Recurring concern

Failure to ensure medication packaging is clearly distinguishable

First to latest report 9 Jan 2015 — 2 Jun 2024

Reports that mention this concern
4
Times this concern has been raised
4
Stated actions linked to this concern
11

What this concern includes

Includes failures in the design, labelling, colour differentiation or other dedicated identification controls for medication packaging and dispensing containers where inadequate distinction can cause the wrong medicine or patient's medication to be selected, dispensed or used.

What is not included
  • Excludes medication prescribing, administration, reconciliation and supply failures where packaging or dispensing-container identification is not the deficient control.
  • Excludes general product labelling or medication warnings that do not concern distinguishing medicines or patients' medication containers.
  • Excludes patient-identification failures unrelated to medication packaging or dispensing-container differentiation.
  • Excludes generic dispensing, pharmacy or manufacturing deficiencies unless they directly create inadequate visual or other identification of medication packaging.

Reports and published responses 4 reports

See individual reports that have raised this concern, and the actions taken in response

  1. Berkshire

    AI-generated summary

    Sewa Kaur Chaddha · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Sewa Kaur Chaddha was found collapsed at home after taking her husband’s medication instead of her own for several days, including diabetes medication. She died in hospital from hyponatraemia caused by treatment for hypoglycaemia resulting from the accidental ingestion of hypoglycaemic medication. Concerns included the identical appearance of the couple’s dosset boxes, small patient-name labels, and the absence or poor dissemination of guidance for pharmacists supplying medication to people with cognitive impairment.

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    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to adequately differentiate dosset boxes for elderly or cognitively impaired patients living at the same address

    Wider context from the report

    “1) The medications were provided to the couple by the local pharmacy, then known as Lloyds Pharmacy, in separate dosset boxes. Mrs Chaddha’s medications were provided on a weekly basis. Mr Chaddha’s were provided on a monthly basis. (2) Both patients were elderly and had cognitive impairment. (3) The two patients’ dosset boxes were identical to each other except for a small pharmacist’s label with small type with the relevant patient’s name. (4) Mrs Chaddha used one of Mr Chaddha’s dosset boxes, rather than her own, for several days. (5) Evidence was given at the inquest that there was no guidance or policy in place for Pharmacists to follow when issuing medication to patients with cognitive impairments, or if there was, it was not well disseminated among the pharmacist population. (6) Evidence was given at the inquest that dosset boxes of different colours or labels with different colours were not routinely given to elderly or cognitively impaired patients living at the same address. ”

    Source location

    Sewa Kaur Chaddha · Prevention of Future Deaths report
    Page 2 · concerns

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Consider adding wording recommending clear medicine labelling to distinguish household members, particularly those who are elderly or cognitively impaired.

    Verbatim wording from the response

    “13. The SPS will consider including additional wording to that in Annex 1, to recommend that medicines are clearly labelled for differentiation between household members, particularly for patients who are elderly and/or have cognitive impairment.”

    Source location

    Response from Specialist Pharmacy Service
    Page 3 · response
    Published 15 October 2024

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Review existing guidance and consider refinements for supporting patients with cognitive impairments.

    Verbatim wording from the response

    “The NPA supports its Member pharmacies with advice, guidance and resources to help them to provide person-centred care in accordance with the pharmacy regulator’s, the General Pharmaceutical Council’s, standards. Our support includes guidance on equality, diversity and inclusion, monitored dosage systems (dosette boxes) and reasonable adjustments, including guidance on conducting patient assessments to help pharmacies determine how best to support patients with different needs including visual impairment, confusion and dementia, and signposting to information and support from the General Pharmaceutical Council.”

    Source location

    Response from National Pharmacy Association
    Page 1 · response
    Published 15 October 2024

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Raise the risk of confusing multi-compartment aids in one household with the Royal Pharmaceutical Society and request consideration of additional guidance or information.

