An overiew of non medical prescribing across one strategic health authority: a questionnaire survey

Abstract

BackgroundOver 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP) has been implemented within organisations across a strategic health authority (SHA). The aim of the study was to provide an overview of NMP across one SHA.MethodsNMP leads across one SHA were asked to supply the email addresses of NMPs within their organisation. One thousand five hundred and eighty five NMPs were contacted and invited to complete an on-line descriptive questionnaire survey, 883 (55.7%) participants responded. Data was collected between November 2010 and February 2011.ResultsThe majority of NMPs were based in primary care and worked in a team of 2 or more. Nurse independent supplementary prescribers were the largest group (590 or 68.6%) compared to community practitioner prescribers (198 or 22.4%), pharmacist independent supplementary prescribers (35 or 4%), and allied health professionals and optometrist independent and/or supplementary prescribers (8 or 0.9%). Nearly all (over 90%) of nurse independent supplementary prescribers prescribed medicines. Approximately a third of pharmacist independent supplementary prescribers, allied health professionals, and community practitioner prescribers did not prescribe. Clinical governance procedures were largely in place, although fewer procedures were reported by community practitioner prescribers. General practice nurses prescribed the most items. Factors affecting prescribing practice were: employer, the level of experience prior to becoming a non-medical prescriber, existence of governance procedures and support for the prescribing role (p < 0.001).ConclusionNMP in this strategic health authority reflects national development of this relatively new role in that the majority of non-medical prescribers were nurses based in primary care, with fewer pharmacist and allied health professional prescribers. This workforce is contributing to medicines management activities in a range of care settings. If non-medical prescibers are to maximise their contribution, robust governance and support from healthcare organisations is essential. The continued use of supplementary prescribing is questionable if maximum efficiency is sought. These are important points that need to be considered by those responsible for developing non-medical prescribing in the United Kingdom and other countries around the world.

Non-medical prescribing assessment – An evaluation of a nationally agreed multi method approach

“…Line managers and medical practitioners were equally distributed between primary and secondary care. This decrease in student recruitment from primary care is consistent with previous studies which have reported a gradual shift from primary to secondary care (Ahuja, 2009;Courtenay et al, 2007Courtenay et al, , 2012. This can perhaps be attributed to changes in legislation in 2006, and with non-medical controlled drug prescribing aligned with medical prescribing recruitment from secondary care is likely to remain high.…”

“…This may reflect a change in practice since the extension of independent prescribing legislation, or may be a reflection of the change in student demographics from primary to secondary care. Although previous research has supported the view that supplementary prescribing may be beneficial for novice prescribers (Cooper et al, 2008) it is generally viewed a cumbersome form of prescribing which has the potential to restrict practice (Courtenay et al, 2012;Courtenay and Carey, 2008). This research has provided further evidence that supplementary prescribing may no longer be a necessary form of prescribing for non-R.E.…”

Introducing nurse independent and supplementary prescribing to Jersey

“…Interestingly, supplementary prescribing has notbeen used. This is congruent with reports from Courtenay et al (2012), who question its continued use when prescribers have maximum efficiency. While the number of prescriptionsmay seem small when compared with the millions of items issues by nonmedical prescribers on FP10s everyyear in England (National Prescribing Centre, 2010), this number is significant within the context of Jersey.…”

“…However, the proposed legislative changes are at an advanced stage and will be amended in 2016. These progressive legislative amendments mirror the UK's increased socioeconomic and political demands, which have paved the way for boundaries to be extended (Courtenay et al, 2012).…”

Non-medical prescribing in palliative care: A regional survey

“…1 There are now 54,000 nurse and midwife prescribers across the United Kingdom prescribing over 12.8 million items per year. 2 Arguably, this growth has outpaced research to evaluate the clinical and economic value of NMP.…”