Non-Medical Prescribing Guidance for Prescribers In General Practice
UPDATE FEB 2021
In February 2021, the GMC have published guidance on remote prescribing which has increased during the COVID-19 crisis and likely to continue..
Key updates include:
· New advice for doctors not to prescribe controlled drugs unless they have access to patient records, except in emergencies.
· Stronger advice on information sharing, making it clear that if a patient refuses consent to share information with other relevant health professionals it may be unsafe to prescribe.
· Alignment with the GMC’s updated Decision making and consent guidance, highlighting the importance of good two-way dialogue between patients and doctors in all settings.
We are in a time of great change in general practice with practices merging, evolution of federations, locality working and the emerging accountable care systems. The list based system of general practice remains a cornerstone of the NHS and is the main reason that the NHS is judged internationally to have one of the most cost-effective healthcare systems in the world. But this is no longer enough, the NHS is facing both a financial and workload crisis. The future will mean that we need an out of hospital model delivered at scale that is supportive of and embedded in general practice.
General Practice has worked closely with clinicians such as practice and community nurses in the past and the ability to allow nurses to prescribe has been a welcomed positive step and has proven to be safe, effective and appreciate use of time, knowledge and skills. Over the last 5-10 years increasingly there are other healthcare professionals joining the primary care team such as Specialist Nurses, Advanced Nurse Practitioners, Pharmacists, Paramedics, MSK Practitioners and Mental Health workers. To add value to the primary care team and provision of care to patients, these individuals have developed their skills and knowledge to have a deeper understanding of disease processes, making a diagnosis and managing a variety of conditions that fall within their scope of practice and competencies. Prescribing is an integral part including prescribing the appropriate medication.
I hope you will find this document useful in supporting Non-Medical Prescribers employed in general practice to provide evidence of their competencies through reflection and continuous professional development:
Health Education England Guidance for Non-Medical Prescribers Employed in Wessex Community Trusts
Health Education England Guidance for Non-Medical Prescribers Employed in Wessex Hospital Trusts
Independant Prescribing and Paramedics: FAQs.
Principles for good practice issued to protect patients online
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Dr Nigel Watson, MB BS FRCGP DCH DRCOG Helene Irvine Designated Prescribing Practitioner Competency FrameworkHistorically only doctors could provide supervision and support to those professionals undertaking NMP. Regulatory changes in 2018/19 have enabled NMPs to take on the role of Designated Prescribing Practitioners (DPP) as long as they fulfill certain regulatory competency framework for all prescribers. Please click here to find out more - https://www.wessexlmcs.com/designatedprescribingpractitionercompetencyframework Antibiotic awareness: toolkit for healthcare professionals in England
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CQC Links
https://www.cqc.org.uk/guidance-providers/gps/nigels-surgery-95-non-medical-prescribing
NMC Document - High level principles for good practice in remote consultations and prescribing
"This information is for all healthcare professionals with prescribing responsibilities. It sets out the shared high level principles of good practice expected of everyone when consulting and or prescribing remotely from the patient. The principles are underpinned by existing standards and guidance from professional and system regulators. Healthcare professionals should continue to follow guidance from regulatory bodies and take clinical guidance into account in their decision making."
The document has many useful links on pages 5 to 8 including Standards for prescribing, Prescribing Competency Framework, The Mental Capacity Act, Remote Consultations, Standards for Online and remote providers of SH/SRH services as well as many others.
Please click HERE to access the document