    Verbatim wording from the response

    “Our action. We will bring this concern – the need for different MCAs in one household to be very clearly identified in such a way that those with cognitive impairment remain safe and take their medicines - to the RPS and the Community Pharmacy Patient Safety Group (CPPSG), and ask each to consider additional guidance and/or information to be made available to pharmacies and pharmacists. We will also make community pharmacy owners we represent aware of this concern or specific risk, initially ourselves and subsequently if the RPS or CPPSG issues any advice or reports. We will seek to take these actions in the autumn of this year.”

    Source location

    Response from Community Pharmacy England
    Page 2 · response
    Published 15 October 2024

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Raise the risk of confusing multi-compartment aids in one household with the Community Pharmacy Patient Safety Group and request consideration of additional guidance or information.

    Verbatim wording from the response

    “Our action. We will bring this concern – the need for different MCAs in one household to be very clearly identified in such a way that those with cognitive impairment remain safe and take their medicines - to the RPS and the Community Pharmacy Patient Safety Group (CPPSG), and ask each to consider additional guidance and/or information to be made available to pharmacies and pharmacists. We will also make community pharmacy owners we represent aware of this concern or specific risk, initially ourselves and subsequently if the RPS or CPPSG issues any advice or reports. We will seek to take these actions in the autumn of this year.”

    Source location

    Response from Community Pharmacy England
    Page 2 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Inform represented community pharmacy owners about the risk of confusing multi-compartment aids in one household.

    Verbatim wording from the response

    “Our action. We will bring this concern – the need for different MCAs in one household to be very clearly identified in such a way that those with cognitive impairment remain safe and take their medicines - to the RPS and the Community Pharmacy Patient Safety Group (CPPSG), and ask each to consider additional guidance and/or information to be made available to pharmacies and pharmacists. We will also make community pharmacy owners we represent aware of this concern or specific risk, initially ourselves and subsequently if the RPS or CPPSG issues any advice or reports. We will seek to take these actions in the autumn of this year.”

    Source location

    Response from Community Pharmacy England
    Page 2 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Double-check each tray with the patient after removing it from packaging.

    Verbatim wording from the response

    “Upon finding out we have amended our processes further to ensure that this does not happen again. We operate strict standard operating procedures which involve each tray being removed from packaging and double checked again with the patient.”

    Source location

    Response from Slough Pharmacy
    Page 1 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Provide differently branded trays with distinct packaging to households where multiple people use trays.

    Verbatim wording from the response

    “We have further added to our SOPs, and now provide a different brand of trays with totally different packaging to any households that involve more than one person with trays.”

    Source location

    Response from Slough Pharmacy
    Page 1 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Community pharmacies are independent contractors under a national framework, limiting the ICB’s direct influence over their processes.

    Verbatim wording from the response

    “I am replying as the Chief Pharmacist for NHS Frimley, responsible for medicines optimisation and pharmacy across our system. While we recognise our duty to address the concerns raised, it is important to note that community pharmacies and other healthcare professionals operate as independent contractors under a national framework or contract, limiting our direct influence over their processes.”

    Source location

    Response from Berkshire Integrated Care Board
    Page 1 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Different dosette or label colours are not currently available because legal labelling requirements limit community pharmacy options.

    Verbatim wording from the response

    “Dosette boxes are not always suitable or the only solution for supporting a patient in taking their medication. Although various types of dosette boxes are available for purchase by the public, there are only a limited number used within community pharmacy due to the requirement that dosettes used must enable fulfilment of the legal labelling requirements. These are not currently available in different colours or label colours.”

    Source location

    Response from Berkshire Integrated Care Board
    Page 3 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Pharmacy dispensing concerns fall outside the medicines regulator’s remit, which covers medicines placed on the UK market.

    Verbatim wording from the response

    “We have reviewed the matters of concern and do not believe we are the right organisation to take these matters forward. We are the medicines regulator, and our approvals cover the placing of medicines onto the market, in their original packaging and are designed to ensure the safety, quality and efficacy of medicines on the UK market.”

    Source location

    Response from MHRA
    Page 1 · response
    Published 15 October 2024

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    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Concerns about pharmacists’ dispensing actions should be addressed to the General Pharmaceutical Council, the pharmacy and pharmacist regulator.

