March 22, 2013 by admin
Nurse prescribing in mental health has been associated with concerns that prescribing may affect the important nurse-patient relationship, and it has not been as well established or researched as in some areas. This study provides evidence that nurses, clients and doctors and nurse managers view nurse prescribing in mental health positively.
Interview and focus groups in one Foundation Trust elicited the following views: nurse prescribers believed that nurse prescribing enhanced the service; their clients welcomed it as they valued the existing relationship, as well as continuity and ease of access; and doctors and nurse managers knew of positive client feedback.
Ross JD, Clarke A and Kettles AM. Mental health nurse prescribing: using a constructivist approach to investigate the nurse-patient relationship. J Psychiatr Ment Health Nurs 2013; published online ahead of print, 17 February 2013.
January 26, 2013 by admin
The ANP has announced that its next annual conference will be held in London on 14 November 2013, so do put the date in your diaries!
December 13, 2012 by admin
Non-medical prescribing has yet to achieve its potential, despite its successes and the growing evidence base. Could the NHS reforms in England, and the tight budgets everywhere, provide the necessary stimulus, as commissioners look for cost savings in the delivery of high quality, joined-up care?
In this light, the recent ANP annual conference was very topical, with a range of speakers highlighting the importance of audit and evidence, and pointing to the growing recognition that the fundamentals of good prescribing practice look the same, whatever the clinical setting or professional background of the prescriber.The ANP annual conference 2013 will be on 14 November in London, come and join us!
Non-medical prescribing: audit, evidence, care in the future
In some organisations, non-medical prescribing is embedded, with good support and infrastructure. Consultant pharmacist Pieter Shaw, who runs a viral hepatology service, described how the difference non-medical prescribers are making in primary care is now apparent to those working in his hospital, as patients come through the system. Non-medical prescribers have also been responsible for bring new drugs into local formularies. Knowledge, competence and skills should provide the boundaries for prescribing, not the profession of the prescriber, he said, a theme that was touched on throughout the conference.
Clinical audit is a powerful tool that can be quick and simple to complete, was the rallying cry from Sam Sherrington (Strategic NMP Lead NHS Northwest, ANP Vice Chair, and the board nurse for three clinical commissioning groups). She described an annual audit tool for non-medical prescribing that involves clinicians filling in online answers to a few questions (for example, was a prescription required?) after each consultation, whether it involved a prescription or not: on average, an audit took 3 minutes. The audit has grown dramatically, from 209 responses in 2009 to over 19,000 this September. This provides a mass of useful information to demonstrate the impact of non-medical prescribing and the possibility of large cost savings - nearly 5000 GP appointments were reported as prevented, and over 1200 subtherapeutic doses identified, in September in this one region, for example.
Another useful tool, often used to look at prescribing, is the Medication Appropriateness Index (MAI). Melanie Hart, a community matron who is the non-medical prescribing and governance lead for a community trust, outlined some fascinating research she has completed that used the MAI to look at how safely and effectively community matrons are prescribing independent prescribers. A small percentage (under 4%) of prescribing of the community matron prescribing was identified as not appropriate; although direct comparison is difficult, a 2003 study using GP records found just over 4% was inappropriate. Two interesting aspects of the research were the use of both qualitative and quantitative methods as a way of capturing events, and the way that the pilot study was use to resolve differences between raters. The prescribers here are part of a rapid response team, working short term with very complex cases, so establishing an understanding of the way they prescribe is important. Given that, the MAI could be used in any setting.
ANP President Dr June Crown CBE pointed out that despite the huge organisational upheavals in the NHS in England, which may mean nurses and other healthcare professionals working for new organisations or for ones outside the NHS, demographic and medical changes mean the focus will remain on older people with a range of co-morbidities. And non-medical prescribing can help deliver good care. ANP Chair Dr Barbara Stuttle CBE also stressed the extent of the changes in England, and how care is getting more complex. Along with policies and procedures, there is a role for common sense and taking individual responsibility for spotting gaps and doing something about them, she argued.
