New Prescribing Role Will Enable Nurses and Pharmacists to Help Patients Directly

Western Mail (Cardiff, Wales), January 23, 2006 | Go to article overview

New Prescribing Role Will Enable Nurses and Pharmacists to Help Patients Directly


Byline: By MADELEINE BRINDLEY Western Mail

Nurses and pharmacists across Wales have been given the authority to start prescribing medicines to patients for the first time. In the first of Health Wales' Big Issues, Health Editor Madeleine Brindley examines what independent prescribing will mean for patients and the NHS

What does independent prescribing mean?

Independent prescribing means that the prescriber takes responsibility for the clinical assessment of a patient, establishes a diagnosis and decides what clinical management of the patient is required, as well as responsibility for prescribing, where necessary, and the appropriateness of any prescription.

Until now, in Wales, only doctors and dentists have had independent prescribing rights.

What kinds of medicines will nurses and pharmacists be able to prescribe?

When the scheme is implemented in Wales, nurses and pharmacists will be able to prescribe any drugs from the full British National Formulary for all clinical conditions within their area of competency.

Health Minister Dr Brian Gibbons said, 'Independent prescribing will mean that suitably qualified nurses and pharmacists will not only be able to offer advice on health promotion and management of chronic conditions but also be able to prescribe independently for their patients in hospital and community settings.

If doctors and dentists already prescribe medicines, then why does Wales need nurses and pharmacists to prescribe too?

Dr Gibbons's announcement that nurses and pharmacists will be able to prescribe medicines to patients comes at a time when the NHS is undergoing major changes, especially in primary care.

For the last two years prescription charges have been falling in Wales - they now stand at pounds 4, falling to pounds 3 in April.

But the traditional prescription fee should be eradicated altogether by 2007, according to Labour's 2003 manifesto pledge.

GPs have been warning for some time that the advent of free prescriptions could see surgeries inundated with patients asking for prescriptions for over-the-counter medicines so they do not have to pay for them.

Dr Andrew Dearden, chairman of the British Medical Association's Welsh GP Committee, and a Cardiff GP, said, 'With the introduction of cheaper, and finally free prescriptions, the request for those medications that would otherwise have needed a visit to the GP to obtain the prescription, could be obtained from for example, the pharmacist, which would release a valuable GP appointment for someone who truly needed it.'

Dr Gibbons also believes allowing nurses and pharmacists to prescribe medicines to patients will also help the implementation of the Welsh Assembly Government's 10-year strategy, Designed for Life.

The document envisages a world-class health service for Wales, where patients have easy access to community-based services and are kept out of hospital as much as possible.

In a Cabinet written statement, Dr Gibbons said, 'The introduction of independent prescribing by nurses and pharmacists will support the achievement of the health targets set by the National Welsh Assembly Government for Wales, assist in the delivery of Designed for Life and deliver high quality, efficient services to patients by NHS Wales.'

I thought nurses and pharmacists could already prescribe some medicines to some patients in Wales?

Currently there are some 200 nurses and pharmacists who have both the training and power to prescribe a limited range of prescription-only medicines to patients - known as supplementary prescribing.

Supplementary prescribing is defined as, 'a voluntary prescribing partnership between an independent prescriber and a supplementary prescriber, to implement an agreed patient-specific clinical management plan with the patient's agreement'.

In essence this means that trained nurses and pharmacists are able to prescribe a limited range of medicines, which are part of an agreed clinical management plan for a named patient. …

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