    Verbatim wording from the response

    “However, the matters of concern relate to actions taken by a pharmacist during the dispensing process, and we believe therefore they are better addressed to the regulatory body for pharmacies and pharmacists, the General Pharmaceutical Council. A link to their website and an email address for their enquiry team can be found below:”

    Source location

    Response from MHRA
    Page 1 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Responsibility for labelling dispensed medicines lies with the regulator, so the service does not provide labelling information.

    Verbatim wording from the response

    “11. The labelling of dispensed medicines is within the remit of the regulator, the General Pharmaceutical Council, who has also been sent a copy of the Regulation 28 Report. The SPS does not provide information regarding the labelling of dispensed medicines.”

    Source location

    Response from Specialist Pharmacy Service
    Page 3 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Dispensing medication is governed by a national pharmacy contract agreed and negotiated nationally, rather than by the local pharmacy committee.

    Verbatim wording from the response

    “In response to your report, it must be noted that the LPC represents local pharmacy contractors in the delivery of specific pharmacy services to patients living in our community, the dispensing of medication falls within a national pharmacy contract which is agreed, and negotiated at a national level.”

    Source location

    Response from Community Pharmacy Thames Valley
    Page 1 · response
    Published 15 October 2024

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    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Responsibility for commissioning dispensing medication rests with Frimley ICB, which has raised the matter with NHS England.

    Verbatim wording from the response

    “With respect to this I have escalated the issues raised with Frimley ICB, who have delegated commissioning for the dispensing of medication, who in turn has raised this matter with NHS England. I have also conversed with our national body – Community Pharmacy England.”

    Source location

    Response from Community Pharmacy Thames Valley
    Page 1 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Community pharmacies operate as independent contractors under national contracts, limiting direct influence over their processes.

    Verbatim wording from the response

    “I am replying as the Chief Pharmacist for NHS Frimley, responsible for medicines optimisation and pharmacy across our system. While we recognise our duty to address the concerns raised, it is important to note that community pharmacies and other healthcare professionals operate as independent contractors under a national framework or contract, limiting our direct influence over their processes.”

    Source location

    Response from NHS Frimley ICB
    Page 1 · response
    Published 15 October 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Different dosette or label colours are not currently available because community-pharmacy dosettes must meet legal labelling requirements.

    Verbatim wording from the response

    “Dosette boxes are not always or the only solution for supporting a patient in taking their medication. Although various types of dosette boxes are available for purchase by the public, there are only a limited number used within community pharmacy due to the requirement that dosettes used must enable fulfilment of the legal labelling requirements. These are not currently available in different colours or label colours.”

    Source location

    Response from NHS Frimley ICB
    Page 3 · response
    Published 15 October 2024

    Open published response

  2. Suffolk

    AI-generated summary

    Susan Warby · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Susan Warby was admitted to hospital with a perforated bowel and underwent emergency surgery. An incorrect intravenous fluid attached to an arterial line, combined with incorrect blood-sampling technique, produced erroneous results that led to unnecessary insulin treatment, hypoglycaemia and a brain injury; her death followed multi-organ failure, septicaemia and disseminated aspergillus pneumonia. The principal concerns were the lack of distinctive labelling for fluids used with arterial lines and inadequate blood-sampling technique and training.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Insufficiently distinctive packaging and visual identification of intravenous fluids for arterial line transducer sets