An example of the benefits of nurse prescribing was provided by Helen Ward (Principal Lecturer on the non-medical prescribing programme at London South Bank University), as she went step by step through the process of a structured medication review with a 75-year-old. This led to new diagnoses and a much fuller understanding of what was really going on. Looking to the bigger nursing picture, Barbara Stuttle and Sam Sherrington gave a sneak preview of the Chief Nursing Officer’s ‘Six C’s’: care, compassion, courage, communication, competence and commitment, Compassion in Practice.
Non-medical prescribing: regulation, frameworks and legislation
Right touch regulation is the name of the game now in healthcare regulation. Fiona Culley, who was prescribing and medicines management advisor at the Nursing and Midwifery Council (NMC) and is now an independent consultant, mapped out the changes to the system and the way the NMC’s role has changed. This follows the ‘Strategic Review of the NMC’, conducted earlier this year by the Council for Healthcare Regulatory Excellence (CHRE) which identified problems ‘at every level’ and said there had been confusion over its purpose: ‘the role of the regulator is to set the ‘baseline’, the standard below which professional practice must not fall. It is the role of professional bodies to seek to raise the bar and to encourage nurses and midwives to achieve excellence in practice.’ And employers have a role, in performance management, training, support, and workplace systems. All the healthcare regulatory bodies will now be working towards right touch regulation, the use of minimum regulatory force to achieve the desired result.
Another area where professional boundaries are no longer relevant is the new single competency framework for prescribers. The National Prescribing Centre (NPC, now part of NICE) was asked in 2009 to look at competency frameworks for physiotherapists and podiatrists, as they started to move towards independent prescribing. It became clear, explained Jane Brown, who led the NPC project, that there was a core set of prescribing competencies, regardless of profession. And the General Medical Council’s work on prescribing errors by doctors showed that this should be something for all professionals. So instead, the NPC took existing frameworks, updated and consolidated them, and developed these using wide consultation into a single framework, published in May this year. She highlighted the different ways in which it can be used, as did the audience discussion.
Finally, it looks like junior doctors will be undergoing prescribing assessments in future. The British Pharmacological Society and the Medical Schools Council, which are developing it together, say that the results of the two-hour pilot tests in 2013 will inform the next stage of implementation.
What happens when things go wrong, which they can do? Solicitor John Glendening swept though recent legislative changes - particularly the controlled drugs amendments and the Human Medicines Regulations 2012 - and then looked at the procedures that may kick in after something goes wrong. Nurses are now much more likely to be called to appear as witnesses in inquests, so it is vital to keep real-time accurate records, and to be certain that any information supplied to an employer or the regulator is accurate after an incident - it may end up in court, months down the line. Absolutely essential, in his view, is professional indemnity insurance for anyone undertaking any kind of extended nursing role.
March 30, 2012 by admin
The ANP has announced that it will be holding two conferences in 2012:
- Tuesday 4 September at the University of Surrey in Guildford
- Thursday 22 November at the Wellcome Collection Conference Centre in London.
Given the changes underway in the NHS, and the pace of clinical developments, it is more important than ever for nurse prescribers to stay up to date with what is happening in their area. So do consider joining us at one of these events, which will have a range of speakers and plenty of opportunity for discussion.
The full programme details will be announced soon - so watch this space.
November 22, 2011 by admin
The nursing profession can congratulate itself on the way it has handled non-medical prescribing, as other professional groups now take on these responsibilities, said Dr June Crown CBE, President of the Association for Nurse Prescribing (ANP), at the start of its annual conference held in London recently. Despite the frustrations accompanying the occasionally slow progress made since the Cumberlege review 25 years ago, much has been achieved. The course is set now, even if it is slow: no more battles lie ahead.
