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'Contentious’ NMC prescribing changes and removal of meds standards set to go ahead

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A “contentious” proposal by the nursing regulator to allow nurses and midwives to gain prescribing qualifications at earlier points in their careers is still due to go ahead under final plans, but registrants will need to provide evidence they are competent before beginning programmes.

As part of a series of changes due to be finalised this week, the Nursing and Midwifery Council also still intends to remove its standards for medicines management, despite “mixed” views among the profession about the proposal.

“We are proposing that the one-year post registration experience requirement for independent/supplementary prescribing… stands”

NMC council papers

However, the regulator said it would in the future produce cross-professional guidance on safe and effective medicines management, by working with the Royal Pharmaceutical Society.

The NMC council will decide on Wednesday whether to sign off a number of changes affecting prescribing, as part of a wider overhaul of nursing education and student assessment.

The body said feedback from its consultation on the proposals had shown the plan to permit registrants to start prescribing courses much sooner than is currently allowed was “contentious”.

According to NMC council papers released last week, the regulator is standing by its suggestion that newly qualified nurses and midwives should be able to go on a prescribing course straight after their initial training, due to its plans to include more prescribing theory in undergraduate programmes.

The qualification they would gain – through taking part in a V150 programme – allows nurses to prescribe from a limited formulary. Nurses and midwives currently wait two years after registration before beginning this training, said the NMC.

In addition, the NMC still plans to allow nurses and midwives to go on a more advanced prescribing course – the V300 programme – after only one year of experience in practice, instead of the current three.

This is despite concerns raised by the Royal College of Nursing and others about the proposal during the consultation, noted the NMC in its council papers.

The papers revealed that the RCN thought two years of practice following initial registration should be required as a minimum before nurses could begin the V300 course to become a supplementary or independent prescriber.

“We have not concurred with this position, as we are proposing that the one-year post registration experience requirement for independent/supplementary prescribing that we consulted on stands,” said the NMC papers.

But in the council papers, the regulator said it had slightly altered its approach and would now require applicants to provide evidence showing they have the “competence, experience and academic ability necessary to commence the programme”.

They would also need to show they are “proficient to a level appropriate to the prescribing programme they wish to undertake” and also suitably prepared for “their intended area of prescribing practice in areas such as clinical/health assessment, diagnostics/care management and the planning and evaluation of care”.

The NMC confirmed to Nursing Times that the revised requirements would also apply to registrants applying for the V150 programme.

Meanwhile, the NMC said it also still planned to adopt the Royal Pharmaceutical Society’s multi-professional framework as its standards of proficiency for nurse and midwife prescribers from January 2019. It said it had received “strongly supportive” comments in relation to the proposal.

According to the regulator, 82% of responses to the consultation supported the plan to adopt the RPS framework and 95% of those felt doing so would lead to shared approaches to prescribing across health and social care professions.

If agreed on Wednesday by the regulator’s council, universities will be required to update courses in line with all new requirements by September 2020.

If the council agrees to the removal of the NMC’s medicines management standards, the date for withdrawing them will be no later than 31 July 2018, stated the council papers.

However, the NMC did not confirm to Nursing Times whether the cross-professional medicines management guidance it is intending to produce would be drawn up before the removal of the standards.

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