Fundamentals Of Prescribing

Question 1

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

Answer 1

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

Question 2

1990s - non medical prescribing

Answer 2

community nurses could prescribe from a limited list

Question 3

2003 - non medical prescribing

Answer 3

In 2003 law (Medicines Act) changed and nurses and pharmacists could train to
become ‘Supplementary Prescribers’ (SP)

Question 4

2005 - non medical prescribing

Answer 4

In 2005 other healthcare professionals could train to become ‘Supplementary
Prescribers’ and SPs could prescribe CDs

Question 5

What is supplementary prescribing?

Answer 5

“a voluntary prescribing partnership between an independent
prescriber (a doctor or a dentist) and a supplementary prescriber
(SP), to implement an agreed patient-specific clinical management
plan (CMP) with a patient’s agreement”

Question 6

2006 - independant prescribing

Answer 6

Nurse and pharmacist Independent prescribing introduced

Question 7

2013 - independant prescribing

Answer 7

Physiotherapist and podiatrist Independent prescribing introduced

Question 8

2018 - independant prescribing

Answer 8

Paramedic Independent prescribing introduced
The Human Medicines Regulations 2012 replaced the Medicines Act, and Chapter 2, Regulation 14 specifies who can issue a prescription for a POM

Question 9

What is the difference between an independent pharmacist prescriber and supplementary?

Answer 9

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

Question 10

What is a part of prescribing?

Answer 10

Prescribing is a whole consultation, diagnostic and decision-making process
Clinical 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

Question 11

What are the steps before you issue/don’t issue a prescription?

Answer 11

*history taking
*observations
*physical examination
*diagnostic tests & results
*clinical experience, professional judgment, decision making == step where you issue or DONOT issue prescription

Question 12

What is the RPS framework for prescribers?

Answer 12

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