Dr Crown added that prescribing “is of its time”: we have an ageing population whose multiple chronic diseases are increasingly being managed outside hospital by non-medical health professionals, often using prescribing to deliver the full range of care. When non-medical prescribing was first introduced, it was not defined by the setting in which it occurred: how prescient this has proved now, as different settings become intertwined and the boundaries blurred. Huge challenges lie ahead in healthcare given the financial regime, but this does provide opportunities to develop how care is delivered even further and prescribing will be central to this.
Of course, regulation and professional standards must be robust, whatever the setting, and keep pace with the changes - this was a theme reiterated throughout the day.
Much has happened since 2006, and Fiona Culley, Professional Adviser to the Nursing and Midwifery Council (NMC), explained that work has now started on revising the NMC standards, both for prescribing and for medicines management. They will be combined, clarified and updated, with new education standards also underway. Consultation will be wide - do look out for developments and contribute. The National Prescribing Centre (NPC) is developing a single competency framework for all prescribers, with publication due in March 2012.
Most of the calls received by the NMC advice centre relate to prescribing and medicines management: remote prescribing, private prescriptions, methods of supply and administration, storage of drugs and controlled drugs are particular favourites. The bottom line is that meeting regulatory and legal requirements is not optional - whatever the setting or circumstances - and there can be no private agreements. The NMC is the regulatory body for nurses and midwives - it is irrelevant if GPs, for example, disagree with its standards. And different professional bodies adopt different lines, on self-prescribing for example. The GMC has consulted recently on medicines and prescribing standards and has asked about sports medicine in particular - the final version is due out soon.
The NMC is now hearing more fitness to practise cases than in the past, probably reflecting greater reporting because of increased media attention and public awareness. Only a handful of these have concerned prescribers, but many more relate to people who are not prescribers but think that they might be! As of September 2011, there were 57 838 nurse and midwife prescribers recorded by the NMC.
The conference included two workshop sessions with several choices for each, so delegates could follow their interests. One was a sobering but fascinating account of the state of diabetes care by Dr Rowan Hillson MBE, National Clinical Director for Diabetes, focussing particularly on the scale of the problem from a public health perspective and on some of the failures of the system when people with diabetes end up in hospital - as they so often do.
The scale of the problem is shown starkly with the Association of Public Health Observatories prevalence model: the 2010 estimate for people over 16 with diabetes is 3.1 million; by 2030 this figure is 4.6 million. Dr Hillson highlighted the importance of integrating services across settings in the NICE Quality Standards for Diabetes, stressing that for patients there should be no boundaries between care settings; and for professionals taking responsibility when they notice problems, ranging from getting specialist foot teams to see people with foot problems, to immediate referral for children with high blood glucose who may have diabetes. Dr Hillson also raised the question of why the under 55s are not doing better with their glucose control - and why they do not seem to be getting statins - are services really set up to meet the needs of the working population? Who influences your prescribing decisions and why do you make the decisions you do? All sorts of factors come into play here - local formularies, representatives of pharmaceutical companies, consultants and GPs, and NICE.
The 2010 National Diabetes Inpatient Audit captured data about the people in hospital on one day, with some exclusions. This revealed that up to a quarter of beds were occupied by people with diabetes but 31% of sites had no inpatient diabetes specialist nurses, with nearly as many having no inpatient dietetic provision for people with diabetes. The foreword pulls no punches about the report’s findings: “compared to the general inpatient population, people with diabetes in hospital are older, sicker, have more complex disease and stay longer. It also shows that they suffer frequent medication errors and not infrequently come to harm as a consequence…..many hospitals have under-staffed and under-resourced diabetes teams.”
Dr Hillson finished as she began - with the powerfully simple message that everyone with diabetes deserves the highest standards of personalised diabetes care. The discussion which followed highlighted the importance of good communication and joined-up care, and how nurse prescribers need to ensure their patients receive this, particularly with all the changes.
Another hot topic at the moment is prescribing and medicines management in aesthetic medicine, where the workshop was led by Karen Ford, Senior Lecturer and Non-Medical Prescribing Lead at De Montfort University.
