Locum GP Controlled Drugs Self-Assessment and Declaration Form

Overview

DoH  Accountable Officer  (AO) has a legal responsibility to seek assurance that all CDs are managed appropriately across primary care, including by individual GPs. Please complete the CD Self-Assessment and Declaration below.

Refer to the cover letter for further background to this self-assessment and declaration, and supporting information including Frequently Asked Questions (FAQs), which may be helpful in completing this form. Appendix 1 of the letter shows common examples of CDs in each Schedule (S).

Note:  No patient/carer identifiable information should be included in the responses.

• Complete Section A Only: if you currently work as a GP Locum in Northern Ireland
• Complete Section B Only: if you no longer work as a GP Locum in Northern Ireland