Strong growth in pharmacist prescribing
March 15, 2011 by admin
The number of items prescribed in general practice by pharmacists increased by nearly 80% in the year to September 2010 compared with the previous year, according to a report published in February by the NHS Business Services Authority. Pharmacists prescribed more than 308,000 items in the year ending in September, although prescribing in just five Primary Care Trusts accounted for 54% of the total.
Nurse prescribing also continued to grow, with 13.6 million items prescribed by nurses in general practice in the year to September 2010, a 10.9% increase on the previous year. The vast majority are now prescribed by nurse independent prescribers rather than community practitioners.
Generic substitution plans dropped
November 10, 2010 by admin
The Department of Health (DH) has announced it will not be going ahead with plans for generic substitution of medicines in primary care in England, following the consultation earlier this year (see here for details and here for responses. It says that professionals will continue to base their prescribing decisions on their assessment of individual patients and their circumstances. Nearly 85% of prescriptions are already for generics and the DH says it will continue to look for ways of supporting the use of generics. Minister Lord Howe said that, as well as listening to concerns, it was also, “not clear whether the proposals would have provided substantial benefit to the NHS, compared to the efforts of frontline staff to implement them”.
What barriers to nurse prescribing remain?
July 30, 2009 by admin
It is clear that despite the rapid growth in nurse prescribing, some obstacles remain, particularly in certain clinical areas. Two recent articles discuss some of these issues.
In one [1], the author traces the recent development of nurse prescribing and how it is now being implemented and argues that although it is now mostly supported by doctors, and there has been much progress, some barriers remain.
As predicted, the proportion of nurses qualified to prescribe independently who use supplementary prescribing has fallen since the formulary was opened up. According to Professor Molly Courtenay, that figure is now 20%, down from 40% in 2006, and she points out that some nurses prefer to use supplementary prescribing, to help build confidence and skills, or because their patients have complex conditions.
Some trusts are, however, requiring nurses to practice as supplementary prescribers for a period after qualifying, for a variety of reasons. These policies have their critics and can be seen as frustrating obstacles. Other restrictions include a lack of training and support once nurse prescribers have finished the course, as highlighted by recent research.
Another article [2] discusses nurse prescribing in mental health in Scotland, which has been slow to take off, and shows that evidence about what the barriers are is lacking, concluding that there is an urgent need for research in this area.
[1] Lomas C. Nurse prescribing: The next steps. Nursing Times 2009; 14 July.
[2] Ross J. Researching the barriers to mental health nurse prescribing. Nurse Prescribing 2009; 7(6): 249-253.