Some aesthetic nurses work in large organisations and some on their own but whatever the setting, practice should be professional and the laws and regulations on prescribing and medicines management followed to the letter. Nurses are professionally accountable to the NMC for their practice - what the GMC says is irrelevant - they have to follow their own standards and regulations. Professional accountability and reporting concerns are professional duties.
The workshop looked at some of the issues around stock management, stressing that stock becomes the patient’s property when a prescription is issued, the use of patient specific directions and patient group directions, where there has been confusion, and the use of the same drug under different names because of licensing. The whole remote prescribing issue again brings out the importance of professional standards: nurses must follow the NMC advice whatever other professionals may say.
How can non-medical prescribing in mental health be developed and sustained? What actions are needed to deliver safe, high quality prescribing within an organisation? Steve Turner, a nurse prescriber, director of a social enterprise company and Associate Lecturer at the University of Plymouth, led a workshop looking at these issues.
He started by looking at three key documents (see here and here) and discussing how a model of successful change can be applied to the situations faced by delegates. With this as a basis, the discussion then turned to the remaining difficulties and obstacles in the implementation of non-medical prescribing in mental health, and what is needed to make it successful. A common quality assurance framework incorporating best practice from all service areas is needed, and it is important at a time of change to demonstrate the value of non-medical prescribing including involving patients and public in service developments, perhaps using audits and national and local patient and staff satisfaction surveys. It is also important to educate staff, patients and the public about non-medical prescribing.
The workshop discussion produced a checklist of items vital for adequate planning and for support for newly qualified non-medical prescribers, which delegates felt should all be included in local policies. Items included dedicated medical supervision and consultant/medical support; peer support (including within specialties); regular non-medical prescribing meetings; induction packs and preceptorship; access to continuing professional development (CPD); the issue of CPD portfolios which can be used in review sessions; involvement in audit and service evaluation; mentoring and buddying; development of career pathways; and education about the benefits of non-medical prescribing for the entire workforce.
Another workshop that highlighted the importance of CPD and education for professionals, and also good education and resources for patients, was on breakthrough cancer pain (BTcP). It was facilitated by Ray Bunn, Community & Palliative Care Pharmacist, Kamsons Pharmacy and St Catherine’s Hospice, Crawley, West Sussex.
After a presentation on the definition, assessment, diagnosis and management options for BTcP, participants discussed and identified key issues that should be addressed to improve the management of BTcP in secondary, hospice and primary care settings.
For healthcare professionals, one issue was inconsistent understanding of the terms ‘breakthrough cancer pain’ and ‘end of dose’ pain. Other issues and barriers included: inadequate understanding of the role of opioids in BTcP, including which options are appropriate; the indications, prescribing and baseline opioid dosing if a ‘rapid release fentanyl’ is considered; the fact that primary care has not really embraced the increased profile of rapid release fentanyls with, perhaps, the exception of Actiq; concerns about their use and the potential for tolerance and addiction; and potential side effects and how to manage them.
For patients, better understanding of dose titration for the various opioids used for BTcP and the relative complexity of titration would be helpful. There are also some availability issues for some preparations from pharmacies, especially rapid release fentanyls.
All this led to the conclusion that more education and educational resources are needed: for professionals, including more accredited CPD; more verbal patient education including one to one patient and carer education by healthcare professionals; and more patient education resources, for example Patient UK information leaflets, which are used extensively in general practice and community pharmacies.
Dr David Edwards is a GP with an interest in sexual medicine - he is president elect of the British Society of Sexual Medicine and has a post-graduate degree in medical anthropology. He led workshops on sexual health that followed the interests of the participants using case studies as a starting point for discussion.
Something that emerged as a common issue was getting the patient comfortable in talking about sexual matters and the discussion also touched upon the difficulties that the healthcare professional might have in asking about such matters. Many aspects of female sexual problems were covered, particularly vaginismus, which many delegates had encountered.
