is that I am aware that Hospital Guidelines/Protocols for acute agitation, psychosis, behavioural or psychological disturbance generally seem to include Haloperidol as the first-line pharmacological treatment of choice, given either orally or intramuscularly. This week in the British Medical Journal the following paper has been published: “Change Page: “Don’t use antipsychotics routinely to treat agitation and aggression in people with dementia”
This refers to individuals who may be diagnosed with dementia, but I am aware that prescribing of Haloperidol, as part of Hospital Guidelines/Protocols is also part of management of Delirium.
I am ware that prescribing of Haloperidol is also routinely part of protocols in those aged under 65 for acute or chronic agitation, psychosis, behavioural or psychological disturbance.
Could you please answer the following questions as completely as possible:
  1. For the last 5 years (2009 to 2013 inclusive) could you confirm the quantity of Haloperidol issued to cover all acute and community hospitals in your NHS Board area as per each strength:
ORAL TABLET HALOPERIDOL
0.5mg,
1.5mg,
5mg
10mg
20mg
ORAL LIQUID HALOPERIDOL
1mg/ml
2mg/ml
INJECTABLE HALOPERIDOL
5mg/ml
  1. Can you supply any protocols/guidelines in place for your NHS Board area that include Haloperidol as part of a treatment pathway.
  1. Can you confirm if you have a protocol for Delirium and if it includes recommendation of Haloperidol?
  1. Can you confirm if you have a protocol for Dementia and if it includes Haloperidol as a treatment option for “BPSD” (Behavioural and Psychological Symptoms of Dementia)
  1. Can you confirm when each protocol was first issued?
  1. Can you confirm if Haloperidol is ever prescribed in those under 16 years of age?

Response
  1. Please be advised that NHS Orkney is a small remote and rural health board which operates one hospital – the Balfour hospital.The figures below relate to the number of Haloperidol doses issued at the Balfour Hospital between 2009 and 2013.
Haloperidol form / Strength / Number of doses
Oral solid form / 0.5 mg / 1123
1.5 mg / 540
5.0 mg / 436
10.0 mg / Nil
20.0 mg / Nil
Oral liquid form / I mg per ml / 200ml
2 mg per ml / 200ml
Injections / 5 mg/ml / 347 amps
  1. NHS Orkney does not have any local protocols/guidelines in place that include Haloperidol as part of the care pathway. NHS Orkney follows NHS Grampian’s Joint Formulary; please follow this link to NHS Grampian’s Joint Formulary: NHS Grampian Joint Formulary.
Several documents such as the Palliative and Supportive Care Plan 2013 can be found on this website.
  1. No protocols identified for Delirium including recommendation of Haloperidol
  1. No protocols identified for dementia including recommendation of Haloperidol
  2. N/A.
  3. Haloperidol is not prescribed to patients under the age of 16 at the Balfour Hospital, NHS Orkney.

I hope this helps with your request.

NHS Orkney is a small remote and rural health board within Scotland. All responses to Freedom of Information requests are collated in accordance with the terms of the Freedom of Information (Scotland) Act 2002.

Under section 20 (1) of the Act, if you are dissatisfied with the way NHS Orkney has dealt with your request, you have a right to ask for a review of our actions and decisions in relation to your request, and you have a right to appeal to the Scottish Information Commissioner.

A request for review should be made within 40 working days of receipt of this letter and NHS Orkney will reply within 20 working days of receipt. Review requests should be sent in writing to Dr Louise Wilson, Director of Public Health, NHS Orkney, Garden House, New Scapa Road, Kirkwall, Orkney KW15 1BQ or by e-mail via .

Requests for appeal should be made in writing to: Scottish Information Commissioner, Kinburn Castle, Doubledykes Road, St Andrews, Fife, KY16 9DS. Telephone: 01334 464610, Fax: 01334 464611,e.mail: .

FOI responses (subject to the removal of personal information) are published on NHS Orkney’s website at:

Yours sincerely,

Freedom of Information Office

NHS Orkney

Orkney NHS Board Headquarters:

Garden House, New Scapa Road,

Kirkwall, Orkney KW15 1BQ

Chair: John Ross Scott

Chief Executive: Cathie Cowan

Caring for the people of OrkneyOrkney NHS Board is the common name of Orkney Health Board