On 22 May 2023, David Cousins, aged 68 years, of Derby, Derbyshire. Mr Cousins registered with the Society in 1977.
It is with great sadness we learnt of the death of David Cousins. Many will pay tribute to his work as chief pharmacist at Derbyshire Royal Infirmary (DRI) where, as the forward-thinking chief pharmacist he was, he led on many innovative roles for both pharmacists and pharmacy technicians. These new roles included pharmacist attendance at cardiac arrests, tech-tech accuracy checking of dispensed medicines (now widely adopted throughout the UK) and aseptic services for compounding total parenteral nutrition, cancer chemotherapy and IV antibiotics. With a clear understanding that delivery of advanced clinical pharmacy services needed to be underpinned by matching postgraduate training, David developed links with the University of Illinois on a “twinning” basis, to deliver the first PharmD programme based in a UK hospital at the DRI.
Most of all, David will be remembered for his enormously effective work with the National Patient Safety Agency (NPSA), where he used his listening skills and analytical approach to identify areas of risk with medicines use and made changes to improve safety. In 2007, David was lead author of ‘Safety in Doses’, the fourth report of the NHS Patient Safety Observatory. The report presented learning about medicine safety, drawn from almost 60,000 medication incidents reported to the NPSA via the National Reporting and Learning System (NRLS) between January 2005 and June 2006. It brought together the key messages from reports to the NRLS, evidence from published research and data from other organisations; for example, the NHS Litigation Authority. It also identified seven priority actions for healthcare staff, NHS organisations and healthcare commissioners. There were three general recommendations and four related to specific risks that, together, accounted for 65% of all medication incidents reported to the NRLS. This report remains relevant today and was 12 years ahead of the World Health Organization’s global technical reports on medication safety.
David’s vision ensured that practitioners in the NHS would have guidance on how to deliver these objectives. He was the lead author of many NPSA alerts and guidance documents between 2002 and 2010 — a selection of which included safe use of potassium injections, epidural and intrathecal medicines, methotrexate, oral anticoagulation, heparin flush solutions, lithium therapy, opioid use and many more. In 2014, a NPSA alert required every NHS organisation in England to appoint a medication safety officer. Under his leadership, NPSA produced guidance for the pharmaceutical industry on safe labelling of injectables, both for outer packaging and on immediate units of administration.
As David campaigned for better medicines labelling, (using his evidence base as always) many changes were introduced and labelling is now part of the assessment of medicines in NHS procurement contracts. In his NPSA role, he also led on the introduction of medicines reconciliation for patients admitted to hospitals in the UK, which is now a minimum service standard in NHS hospitals.
David was an internationalist and looked beyond the UK, not only for ideas, but for where he could offer service to others. Along with the Chicago collaboration mentioned above, he collaborated with Mike Cohen (then president of the Institute for Safe Medication Practices and chair of the International Medication Safety Network) on his NPSA work. In 2020, David became the 23rd recipient of the prestigious Institute for Safe Medication Practices Cheers Lifetime Achievement Award.
Closer to home, in Europe, David gave generously of his time and expertise to develop the quality and effectiveness of the European Association of Hospital Pharmacists’ (EAHP) Annual Conference Scientific Programme, between 1995 and 2002. As a member of the inaugural EAHP Congress Scientific Committee, he brought his energy and enthusiasm to the role and was instrumental in developing and modernising the Congress Scientific Programme and ensuring that its educational objectives were met. He looked to expand the clinical content of the programme and showcase the innovative roles of pharmacists. Not only was he a speaker at EAHP Congresses but, on occasion, he took to the stage to play saxophone with the orchestra at gala dinners.
David was a regular visitor to Ireland from as early as 1987, where he presented at national conferences on documentation of clinical pharmacists’ activities, aseptic services, and later medication safety leadership. The structure and delivery of the Trinity College Dublin masters in hospital pharmacy, inaugurated in 1996, was heavily influenced by the DRI model, and continues successfully today. There is no doubt that David had an enormous positive influence on the development of hospital pharmacy practice in Ireland.
The Guild of Healthcare Pharmacists recognised his many achievements by awarding David the Medeva gold medal in 2003 for an outstanding contribution to hospital pharmacy. David was also a Fellow of the Royal Pharmaceutical Society and recipient of lifetime achievement awards from the Society and the United Kingdom Clinical Pharmacy Association. He leaves a great legacy for which the profession is grateful — a legacy of which his family can be proud. David relaxed by bike riding, listening to jazz and playing the saxophone. Our thoughts are with his wife Trina and sons Christopher and Daniel.
Ron Pate, Tim Delaney and Ged Lee
I write in recognition of the recent passing of David Cousins.
David made profound contributions to our medication practice here at the University Hospitals of Derby and Burton.
As a former chief pharmacist of the then Derbyshire Royal Infirmary, David led what were, at the time, groundbreaking pharmacy service developments. These included the introduction of pharmacists on the resuscitation team, management of pump/syringe driver libraries, hospital-wide central IV additive services and decentralised satellites situated in the heart of clinical departments.
David went on to be the first chief pharmacist of Derby Hospitals NHS Foundation Trust, formed after the merger of the city’s hospitals. Overall, David provided almost 20 years’ service to our organisation. His commitment and influence within our city, where he had continued to live, was further evidenced by his work to develop a postgraduate clinical pharmacy faculty at the University of Derby.
He is remembered fondly by many of our longest serving staff, both within the pharmacy and among our wider hospital workforce.
His wife worked alongside us as a highly valued pharmacy colleague, up until her retirement last year. She was a huge support to David and their family throughout his career.
Many people will know David for his work as head of safe medication practice at the National Patient Safety Agency (NPSA). Under David’s leadership, the NPSA issued alerts on ‘big ticket’ medicines safety issues, such as reducing harm from delayed/omitted medicines, opioids, insulins and anticoagulants.
Even after retirement, David remained steadfast in his drive to improve patient safety, contributing to expert panels and writing papers or opinion articles. I had the fortune to receive guidance from David in recent years as he visited me in my role as medicines safety officer at Derby and Burton. He remained as interested and inquisitive as ever to understand ‘shop-floor’ medicines safety views!
David used the term ‘giant risks’ in medicines safety to describe those high-risk drug groups or incident categories that continue to be documented as the cause of the majority of medication-related harm in NHS patients.
A week does not go by in my role without me discussing the ‘four giants of medicines safety’: opioids, anticoagulants, insulin and (omission or delay of) antibiotics.
Perhaps, this week, you will join me in remembering David Cousins as the fifth giant of medication safety.