The Role Of Independent And Non Medical Prescribing

(DoH, 2005, p8). A diagnosis and treatment plan is agreed on by the independent prescriber and from this the supplementary prescriber can review and amend doses as seen appropriate with the patient. DoH (2005) initially suggested supplementary prescribing was more appropriate for a longer-term setting because an agreed CMP is required prior to prescribing. Nuttall & Rutt-Howard (2011) states many professionals often feel limited in supplementary prescribing as they are boundaried by the CMP. By adopting this outlook, patient’s presentations in the longer-term setting would then be classed as all being uncomplicated and predictable. DoH (2005) reports supplementary prescribing allows clinicians to develop their confidence. By understanding not all patients are the same and that complex cases are common, the supplementary prescriber can therefore exercise skills in observing and reviewing any changes in clients and report back to the independent prescriber in a safe manner and develop their

The Medicines Acts 1968 and various amendments cover the legal management of medication. While care staff are not expected to have detailed knowledge of the legislation, they do need to be aware of the legal difference between types of drugs and the legal framework that allows them to handle medicines on behalf of the service user.

Constraints of the System: A doctor is required for the expert opinion by health care professionals of various disciplines. This multitasking role might not provide the doctor with the time to read the prescribed drug(s) once again. Sometimes sound alike names of the drug also cause confusion leading to medical errors.

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

the roles and responsibilities of the person prescribing medication are to prescribe in the best interests of the persons. They will need be know the patient’s medical history and the current medication they are taking, give all information to the patient so the patient can make an informed choice, know the current guidance which is published in the BNF, prescribe the current dosage and make a follow up appointment.

When making the decision to prescribe there are a number of influence you have to consider. It is important to have an awareness of these influences and take them into consideration when issuing a prescription. It is importance to have knowledge of the DOH (2006) Medicines Matters this give guidance on the mechanisms available for prescribing and administration and supply of products. Team trends and external company’s and there representatives promoting their products have a big influence on your prescribing practice Bradley (2006) found that these influences were of concern to some nurses feeling that their colleague may ask them to prescribe for patients they haven’t seen. Thomas (2008)

* Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).

‘Independent prescribing is prescribing by a practitioner (e.g. doctor, dentist, nurse, and pharmacist) responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing. In partnership with the patient, independent prescribing is one element of the clinical management of a patient. It requires an initial assessment, interpretation of that assessment, a decision on safe and appropriate therapy, and a process for ongoing management. The independent prescriber is

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

There are four principles of ethics: Respect for autonomy, Beneficence, Non maleficence and Justice. This four principles offers comprehensive thought of the ethical issues in clinical settings (Beauchamp and Childress 2001 cited in UK Clinical ethics Network 2011).

1.1.1 A prescription is a written instruction from a physician, dentist, etc., to a pharmacist stating the form, dosage strength, etc., of a drug to be issued to a specific patient.

M1 – discuss organisational policies and procedures are by influenced legislation and guidelines with regard to the administration of medication

In the UK, nurse prescribing was born out of the need to increase efficiency in the NHS by making best use of its resources. Nurse-led services are one means of improving healthcare provision and a string of legislative change has gradually broadened the scope of nurse prescribing in the UK. (Courtenay et al 2007).

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.