Better job satisfaction but more stress: prescribing in general practice?
October 20, 2011
Independent prescribing increased job satisfaction for nurse practitioners working in general practice but also increased the levels of work-related stress, according to this small study involving interviews with six nurse practitioners working in a busy inner city general practice.
Cousins R and Donnell C. Nurse prescribing in general practice: a qualitative study indicates increased job satisfaction and work-related stress. Fam Pract 2011; published 28 September online ahead of print.
http://dx.doi.org/10.1093/fampra/cmr077.
NPC seeks non-medical prescribers
October 20, 2011
The NPC is looking for active non-medical prescribers to help it validate a draft of a new generic competency framework for all prescribers, including doctors. It will be holding focus groups on the framework on 8 November in London and 28 November in Liverpool and would like to hear from interested nurses, midwives, physiotherapists, podiatrists, radiographers and optometrists. See here for more information.
DH consults on independent prescribing by podiatrists and physiotherapists
October 20, 2011
Should independent prescribing be extended to podiatrists and physiotherapists? The Department of Health and MHRA have published two consultations with these proposals, which can be found here. The deadline for responses to both is 8 December 2011.
The physiotherapist consultation proposes that physiotherapists can become independent prescribers and that physiotherapist independent prescribers should be able to mix medicines before administration, and direct others to do so, and to prescribe some specified controlled drugs independently. Those physiotherapists who are currently supplementary prescribers would have to undergo additional training to become independent prescribers. The proposals would need changes to the Misuse of Drugs Regulations 2001, as well as to the Medicines Act 1968. Independent prescribing of unlicensed medicines is not included in either document.
The consultation sets out the list of options, ranging from prescribing for any condition from the complete formulary, to prescribing for specified conditions from a specified formulary. The proposals for podiatrists are similar and both consultations give examples of areas where independent prescribing could be useful.
An analysis of the responses to last year’s engagement exercise (see here) is included in the consultations, and shows a lot of support for the option of prescribing for any condition from the full formulary (option 5). The most limited extension - independent prescribing for specified conditions from a specified formulary - found support with the BMA and the Royal College of Physicians, among others. The more limited versions are likely to require frequent revisions to the lists of conditions and/or formularies, a process that those nurses who were prescribing before the formulary was opened up will remember only too well!
Audit of non-medical prescribing in a mental health trust
September 28, 2011
A questionnaire survey of nurse and pharmacist prescribers within one mental health trust has concluded that although there is a high degree of compliance with the UK standards adopted by the trust, clinical supervision and training needs improving to meet them fully. Additional regular monitoring arrangements would ensure compliance.
Of the 24 non-medical prescribers included, 18 nurses and two pharmacists replied and their answers revealed two groups - high-frequency and lower-frequency prescribers (including the two pharmacists). The high-frequency prescribers were specialists, working in areas such as mental health services for older people, and were prescribing repeat or maintenance specialist medications whereas the lower-frequency prescribers started treatments themselves.
The authors say that the shortfall in supervision could be because of a lack or supervisors, lack of training for them or simply a lack of availability of supervision. Although the respondents were positive about the benefits of non-medical prescribing, 60% believed that training and supervision had shortfalls.
Some conflict with psychiatrists was reported but all respondents said they would seek advice from psychiatrists when necessary.
Gumber R, Khoosal D and Gajebasia N. Non-medical prescribing: audit, practice and views. J Psychiatr Men Health Nurs 2011; published online 18 July.
http://dx.doi.org/10.1111/j.1365-2850.2011.01779.x.
Welsh guidance on prescribing dilemmas
September 28, 2011
New guidance has been published on non-NHS and other prescribing dilemmas by the All Wales Medicines Strategy Group and can be found here. It covers topics such as immunisations, unlicensed medicines, private prescriptions, prescribing outside national guidance and minor ailments.
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