Fundamentals Of Prescribing

• Who were traditionally allowed to prescribe + who were the non-medical prescribers?

  Traditionally consider GPs/ doctors /dentists as prescribersBUT many other HCPs can prescribe medicines (non-medical prescribers) :* Nurses/midwives* Optometrists* Paramedics* Physiotherapists* Podiatrists* PHARMACISTS
• 1990s - non medical prescribing

  community nurses could prescribe from a limited list
• 2003 - non medical prescribing

  In 2003 law (Medicines Act) changed and nurses and pharmacists could train tobecome ‘Supplementary Prescribers’ (SP)
• 2005 - non medical prescribing

  In 2005 other healthcare professionals could train to become ‘SupplementaryPrescribers’ and SPs could prescribe CDs
• What is supplementary prescribing?

  "a voluntary prescribing partnership between an independentprescriber (a doctor or a dentist) and a supplementary prescriber(SP), to implement an agreed patient-specific clinical managementplan (CMP) with a patient’s agreement”
• 2006 - independant prescribing

  Nurse and pharmacist Independent prescribing introduced
• 2013 - independant prescribing

  Physiotherapist and podiatrist Independent prescribing introduced
• 2018 - independant prescribing

  Paramedic Independent prescribing introducedThe Human Medicines Regulations 2012 replaced the Medicines Act, and Chapter 2, Regulation 14 specifies who can issue a prescription for a POM
• What is the difference between an independent pharmacist prescriber and supplementary?

  independant: *pharmacist is responsible for patient assessment and diagnosis *can prescribe any drug within scope/competence*patient and pharmacist agree on management plan for patient Supplementary:*doctor is responsible for patient assessment and diagnosis *can only prescribe drugs included in the CMP*doctor, pharmacist and patient agree management plan for the patient
• What is a part of prescribing?

  Prescribing is a whole consultation, diagnostic and decision-making processClinical decision making* A process that involves gathering and understanding of information e.g. from,patient, diagnostic test* Application of clinician knowledge* Provide the most appropriate treatment that will benefit treatment and reduce harm
• What are the steps before you issue/don’t issue a prescription?

  *history taking *observations *physical examination *diagnostic tests & results *clinical experience, professional judgment, decision making == step where you issue or DONOT issue prescription
• What is the RPS framework for prescribers?

  • Royal Pharmaceutical Society Framework – Competency framework for allprescribers
  • 2 domains
  • The consultation
  • Prescribing Governance
  • 10 Competencies across domains