    Wider context from the report

    “1. During the evidence it was clear that packaging and visual identification aids available for intravenous fluids to be used in arterial line transducer sets were not sufficiently distinctive. It was heard that following Mrs Warby's death that as far as possible the West Suffolk Hospital has asked its suppliers to change the labelling on the intravenous fluids it purchases. These were exhibited in court and even with the changes the manufacture was prepared to make, the packaging cannot be considered at all distinctive for fluids to be used in an arterial line. In direct contrast, we saw that the tubing used on an arterial line transducer set has a solid red line running its length. This is to clearly indicate to staff that it is an arterial line therefore must not be used for the administration of drugs or medicinal fluids. I am therefore concerned that the packaging of the 0.9% Sodium Chloride intravenous fluid to be used with an arterial line is not also so clearly distinguished. It was heard in evidence that there is currently no 0.9% Sodium Chloride intravenous fluid available which is specifically and clearly labelled for arterial line use only. It is important to note that the issue identified in this inquest regarding the use of incorrect intravenous fluid in an arterial line is not a new one. In 2008 the UK National Patient Safety Agency issued a Rapid Response report highlighting problems with infusions and sampling from arterial lines. In that 2008 report the UK National Patient Safety Agency had already identified 84 incidents where the wrong infusion was attached to an arterial line with two of those cases proving fatal. It is understood that the 0.9% Sodium Chloride intravenous fluid has a number of medicinal uses other than just as a flushing fluid in an arterial line. However, the number of cases identified where the incorrect fluid is being used in arterial lines, clearly demonstrates the confusion and errors which occur when using generally labelled intravenous fluids with an arterial line transusion set. ”

    Source location

    Susan Warby · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Consider improvements with the marketing authorisation holder to make statutory information easier for clinical staff to assimilate and reduce selection errors.

    Verbatim wording from the response

    “Nonetheless, we will consider further with the marketing authorisation holder whether improvements could be made to assist clinical staff to more easily assimilate the statutory information to reduce the likelihood of errors of this nature in future.”

    Source location

    2020-0188-Response-from-MHRA-Redacted.pdf
    Page 1 · response
    Published 23 November 2020

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Colour cannot be used in IV-fluid labelling because container manufacturing prevents it; other local risk controls are required.

    Verbatim wording from the response

    “You will also know that the MHRA has explained that the way in which the containers of the IV fluids described in your report are manufactured (bags composed of polyolefin/polyamide co-extruded plastic), means that judicious use of colour cannot be used within the labelling to aid differentiation and reduce the likelihood of error at the point of selection. The MHRA states that other risk minimisation measures should be employed locally within clinical areas to assist correct identification. However, the MHRA has undertaken to consider further with the marketing authorisation holder whether improvements can be made to the labelling to help ensure the medicine is used appropriately and reduce the likelihood of such errors in future.”

    Source location

    2020-0188-Response-from-Dept.-of-Health-and-Social-Care-Redacted.pdf
    Page 2 · response
    Published 23 November 2020

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Because Viaflo containers cannot use colour differentiation, local clinical areas must implement other measures to identify intravenous fluids correctly.

    Verbatim wording from the response

    “Intravenous fluids as described in your report are supplied in bags known as ‘Viaflo’ which are composed of polyolefin/polyamide co-extruded plastic. The way that these containers are manufactured means that ‘judicious use of colour’ (as recommended in our best practice guidance) cannot be used within the labelling, to aid differentiation and reduce the likelihood of error at the point of selection. As a result, other risk minimisation measures must be employed locally within clinical areas to assist in the correct identification of intravenous fluids one from another.”

    Source location

    2020-0188-Response-from-MHRA-Redacted.pdf
    Page 1 · response
    Published 23 November 2020

    Open published response

  3. Manchester West

    AI-generated summary

    Victor James Hall · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Victor James Hall died at Salford Royal Hospital on 29 June 2018 after being admitted with shortness of breath and an exacerbation of chronic obstructive pulmonary disease. He was mistakenly administered Phosphate Polyfusor instead of prescribed sodium bicarbonate after dispensing, pharmacy checking and ward checking errors, although the post-mortem and toxicology evidence concluded that the medication error played no role in his death. Concerns were raised about the similar Polyfusor product design and about medication-checking, recording, dispensing, training and supervision procedures.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Phosphate Polyfusor product design failing to distinguish the medication clearly

