Independent nurse prescribing within the care home sector remains relatively uncommon. Across the UK, examples are still limited, particularly within the independent social care sector, making this achievement all the more significant.

The Independent Prescribing programme is designed for registered nurses who can demonstrate a clear clinical need for prescribing within their role. The course requires students to develop advanced skills in clinical assessment, decision-making, pharmacology, medicines optimisation, safe prescribing and multidisciplinary working, all underpinned by robust legal, ethical and professional frameworks.Meeting the academic, clinical and professional requirements of the programme is no small undertaking.

For nurses working in the independent sector, additional challenges often exist. These can include securing financial support, accessing appropriate practice opportunities, establishing governance arrangements and obtaining the clinical supervision necessary to meet programme requirements. 

This is where Wales's independent care home providers demonstrate their true value. Described by Care Forum Wales Chair Mario Kreft MBE as "national treasures", many family-owned care homes are deeply embedded within the communities they serve. They provide local employment, support local economies and play a vital role in supporting both social care and NHS services.

The celebration at Glan Rhos reflected the strength of these community partnerships. Attendees included representatives from Betsi Cadwaladr University Health Board, Ynys Môn County Council, local elected representatives and community leaders, all recognising the importance of partnership working in developing innovative clinical roles within social care. 

Partnership has been central to Ezelina's success. Having worked at Glan Rhos for more than 20 years, she’s demonstrated a longstanding commitment to residents, families and the local community. Equally, the family owners of Glan Rhos demonstrated their commitment by investing in her professional development. Local GPs supported the prescribing programme through supervision, assessment and access to clinical learning opportunities, ensuring that programme outcomes could be achieved in full. 

This achievement belongs not only to Ezelina, but also to the wider team that recognised the potential benefits of advanced nursing practice within the care home setting and worked collaboratively to make it a reality. The shared commitment of Ezelina, her employers, Kim and Helen, and the GP colleagues who supported her throughout the programme, demonstrates what can be achieved when health and social care partners invest in workforce development and place residents at the centre of decision-making.

Independent prescribing is an important achievement and a powerful enabler of person-centred care within social care settings. However, prescribing should be viewed as the beginning of a wider journey rather than the final destination.

Advanced practice is founded upon four pillars: advanced clinical practice, leadership, education and research. Prescribing strengthens the clinical pillar, but the greatest benefits for residents, providers and the wider health and care system will be realised when practitioners are supported to develop across all four domains. Advanced practitioners can provide expert clinical care, lead service improvement, educate and support the workforce, contribute to research and champion innovation throughout the sector.

As Wales continues to develop community-based models of care, there is a significant opportunity to build a sustainable pipeline of advanced practitioners working within social care. Such roles have the potential to improve access to care, enhance continuity for residents, reduce avoidable hospital admissions and help people remain closer to home for longer.

But right now, the focus is firmly on celebration. Ezelina has demonstrated the dedication, resilience and professional courage required to pioneer a role that remains uncommon within the care home sector. Her achievement is a testament to her own commitment, the support of her employer and clinical colleagues, and the strength of partnership working across health and social care.

Pictured above: Kim Ombler, Ezelina Dacruz, Helen Ombler Williams, GP Tomas Hywel

Pictured at top: Llinos Medi MP, Ezelina Dacruz, Mario Keft