The importance of erectile dysfunction and testosterone deficiency syndrome were discussed, along with the lifestyle issues that are often found and the importance of encouraging patients to help themselves, using a COSH (contract of sexual health). This metaphorical tool enables the patient to help himself whilst the healthcare professional encourages him on lifestyle issues and adjusts factors such as glucose and blood pressure monitoring for example. The clinician, in return, helps the patient deal with the medical treatment aspect of the sexual dysfunction.
The need to demonstrate the impact of non-medical prescribing on patient care, and examine how it works, was raised several times at the conference so the presentation towards the end of the day by Non-Medical Prescribing Lead Sam Sherrington about the audit of non-medical prescribing in NHS North West was very timely. The results demonstrate reductions in GP appointments, consultant appointments, unscheduled care episodes, length of hospital stays, and medicines-related admissions. Clinicians really were prepared to participate and the results demonstrated how non-medical prescribing can support the QIPP agenda.
As other sessions had highlighted, the legal aspects of prescribing can be a complex area and clarity is vital. Emma Galland, a solicitor-advocate at Weightmans LLP who trained at a hospital trust, provided a robust and clear outline of the current situation.
She highlighted those parts of legislation and of the NMC Code and standards that are particularly relevant to prescribers working in different settings. For example, colleagues must be informed when care is shared; this is especially relevant if prescribing is in the community but the patient may need admission. Professional judgement must not be influenced by any commercial considerations. The 2010 Bribery Act is relevant here and prescribers should always be clear that there is a clinical basis for decisions.
The NMC also recommends that nurses have professional indemnity insurance, and this is even more important if extra responsibilities such as prescribing are involved. In her view, having indemnity cover is part and parcel of being a professional. There was a lot of discussion about the change announced recently by the RCN (see here for further information on this). ,
Using abbreviations is one example of the risks involved in writing prescriptions: one example was someone moving from intensive care to the ward coming off a sliding scale who was prescribed 6U of insulin, despite the BNF specifying that U should not be used for units. He was given 60 units and subsequently died. Another example is the security of prescription pads - best practice is to return pads at the end of the day or session so that they can be stored securely.
Another tricky area is that of consent and capacity to consent. Capacity involves the ability to understand the information provided, to retain it, to weigh it up in making a decision, and to communicate the decision by any means. Consent is needed specifically for supplementary prescribing, which must be explained to the patient preferably by the independent prescriber. The patient’s agreement needs to be documented. Consent is also needed for any treatment. If treatment is given without consent, it is an assault.
If an adult is assessed as not having consent, their best interests must be assessed holistically, taking a range of factors including social, religious and cultural, into account. To a limited extent, it is possible in these circumstances to talk to family and friends, but as little confidential information as possible should be disclosed. She also discussed the issue of children consenting or refusing to consent, and what Gillick competence means. This can depend on the consent required and the consequences of the decision.
April 28, 2011 by admin
“We can therefore see no reason for continuing delay” in making the necessary changes to controlled drugs legislation (see here), writes ANP Chair Barbara Stuttle recently in a letter to the Prime Minister, David Cameron. She points out that all political parties and all professional groups support the changes and that, until they are implemented, very seriously ill people are facing delays in getting adequate pain relief. One consequence can be unnecessary hospital admission.
April 28, 2011 by admin
The Association for Nurse Prescribing (ANP) has endorsed a free, online, continuing professional development resource, Therapeutics Plus, aimed primarily at non-medical prescribers. It has been developed by Prescriber, NPC Plus and Keele University and is funded by Pfizer. There are modules available now on the management of chronic asthma, neuropathic pain, smoking cessation and chronic obstructive pulmonary disease (COPD) and more will follow.
December 16, 2010 by admin
More new topics have been added to the Clinical Knowledge Summaries (CKS) website in December: cervical cancer and HPV; diabetes type 1; diarrhoea - adult assessment; pancreatitis - acute and chronic; and pityriasis rosea.
