Law underpinning prescribing Flashcards
When did non-medical prescribing in the UK begin?
- began in 1992.
What change was introduced by the Cumberledge Report in 1992?
- Certain nurses were allowed to prescribe a limited range of products.
What prescribing tool was introduced in 1993 by the Crown Report?
- Patient Group Directions (PGDs).
What is a Patient Group Direction (PGD)?
- written direction allowing the supply or administration of specified medicines by named, authorized health professionals to a well-defined group of patients for a specific condition.
What was recommended in the Second Crown Report (1999)?
- To extend prescribing rights to other healthcare professionals (HCPs) such as pharmacists, optometrists, podiatrists, and physiotherapists.
What significant legislative change happened in 2001?
- Health and Social Care Act was published.
What amendment occurred in 2006 regarding NHS regulations?
- Suitably trained nurses and pharmacists could prescribe any licensed medication for any medical condition within their competence as Non-Medical Prescribers
Who are considered Non-Medical Prescribers?
- Pharmacists, nurses, midwives, and other allied healthcare professionals (AHPs) who have:
- Completed an accredited prescribing course.
- Registered their qualification with their regulatory body.
What is a Supplementary Prescriber (SP)?
- a practitioner who prescribes within an agreed patient-specific Clinical Management Plan (CMP), developed in partnership with a doctor or dentist.
What is the process for a supplementary prescriber to begin prescribing?
- Diagnosis of the clinical condition by a medical practitioner.
- Agreement by the patient (service user) to be managed by a prescribing partnership.
- Creation of a Clinical Management Plan (CMP) by the medical practitioner, supplementary prescriber, and service user.
- Management of the patient within the terms of the CMP.
What is an Independent Prescriber (IP)?
responsible and accountable for:
- Assessing patients with undiagnosed or diagnosed conditions.
- Making prescribing decisions to manage the clinical condition of the patient.
what is the prescribing competency framework ?
- describes the knowledge, skills, characteristics, and behaviours required for safe and effective prescribing.
Who is the prescribing competency framework used by ?
- Prescribers: To underpin professional responsibility and for self-assessment.
- Regulators, education providers, professional organizations: To inform standards and develop education.
- Individuals and organizations: To analyze and improve job performance.
- Evidence: To demonstrate the competencies required for the role.
what are the 2 domains in the Prescribing Competency Framework ?
- the consultation = focuses on the competencies that the prescriber should demonstrate during the consultation with the patient.
- Prescribing Governance = focuses on the competencies that the prescriber should demonstrate with respect to prescribing governance, ensuring safe and effective prescribing practices.
What are the 12 steps in the RPS Guidance on Safely Prescribing?
- Personal Development
- Reflect
- Keep up to date (revalidation, CPD)
- Professional Judgement
- Speak Up
- Professional indemnity
- Improving Practice
- Audit
- Errors/near misses
- Remote Prescribing
- Prescribing legally
- Document
- Support Others
What does prescribing within the scope of practice mean?
- Prescribes within own scope of practice, recognizing the limits of own knowledge and skill.
Why might an HCP expand or change their scope of practice?
- To prescribe a greater range of medicines
- To better support patient care
- To deliver a new service
- Due to a change of job or setting
What is the structured approach to expanding the scope of practice?
- Reflect
- Plan
- Act
- Evaluate
When are remote consultations not appropriate ?
- Lack of patient access or ability to
use technology - Impaired capacity to participate, e.g.
dementia - Red flags identified during triage
suggesting a need for urgent
medical attention - Insufficient access to required
information such as records or
resources
Should prescribing and supply be performed by the same or separate healthcare professionals (HCPs)?
- Prescribing and supply should, wherever possible, be separate functions performed by separate HCPs to improve patient safety and reduce the likelihood of errors.
Is there a legal restriction on prescribing and dispensing by the same person?
- No, there is no legal restriction on prescribing and dispensing by the same person.
In what circumstances can prescribing and dispensing by the same person be done safely?
- It is in the best interest of the patient
- A procedure is followed
- A risk assessment is conducted
- A mental break is taken between activities
- An audit trail and rationale for the decision are maintained
- Errors and near misses are reported to learn and change practice
Is it generally considered good practice for pharmacist prescribers to prescribe for themselves or for close personal relationships?
- considered poor practice.
- GPhC states that pharmacist prescribers must not prescribe for themselves or for anyone with a close personal relationship (e.g., family, friends, colleagues), except in exceptional circumstances.
What should a pharmacist do if prescribing for themselves, friends, or family in exceptional circumstances?
The pharmacist should use professional judgment, considering factors such as:
- Objectivity
- Documentation and monitoring
- External input
