Nurse prescribing

Nurse prescribing is an area of professional development that has made huge steps forward in the past few years. Prescribing of medicines by nurses has been a historic move for the nursing profession and has proved itself in England to be an important part of the solution in improving access to medicines and cutting waiting times for patients.

Changes to the law meant that supplementary nurse prescribing was established in Wales six years ago and further legislation, allowing independent nurse prescribing, was introduced in Wales in January 2007. Supplementary prescribing allows the nurse, patient and a doctor to enter a partnership so that nurses provide prescriptions when reviewing a patient’s condition, such as diabetes or asthma. Independent prescribing, as the name suggests, can be autonomously implemented by a prescribing nurse or pharmacist and relates to any medicine for conditions usually within the nurse’s field of expertise.

New training courses were introduced in Wales last September. Nurses and pharmacists have been studying together, with more than 100 nurses embarking on the course during the first year. 

A total of 430 supplementary nurse prescribers have been trained in Wales since 2004 whilst 208 of these have now trained as independent prescribers, on courses which have been fully funded by the Welsh Assembly Government. However, even with full funding, Wales trails considerably behind England, where there are currently about 9000 independent prescribers, and this number grows every year.   

Evidence shows that nurse prescribing improves patient care. If you are a patient, would you want to wait for a doctor to sign off a prescription or would you be satisfied with a qualified nurse or pharmacist who could prescribe your medication? Widening the prescribing pool has meant that patients receive a fast, more efficient healthcare option. It offers health solutions to the challenges faced in today’s complex healthcare environment. 

It is becoming more likely that, as a patient, you will meet a nurse prescriber either at your GP surgery or whilst being treated at a hospital for physical or mental health problems. A nurse prescriber may help you to manage your diabetes or asthma, for example, and will help to make your visit smoother and quicker by being able to prescribe your medicines; or may help you with a prescription, if needed, as part of a minor illness clinic.

Unfortunately, the Royal College of Nursing is still concerned at the lack of progress on the issue of independent nurse prescribing. The Welsh Assembly Government is looking at this issue and the barriers faced by newly qualified non-medical prescribers and is assessing the impact of widening the prescribing pool.   

Nurses and pharmacists who prescribe are highly skilled in their profession. Research shows that the majority of nurses who prescribe have at least ten years nursing experience before starting their prescribing training. Before they can even access a course, nurses have to be able to demonstrate that they have sufficient assessment and diagnostic skills in the specialist area they will prescribe in. The training course is intensive and thorough and includes a calculations exam that must be passed at 100%.

We now need investment to roll out prescribing skills and knowledge to the entire nursing workforce. An important impact of nurse prescribing is continuity of health care and better access to services offered to patients and clients.

Patients gain improved access to information and advice, which helps with understanding of decisions made about their health and care. For example, a nurse will have been trained to explain fully to the patient what the medicine is and how it should be taken, and will give time for the patient to ask questions so that, if the patient also agrees that the medicine is needed, they will be more likely to use it correctly.

Nurse and pharmacist prescribing will also enable the future development of modern services that respond to patients wherever and whenever they need care.