December 8, 2010 by admin
The enormous changes coming to the NHS and the harsh economic climate present real opportunities for the development of nurse prescribing: this was the message that emerged throughout the day at the recent ANP annual conference held in London.
A time of “great turmoil” in the NHS provides “great opportunities through greater diversity of healthcare delivery” said Dr June Crown CBE, President of the ANP, in a rallying cry for nurse prescribers to take the chance to be innovative while celebrating the progress made - and building on it. The provision of better services, more coordinated care, reaching hard to reach or vulnerable groups, the list goes on.
What are the distinctive features of nurse prescribing - is it ‘doctor prescribing on the cheap’ or does it offer something truly different? Molly Courtenay (professor of clinical practice: prescribing and medicines management, University of Surrey) and colleagues have done a lot of work on how nurse prescribing is perceived by different groups, most recently looking at patients’ views of nurse prescribing, and how they see their relationships with the nurse prescriber (results published here and here). After more than 80 interviews with patients with diabetes or dermatological conditions being cared for by a nurse prescriber, common patient views included: nurses are more knowledgeable than GPs for specialist areas; nurses have more time for discussion; and nurses are more caring, relaxed, approachable and easy to talk to than doctors. Clearly, there is indeed something distinctive going on here, with positive implications for concordance, continuity and efficiency.
Patients were confident about nurse prescribers - one reason for this was the high level of specialist knowledge and experience: in diabetes prescribing in particular, appropriate training and experience were seen as very important. Future research plans from this group include measuring outcomes - not always easy as the prescribing qualification can often change people’s practice over and above the actual prescriptions they write.
A sense of proportion is vital in balancing complacency and fear, according to Fiona Culley (Professional advisor: non-medical prescribing and medicines management at the NMC). She pointed out that there have only been two fitness to practice allegations involving nurse prescribers (both were fairly extreme examples) and that standards and documentation can help nurse prescribers strike the right balance. She urged the audience to engage with the development of the profession, respond to consultations, and keep up-to-date with current standards, guidance and advice, pointing them to useful resources such as the updated advice sheet on the NMC website (see Links ) about mixing medicines. Figures from the NMC for November show that there are now more than 58 000 nurse and midwife prescribers in total, with about 21 000 recorded against the V300, extremely encouraging statistics.
Changes in doctors’ attitudes to, and support for, non-medical prescribing were highlighted by a speaker from the BMA speaking in a personal capacity. Dr Bill Beeby (GP and Chairman of the BMA General Practitioners’ Committee’s Clinical and Prescribing subcommittee) used a splendid wizarding (you had to be there!) metaphor to remind the audience of the initially vigorous opposition to non-medical prescribing in certain medical circles. This was another salutary reminder of those first, tiny steps…..and of the distance travelled since then.
Current attitudes are, of course, much more positive and recent research and the experience in his practice have confirmed the benefits of non-medical prescribing. He urged caution and care in some particular areas. One was the importance and challenge of training and support, and how mentoring can improve mentors’ skills - as long as they understand the process; ensuring the independence of training courses is also vital. Another was supervision, where his practice uses random case analysis, and a third the increased marketing and promotion aimed at nurses. Dr Beeby also advocated resisting pressure to prescribe unlicensed medicines. One suggestion for improving accountability is improving the quality of information, by giving all prescribers a unique number so they are accountable for all their prescriptions, wherever they are written.
Efficiency without quality is unthinkable and quality without efficiency is unsustainable, said Chief Nursing Officer Dame Christine Beasley, as she examined how nurse prescribing supports the current priorities of improving health and wellbeing, QIPP (Quality, Innovation, Productivity and Prevention), personalised care and patient choice. Examples include nurse prescribers taking nicotine replacement therapies and smoking cessation services to mosques and football matches, providing whole episodes of care in A and E departments, particularly for minor injuries and ailments and pain relief, running specialist clinics in secondary care, and improving concordance, access to medicines and clinical outcomes in mental health services. All these illustrate how clinical quality and efficiency now go hand-in-hand.
