Level 3 Diploma Health and Social Care Medication Essay

Supplementary and independent nurse prescribing has taken some years to materialise; this movement was facilitated by Department of Health (DoH), nursing regulators, nursing professional bodies, and general practice (GP) supporters (RCN, 2012). Following the Medicines Act (1992) where only Health Visitors and District Nurses were allowed to prescribe from a limited formulary, over time legislations were subsequently amended allowing non community nurses to prescribe from an extended formulary. In 2003, supplementary prescribing was being recognised and by 2012 The Misuse of Drugs Regulations allowed the nursing formulary to access all of the British National Formulary including controlled drugs. In line with these changes and to ensure that

A prescription can be identified as legally authorised written instruction by a prescribing officer to a pharmacist to dispense medication.

Roles and responsibilities of the person dispensing the medication is to check to make sure the prescription is legal and signed by a qualified person, ensure there are no errors, to dispense the right quantity and dose of medication, make sure the medication is clearly labelled with the instructions of the dose, the name of the medication and person, provide advice and treatment for any minor illnesses and health concerns. Pharmacies will also provide a repeat prescription service.

The scope of practice for non-medical prescribers (NMP) has expanded greatly over the last 2 decades, with legislation now allowing NMP’s to prescribe from the whole BNF (with the exception of treatment in addiction and within the prescribers competency). Since the introduction of the Medicines Act in 1986 there have been over 15 different governmental reports and legislative changes (see Appendix 1 timeline) that have allowed for the development and growth of the NMP role. Initiated by The Cumberledge report of 1986 and followed by advisory group report in 1989 legislation was introduced with the Medicinal products: Prescription by nurses act of 1992 which allowed primary care nurses to prescribe from a limited formulary (V100 & V200). This advancement in legislation recognised previous recommendations and placed the improvement of patient care and effective use of resources at the core of its practice. However these acts did not reflect on other areas like secondary care or pharmacist and it wasn’t until 1998 The Crown Report and its second report published a year later that led to supplementary and independent prescribing (V300). In 2003 legislation was passed allowing some prescribing of controlled drugs in palliative care with restricted circumstances (amendment to Misuse of drugs Act 1971). In May 2006 nurses were empowered to prescribe from the whole BNF with the exception of some controlled drugs, and in 2009 further legislative changes were made to include the

1. The main legislation that governs the use of medication is The Medicines Acts 1968. The following is a list of legislations that have a direct impact upon the handling of medication within a social care setting.

The person dispensing must also be appropriately trained, follow safe systems of work and understand the side effects of various drugs; be able to access appropriate information and understand when to access advice or further information

Non care setting - Medications are often stored and administered in a variety of non-health care settings. These settings include: primary and secondary schools, Child day care centres, Board and care homes, Jails and prisons. In all these settings, employees frequently are responsible for handling and administering prescription and over-the-counter medications to clients or residents. Some organizations may employ licensed health professionals to directly manage the medication administration process. However, many of these settings have no licensed health professionals involved. Where medications are stored and administered to individuals, written policies and procedures should address the following: Acquisition of medications (e.g., from parents, caregivers, pharmacies), Specification of which personnel are allowed access to medications and allowed to administer medications to students, clients or residents, Labelling and packaging of medications managed for students, clients

* All medication should be recorded and signed for by the receiving pharmacist and a proper record maintained in-house.

The principle reason for the Act is to keep the abuse of controlled medications and attains to this by forcing a complete boycott on the ownership, supply, make, import and fare of controlled medications with the exception of as permitted by regulations or by permit from the Secretary o

Assisting – At the request of the service user, opening bottles and packets; removing lids; popping pills out of packages when the service user cannot physically do this and has asked the care worker to help with that specific medicine; shaking bottles.

The Medicines Act 1968:- The Medicines Act controls the manufacture and supply of medicines for human and veterinary use. The act defines three categories of the supply of drugs; Prescription only medicines, Pharmacy Medicine, and General sales list medicines the act controls

1. In the workplace there is a generic Medication Management Policy and Procedures for Adult Services (Issue 10, 2012) document. This is kept to hand in a locked cupboard, readily available to read. It requires that all Healthcare Staff are given mandatory training and refreshers are provided. Legislation which surrounds the administration of medication includes The Medicines Act 1968, The Misuse of Drugs Act 1971, The Data Protection Act 1998, The Care Standards Act 2000 and The Health and Social Care Act 2001

There are several legislations in place with protocols for the administration of medication which I have listed below. The main policy re admin of drugs and storing of drugs and medicines is the Control Of Substances Hazardous to Health or COSHH but along with this there are other policies in place as per the list below.

Legislation – The Medicines Act, Control of Substances Hazardous to Health (COSHH) Regulations, The Health and Safety at Work Act, The Misuse of Drugs Act, The Misuse of Drugs (Safe Custody) Regulations, Health and Social Care Act

Formularies are list of drugs that are used by a hospital. When a Physician prescribes a drug for which an equivalent drug is dispensed unless the physician the physician specifies on the prescription form or order that no substitutions are permitted. Additionally, when in the hospital formulary system implements it is challenging. Also it is legally challenged on the basis of state antisubsitution or generic substitution laws. Moreover, these challenges have not been successful when there is an agreement between the prescriber and dispenser that an equivalent drug may be dispensed. Controlled substance act ( CSA) passed in 1970 and it regulates distribution