‘Dawn of a new era’ as nurses and pharmacists take on full prescribing
pharmafile | May 3, 2006 | News story | |
Trained nurses and pharmacists in England now have the power to prescribe virtually any medicine, which could end the need for patients to see a doctor in many cases.
In practice, the nurses and pharmacists will work within specialised disease areas such as asthma, diabetes and hypertension, with prescribing powers allowing them to manage patients' conditions from beginning to end.
Michael Dixon, chairman of the NHS Alliance welcomed the move saying: "The days when highly skilled nurses had to wait outside a doctor's door for a signature on a prescription when they themselves may be extremely knowledgeable should soon be over."
Pharmacists working in hospitals and in the community also now have the option of becoming prescribers, taking on management of areas such as hypertension and smoking cessation.
The move is a major development for the two professions, and the government hopes the changes will improve patient services and help thousands of nurses and pharmacists make more of their clinical expertise.
Since the NHS Plan was launched in 2000, the government has looked to de-regulate prescribing, allowing appropriately trained nurses and pharmacists to take on what was previously considered the preserve of doctors.
But limits remained on what drugs could be prescribed and inspired limited uptake among nurses and pharmacists, who still relied on doctors for supervision under the schemes.
The government has now swept away these restrictions, and from 1 May the first Nurse Independent Prescribers began work, with Pharmacist Independent Prescribers set to begin work later in the year.
The government's chief nursing officer Christine Beasley said its work with the Royal College of Nursing had helped create a number of new 'advanced nursing' roles, including 3,000 modern matrons in England and more than 800 nurse consultants who are ready to take on the responsibility of independent prescribing.
"We have a large number of nurses working in hospitals and delivering treatment in the community, all providing excellent care to patients and helping us to deliver improvements to the NHS. The ability to comprehensively prescribe for their patients will further improve these services."
Pharmacists and nurses can become independent prescribers by taking a postgraduate training course accredited by their professional body, and the prescribers must then maintain their skills with regular educational updates.
The government's prescribing monitor the Prescription Pricing Authority (PPA) says there are over 4,500 extended formulary/supplementary prescribing nurses on its database, over half of these being practice nurses and the remainder community nurses.
There are thought to be a further 1,200 prescribing nurses working in hospitals.
The government says there are also 550 pharmacists currently registered as 'supplementary prescribers' who, like existing nurse prescribers, could take up the fuller role.
Overall, the PPA says it does not expect the new prescribers to increase the volume of prescriptions written. In most cases they will simply be replacing the work of doctors, who should be freed up to tackle more complex cases.