Looking forward, the controlled drugs legislation has been agreed by ministers and is now awaiting implementation by the Home Office (see here). Even more opportunities for innovation and development in nurse prescribing include more prescribing for patients with co-morbidities, enabling service re-design, and adopting a more strategic approach now that nurse prescribing is well established and integrated in the management of patients’ conditions. The national evaluation commissioned by the Department of Health is about to be published and will provide more evidence about patient satisfaction.
A vision of the future for information prescribing and prescribing was presented by Coleen Milligan and Kathy Drayton from the Department of Health: “paper is no longer fit for purpose”. They stressed the many benefits of electronic prescribing and the use of mobile technologies, commenting that in a time of limited resources, it will be very important for early implementers to help build the evidence base about the savings achieved through, for example, the reduction in adverse drug reactions. This will start to show how the benefits can replay the investment.
Four workshops - from which those attending could choose two - looked at specific areas in more detail, with lots of opportunity for discussion and questions. Dr Clive Grundy, Consultant Microbiologist, Ashford and St Peter’s Hospitals NHS Trust) provided a public health perspective on antibiotic use, including some fascinating examples of the effects of health tourism and travel on bacterial resistance and up-to-date information on patterns of resistance, with case studies and advice about what to prescribe when. He stressed that any antibiotic use selects for bacteria resistant to that antibiotic.
Alison Dugdale (Senior Nurse Practitioner, Minor Injury/Walk-in Centre Service, Eastern and Coastal Kent NHS Community Services) looked at prescribing for soft tissue injuries and sports injuries, with a reminder about non-pharmacological management and that pain is what the patient says it is. Dr David Edwards, in an interesting whistle-stop tour of sexual dysfunction looked at erectile dysfunction, stressing the implications of its link with diabetes, female sexual dysfunction, treatment of sexual trauma, and how to raise the subject and what patients expect. Claire Westwood (Director of happynurses) talked about “the 9Cs of inspired leadership” in nursing.
Throughout the day, speakers highlighted the progress made since district nurses and health visitors took the first tentative steps towards full independent prescribing. Nurse prescribing can drive or facilitate innovative service redesign, more personalised care, better concordance and co-ordinated care, efficient and safe access to medicines, increased patient choice and, of course, better use of nurses’ skills and resources.
So, what can we say about the future of nurse prescribing? As the number of non-medical prescribers and the volume of their prescribing increases, with nurses now running their own clinics and providing complete services, it is important to make the case for the contribution non-medical prescribing can make in the future - and make sure the case is heard. The current imperative to maintain or improve quality of care with reduced resources chimes with the now well-established benefits of nurse prescribing, both for patients and for the system.
December 7, 2010 by admin
Nurse prescribers should make their views on the delays to controlled drugs legislation known, according to nursing leaders. Frustration at the speed - or lack of it - with which the Home Office is introducing the long-promised changes to the law needed to allow nurse and pharmacist prescribers to prescribe all controlled drugs (see here) was apparent at the Association for Nurse Prescribing (ANP)’s annual conference in London last week.
Matt Griffiths, ANP committee member and visiting professor of prescribing and medicines management at the University of the West of England, has been campaigning on this issue for some time and is now urging nurse prescribers to write to their MPs asking them to press ministers to make this happen. The Chief Nursing Officer, Christine Beasley, agreed that nurse prescribers should make their views known to their MPs - she said she knows how important this issue is to nurses and their patients and that the changes will happen, despite the long delay so far.
If you would like to write to your MP, you can do so quickly and easily through this website. Alternatively, Professor Griffiths suggests that a handwrittten letter to your local MP can be a more effective way of getting their attention; and that if practitioners have case studies (anonymised of course) which would demonstrate the cost to services, waste of resources or compromises to the quality of patient care, then this will strength your case. He commented, ‘We have been waiting for this legislation for over two and a half years, and patients really are suffering as a result’. Do let others know through the forum on the community login side of the site.