Health Department
Directorate of Nursing

Trusts should also ensure that ODPs working in hospitals in the independent sector and providing services for NHS patients are appropriately registered. Your attention is also drawn to the arrangements for handling of medicines, particularly controlled drugs, by ODPs. It is important also to involve locally recognised Trades Unions and staff representative groups in the implementation of this Guidance, and to draw this circular to the attention of Theatre Managers.

5. Operating Department Practitioners (ODPs), also called Operating Department Assistants (ODAs), are members of surgical teams working in operating theatres with anaesthetists, surgeons, and nurses during operations. They provide care to patients before, during, and after surgery. Increasingly ODPs can be found working within teams dealing with cardio-pulmonary resuscitation, trauma care, and in Intensive Care Units, Accident and Emergency Departments, Obstetric and Neonatal Units, endoscopy clinics and in Radiology. Pay is negotiated in the "Professional and Technical Staffs B Whitley Council".

6. While the titles "ODP" or "ODA" may be attached to posts by employers, neither the titles nor the activities of these employees is regulated by law. A system of voluntary regulation is however operated by the main professional body representing ODPs, The Association of Operating Department Practitioners (AODP), formerly the British Association of Operating Department Assistants. The Association maintains a non statutory register of competent practitioners and seeks to promote high standards and additional safeguards through its codes of conduct and associated disciplinary mechanisms. Although full members of the Association are automatically entered on the voluntary register, it is not compulsory to join the Association in order to be a part of the voluntary register and bound by its code of conduct. Access to the voluntary register is also granted to appropriately qualified individuals who do not wish to become members of the Association. The Association has also developed a Code of Practice for Locum Agencies.

7. Accreditation by a relevant professional body is an important indicator for employers of competence and suitability. All NHS employers are required to ensure that their employees are qualified and competent to perform the duties for which they are employed and do not represent a risk to patients, colleagues or themselves. This duty includes ensuring that high standards of patient care are maintained at all times. You are reminded that health and safety legislation also has relevance to the employment of properly trained, competent staff to protect both patients and staff. The Health and Safety at Work etc Act 1974 and its relevant statutory provisions place duties, primarily upon employers, to provide information, instruction, training and supervision. The need for pre-employment health checks to be obtained was set out in NHS Circular GEN(1995)4 entitled Occupational Health and Safety Services for the NHS in Scotland. This was reinforced in the recent Occupational Health and Safety Services Strategy entitled "Towards a safer healthier workplace" which is available on the Internet at www.scotland.gov.uk. The Strategy calls for the Occupational Health and Safety Service to review and put in place common minimum standards for pre-employment screening and occupational health surveillance.

8. Since 1991, the Scottish Vocational Qualification/National Vocational Qualification in Operating Department Practice level 3 has formed the basic qualification for employment for practitioners and is now the basic educational requirement for membership of the Association and inclusion in its register. The title "ODP" was adopted by the profession from that date. Registration is automatically available to any practitioner with a recognised qualification acquired since 1976, when the City and Guilds of London Institute 752 Qualification was introduced. In addition, those practitioners who were formally assimilated to the grade of Operating Department Assistant (ODA) as part of a one-off exercise that took place prior to 1979 and who hold a recognised certificate of assimilation are automatically eligible for registration. From 1976 to 1991 the basic qualification for ODPs was the City and Guilds of London Institute 752 for Hospital Operating Department Assistants. Both this and the SVQ/NVQ Level 3 are recognised equally by the Association for access to registration.

9. However, if you currently employ ODPs who were assimilated to the grade prior to 1979 or who do not possess the basic educational requirement and are not on the register, you are asked to encourage them to approach the Association. They will offer advice on sympathetic "grandfathering" arrangements for those with evidence of assimilation and for competent and safe practitioners to be registered based on qualifications and experience.

10. The Association has agreed to provide an advisory service to employers wishing to engage practitioners who are nationals from European Economic Area countries or who have enforceable Community rights or practitioners with other overseas qualifications. It will assess an individual’s qualifications and experience, registering those who meet the required standard and advising others of any deficiency, and the training or practice required to qualify for registration. It is also developing a part of the register which will recognise qualifications gained outside of the UK for a period of 12 months. After that period, it will reassess an individual’s application.

11. ODPs working within theatres, as well as other hospital departments, are becoming involved in the administration of medicines. As with other staff who handle medicines, they should be properly trained and competent to do so. To this end, the SVQ/NVQ in operating department practice covers the handling and administration of medicines. There are, however, special considerations in relation to controlled drugs.

12. Although many operating departments and theatres are now staffed by ODPs, you will wish to note that ODPs are not one of the classes of health professionals authorised under the Misuse of Drugs Regulations 1985 to order, supply and possess controlled drugs. The responsibility for the ordering, possession and supply of controlled drugs in hospital wards and departments rests with the sister or acting sister in charge of the ward or department. This requirement also has implications for the staffing of operating departments and theatres. Annex A gives further information on the requirements relating to the handling of controlled drugs.

 Yours sincerely

 MISS ANNE JARVIE
Chief Nursing Officer

1. The Misuse of Drugs Regulations 1985 authorise doctors, pharmacists and certain other (statutorily regulated) health professionals to order, supply, possess, prescribe or administer controlled drugs in the practice of their professions. They do not authorise operating department practitioners to order, supply or possess controlled drugs. However, the 1985 Regulations also authorise any person who is engaged in conveying a controlled drug to have that drug in his possession, provided that the person to whom he is conveying and supplying it may lawfully have that drug in his possession. An ODP is therefore authorised to convey a controlled drug to a doctor, a registered nurse, or a patient for whom the drug has been prescribed.

2. Under the 1985 Regulations, the responsibility for the ordering, possession, safe custody and supply of controlled drugs in hospital wards and departments rests with the sister or acting sister in charge of the ward or department. To ensure controlled goods are readily available when needed, the sister or acting sister in charge may delegate control of access to another registered nurse, medical practitioner or an operating department practitioner. This access should be strictly controlled in practice and set out in locally agreed written guidelines, eg through the Drug and Therapeutics Committee. A registered nurse or an ODP may only remove controlled drugs from a controlled drug cabinet and return them to the cabinet on the specific authority of either the sister or a medical practitioner. However responsibility for the requisitioning, possession, safe custody and supply of controlled drugs remains with the most senior registered nurse on duty in the department even if the nurse decides to allow access by others.

3. In relation to the administration of controlled drugs, the 1985 Regulations provide that any person other than a doctor may administer to a patient, in accordance with the directions of a doctor, any drug specified in Schedule 2, 3 or 4. An ODP may therefore administer a controlled drug to a patient in accordance with the directions of a doctor. The 1985 Regulations also provide that any person may administer to a patient any drug specified in Schedule 5. ODPs in common with other staff handling or administering medicines should be properly trained and competent to do so.