Storing medicines at the correct temperature is crucial to maintaining their quality, effectiveness, and safety. Beyond safeguarding patient health, proper storage also plays a key role in reducing waste and promoting sustainability by avoiding the costly loss of valuable medicines caused by improper handling.
In recent years, the number of temperature-sensitive products has grown significantly, with an increasing range of inhalers, GLP-1 drugs for weight loss, and vaccines requiring refrigeration. As these services expand, so too does the need for precise monitoring and adherence to storage guidelines.
Refrigerated medicines should generally be kept between 2°C and 8°C, while medicines requiring ambient storage should be maintained between 15°C and 25°C. Pharmacy teams should always refer to the manufacturer's guidance on the packaging to ensure compliance and to minimise environmental and financial impacts from unnecessary waste.
Rising global temperatures due to climate change present a growing challenge for the safe storage of medicines. Higher ambient temperatures can increase the risk of medicines being stored outside their recommended ranges, potentially compromising their quality and efficacy. For example, prolonged exposure to temperatures above 25°C can degrade many medicines, reducing their therapeutic effectiveness.
In addition to its effects on medicines, climate change also impacts the working environment for pharmacy staff. Elevated temperatures can lead to uncomfortable working conditions, affecting concentration, productivity, and overall well-being. It is essential to maintain suitable workplace temperatures—ideally between 18°C and 22°C—to ensure staff can perform their duties effectively while safeguarding both their health and patient safety.
A report by NHS England, Delivering a Net Zero National Health Service, highlights that medicines account for 25% of emissions within the NHS, with inhalers responsible for around 3% (NHS England, 2020). The NHS Long Term Plan set targets to deliver significant and accelerated reductions in total emissions by moving to lower carbon inhalers, such as dry powder inhalers (DPIs). Similarly, NHS Scotland has committed to reducing inhaler-related by encouraging a switch to DPIs where clinically appropriate and improving inhaler disposal practices). NHS Wales also supports the transition to lower global warming potential inhalers and aims for to further reduce environmental impact. Together, these efforts reflect a UK-wide commitment to reducing the carbon footprint of healthcare, particularly in relation to respiratory care.
Meeting the standards in relation to medicines storage
A recent review of pharmacy inspections over the last 12 months showed that:
- 86 pharmacies failed standard 4.3 for a variety of reasons surrounding the storage of medication
- nearly 1 in 20 pharmacies (4.3%) inspected failed standard 4.3 because they were not able to show that the medicines requiring refrigeration were being stored appropriately
Action plans issued for failed standards can lead to follow-up visits and inspections, requiring inspectors to return to pharmacies to verify proper medicine storage. This increase in follow-up visits has an impact on our inspectorate’s limited capacity, and also contributes to a higher carbon footprint from the GPhC inspectorate.
When reviewing these figures some common themes emerged about reason why the pharmacy failed the standards. These included:
- not checking and recording the maximum and minimum temperatures daily, with entries in recorded which don’t match the actual fridge temperatures
- recording temperatures outside the proper range, but not informing the pharmacist who can carry out an investigation
- staff not knowing how to reset the thermometers after checking the temperatures
- overstocked fridges
- fridges with ice compartments- medicines have been found frozen to the back of fridges or to the ice compartment
- using mercury thermometers which may not give correct readings
- using thermometers with a low battery
- positioning the thermometer probe incorrectly, for example a probe positioned at the front of the fridge may mean that inaccurate temperature readings are shown.
Standards that relate to storing medicines safely and appropriately
3.5 Pharmacy services are provided in an environment that is appropriate for the provision of healthcare
4.3 Medicines and medical devices are: - obtained from a reputable source;- safe and fit for purpose;- stored securely;- safeguarded from unauthorised access;- supplied to the patient safely;- disposed of safely and securely.
5.1 Equipment and facilities needed to provide pharmacy services are readily available
5.2 Equipment and facilities are obtained from a reputable source, safe to use and fit for purpose, stored securely, safeguarded from unauthorised access and appropriately maintained.
Steps to take when your pharmacy fridge fails
- Make sure you have a standard operating procedure (SOP) in place that sets out the actions to take for different types of fridge failure- a brief temperature fluctuation may need different actions compared to a complete fridge failure, for example.
- If your fridge breaks down completely, quarantine all affected stock immediately, to make sure it’s not used.
- Carry out an investigation to determine the appropriate actions for each medication, following specific storage guidelines, to protect patient safety and minimise stock loss. You may find it helpful to:
- Consult the Specialist Pharmacy Service (SPS) Refrigerated Medicines Stability Tool, which provides essential information on whether medications remain safe and effective after exposure to temperatures outside their recommended range.
- Check the Summary of Product Characteristics (SPC) for each medicine, which provides detailed storage and stability information.
- Contact pharmaceutical wholesalers, as they can provide guidance on handling affected stock and potential returns.
- If you need to dispose of medication, remove and recycle the cardboard packaging to maximise space in the medication waste bin, and to reduce both disposal costs, and environmental impact. You can also recycle patient information leaflets.