Will extended prescription powers to
pharmacists and nurses increase negligence risk?
The Department of Health and the Medicines and Healthcare
Products Regulatory Agency has proposed to extend the prescribing
powers of pharmacists and nurses, with several option being
considered, including granting the ability to prescribe for any
medical condition. Greg Bousfield talks to David Reissner, head of
Charles Russell's Pharmacy Group, about the possible changes under
consideration...
Proposed
extended prescribing powers for pharmacists and nurses will invoke
corresponding duties towards patients - but the two professions will
mostly be issuing repeat prescriptions, says David Reissner, head of
Charles Russell’s Pharmacy Group.
“Just as a GP doing the same activity would incur a liability by
doing something negligent, when the same thing is done by a
pharmacist or nurse negligently, there would be a similar
liability,” he says.
Proper training corresponding to any increased prescribing powers of
both professions is going to be central to making sure that the
risks of negligence are minimised, he adds.
However, diagnosis is to remain in the hands of doctors. “Doctors
will make the initial diagnose and prescriptions and pharmacists and
nurses prescribing under the extended prescription rules would be
issuing repeat prescriptions, which are the most common form of
prescription in the UK,” he says.
The Department of Health and the Medicines and Healthcare Products
Regulatory Agency (MHRA) issued the consultation document on
independent prescribing powers this week. Under discussion are seven
options for pharmacists, ranging from a limited increase in powers
to prescribing for any medical condition. For nurses, five options
are being considered from allowing prescriptions for any medical
condition to training nurses with specific prescribing
specialisation.
“The changes are likely to remove pressure from GPs and provide
cost-effective services,” Reissner says. “It also means that for a
number of services for which patients might currently to see their
GP, they can be dealt with more than adequately by using the
expertise of pharmacists.” The government hopes the changes will
enable patients to get their medication faster.
If adopted, the proposals will add to the prescribing powers already
given to nurses and pharmacists in April 2003 under the Health and
Social Care Act 2001, which allows nurses to prescribe from a list
of 180 products, and gives community pharmacists the power to
prescribe medicines in partnership with doctors. Most of the
prescribing is directed at minor conditions or long-term care – such
as nurses being able to prescribe an asthma inhaler instead of being
restricted to measuring lung function. The 2003 changes also
involved setting up a working partnership between the doctor and the
supplementary prescriber, underpinned by a clinical management plan.
The plan, drawn up by doctor with the patient’s agreement, sets
limits and conditions for nurse and pharmacist prescribing. It
contains details of the range of medicines that may be prescribed to
the named patient by the pharmacist or nurse, the circumstances
under which the pharmacist and nurse can vary the dosage, frequency
and formulation of the medicines, and when to refer back to the
doctor.
The current proposals are likely to simply expand the range of
prescribable conditions. “It’s an extension of professional
responsibilities and part of a recognition on the part of the
government that their skills have not been fully utilised and so
they are looking to maximise the benefit they get from them,”
Reissner says.
The consultation period will run for three months.
(08/03/05)
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Legislative annotations in other services:-
Health and Social Care Act 2001
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