    Wider context from the report

    “During the Inquest, evidence was heard that:- 1.Salford Royal Hospital had undertaken an internal investigation and concluded that one of the root causes for the medication error, was the Phosphate Polyfusor product design. i. The Pharmacy and Nursing Matron Lead, concurred that the staff involved in the incident had relied on the word Polyfusor, without actually checking the medication packaging against the prescription chart and label. Salford Royal Hospital, wrote to the Medicines and Healthcare products Regulatory Agency (MHRA) in 2018, requesting the word Polyfusor be removed from the Phosphate design product packaging to prevent future medication errors. Despite repeated requests from Salford Royal Hospital for an MHRA update, the product design for Phosphate Polyfusor remains the same. 2. I request that The Chief Executive, Medicines and Healthcare products Regulatory Agency (MHRA) reviews the: i. Product design on the Polyfusors in question 3.The Chief Executive, Nursing & Midwifery Council, 23 Portland Place, London W1B 1PZ reviews the: i.Guidance given to their members in relation to the administration of medication to consider and include the simplest of steps, namely that a Healthcare Professional should check the name of the medication on the prescription chart against the name of the medication on the packaging and labelling of the medication at the time of each administration of medication to ensure that the correct medication is always administered to a patient. ii.Guidance given to their members in relation to their duties, to accurately record and contemporaneously document the packaging, label an prescription checks they have undertaken to ensure the correct medication is always administered to a patient. 4.The Chief Executive, Salford Royal Hospital, NHS Trust Hospital, Stott Lane, Salford M6 8HD reviews the: i.Guidance and procedures in relation to the dispensing and transfer of medications from the Pharmacy Department to a ward, to include a system of checking medications against the packaging, labelling and prescription chart at the time of receipt by the ward. Furthermore, to consider documentary evidence of the fact that the medication packaging has been checked against the prescription chart and an acknowledgement of receipt of the correct medication by the pharmacy and ward staff, evidenced by a signature of the recipient. ii.Training, Auditing, Supervision and monitoring of all staff, particularly Nursing and Pharmacy staff, in relation to the above issues. ”

    Source location

    Victor James Hall · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Ensure nursing staff recognise different Polyfusor products and check all medication details in full.

    Verbatim wording from the response

    “| ████████ | 29th February 2020 Analysing near miss data to identify common dispensing errors and introducing on-going communication of this to staff. | ████████ | 29th February 2020 Reviewing the accuracy checking test to incorporate a wider range of medications. | ████████ | 29th February 2020 Monitoring of compliance of medicines safety training completed by nursing staff on Ward H2. | ████████ | Commenced Monitoring of medicine safety incidents on ward H2 | ████████ | Commenced Policy to be published about the process to follow when involved in a medicines safety incident. | ████████ | 29th February 2020 All nursing staff to be made aware that there are many different types of Polyfusor products. In order”

    Source location

    2019-0482-Response-by-Northern-Care-Alliance-NHs-Trust
    Page 3 · response
    Published 16 October 2019

    Open published response

  4. Birmingham and Solihull

    AI-generated summary

    Annette Charlton · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Annette Charlton, who had emphysema and lung fibrosis requiring continuous oxygen therapy, was dispensed Naproxen instead of prescribed antibiotics and died on 28 September 2014. The principal concern was that medication manufacturers used almost identical packaging, which was considered likely to contribute to dispensing errors and potentially patient deaths.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Almost identical medication boxes

    Wider context from the report

    “(1) Manufacturers are able to produce medication in almost identical boxes which is very likely to contribute to dispensing errors and potentially patient deaths. ”

    Source location

    Annette Charlton · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Meet with the MHRA to discuss packaging redesign and colour differentiation between products and strengths.

    Verbatim wording from the response

    “Regarding the issue of packaging similarity, Crescent has scheduled a meeting with the MHRA on the 20th January 2015 to discuss packaging redesign and use of colour to differentiate between different products and strengths, after their request to do so in May 2014.”

    Source location

    2015-0009-Response-by-Crescent-Pharma-Limted
    Page 1 · response
    Published 9 January 2015

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Revise product artwork to minimise pharmacist dispensing errors caused by failure to verify product identity.

    Verbatim wording from the response

    “Crescent are therefore committed to revising product artwork to help minimise pharmacist error, caused by the failure to verify product identity during dispensing.”

    Source location

    2015-0009-Response-by-Crescent-Pharma-Limted
    Page 1 · response
    Published 9 January 2015

    Open published response

Actions and positions describe what organisations say in published responses. Implementation is not independently verified.

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Data last updated 7 September 2026