FOI Ref: 0089FOI1920 

16th August 2019 

Freedom of Information Act 2000 – Request for Information 

We are pleased to respond to your request for information and our response is set out below: 

Request / Response  

We are researchers from [redacted] working on the flammability of skin emollient products when soaked into fabric. This work is in collaboration with [redacted] and the Medicines and Healthcare products Regulatory Agency (MHRA). 

In light of our work on this matter, we wish to understand how the warnings and advice produced because of our original research are now being implemented across health care services. 

Therefore, please could we request answers to the following based upon the December 2018 MHRA report on emollient flammability: 

1. Has this information provided by the MHRA been implemented across your CCG to advise healthcare professionals?

The CCG produced guidance on the risks of emollients with less than 50% paraffin content prior to the MHRA alert. This was based on information provided by the W Yorkshire Fire Service and coroners’ reports. The guidelines were developed through the auspices of the Medicines Safety Group (MSG) and approved in November 2018. The MHRA alert was considered at the MSG meeting in Jan 2019 and amendments to the guidelines approved. However, there has been a delay in publishing the update due to uncertainty of the place of paraffin free emollients and the other topical products mentioned in the MHRA alert: ‘other products which are applied to the skin over large body areas, or in large volumes for repeated use for more than a few days’. It is unclear what products should be included and we received information that a further meeting of the MHRA is being held that is considering all inflammable ingredients in any topical preparations, not just emollients. Thus the outcome of this meeting is awaited to avoid another revision of the local guidance. The CCG has been liaising with our local acute hospital Medicines Safety Committee so that a consistent message is issued across primary and secondary care. This has caused further delay awaiting approval from dermatology. 

2. How has this been implemented? Please also provide details of any future intentions. 

As above; the Nov guidelines are on our website https://www.intranet.sheffieldccg.nhs.uk/Downloads/Medicines%20Management/Practice%20resources%20and%20PGDs/Medicines%20Safety/Fire%20hazard%20with%20paraffin%20emollients.pdf

but there has been no active promotion. The intention is that once the revised guidelines have been issued this will be accompanied by promotion to all health care providers. We have links to community pharmacies, care homes and also to domiciliary care providers. 

3. Has this information provided by the MHRA been implemented across your CCG to advise the public on how to use emollient skin products safely? 

We have not undertaken this at this moment in time as It would be helpful to have nationally produced patient information resources to avoid duplication by local organisations. The MHRA alert states that the manufacturers patient information leaflets will be updated to include the fire risk and ways of reducing this. We note that the MHRA alert also includes: Additionally, MHRA is setting up a specific stakeholder group to make proposals for measures to promote education and awareness of this risk. 

4. How has this been implemented? Please also provide details of any future intentions. 

As above; we have a public facing website where information to the public can be included depending if information was provided nationally. We are not currently planning to produce our own patient information literature. 

If there is any additional information that I can provide, if required, please do not hesitate to contact.