Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

NHS cost-cutting will mean more nurse prescribing

  • 8 Comments

Efforts to cut costs in the NHS will require a significant extension of nurse prescribing, one of the NHS quality and productivity leads has said.

NHS Ashton, Wigan and Leigh chief executive Peter Rowe has been asked by the Department of Health to find savings in the area of medicines and prescription.

Mr Rowe told Nursing Times wider and earlier access to appropriate medicines would help keep people out of expensive acute settings.

He said: “Non-medical prescribing will be an important element. We need to demystify access to medicines and make them available through more channels.”

Research has also suggested nurses are more likely than GPs to follow guidelines on prescribing patients with cheaper generic alternatives to branded drugs (news, 22 January 2008, page 3).

The Department of Health’s quality, improvement, prevention and productivity programme is also asking trusts to extend enhanced recovery programmes which, usually led by nurses, can reduce length of stay after surgery.

  • 8 Comments

Readers' comments (8)

  • I despair.
    There we have it in a nutshell. The spin will be about "empowering" nurses, the truth will be cheap prescribing by the underpaid and under-qualified.
    I wonder how many who pay for private medicine would accept being seen by a nurse rather than a doctor. I know I wouldn't.

    Unsuitable or offensive? Report this comment

  • Mr Rowe is absolutely right. Along with choice, service users should access their medicines from the right person at the right time in the right place. Non Medical Prescribers are advanced practitioners who undertake rigourous training and are robustly assessed (NOT UNDER-QUALIFIED); they are well placed to prescribe within their area of competence. Nurses and Pharmacists prescribe according to their regulatory body Standards of Practice, which incidentally doctors do not have (they have guidance which closely reflects the NMC/RPSGB Standards).
    Having lectured on the NMP course for 3 years and seen nurses working in private medicine qualify, I am encouraged to see that it is not only the NHS who are embracing one of the most logical and revolutionary developments in heathcare.

    Unsuitable or offensive? Report this comment

  • "Non Medical Prescribers are advanced practitioners who undertake rigourous training and are robustly assessed (NOT UNDER-QUALIFIED); they are well placed to prescribe within their area of competence."

    Not in my experience they aren't. We have a nurse in our team who is doing the nurse prescribing course. The training is neither robust or rigorous and the nurse in question is as thick as two short planks placed end on. The other day she was asking a colleague to help her with some pretty basic arithmetic to do with calculating dosages that was completely beyond her.

    The thought of that numpty being let loose with a copy of the BNF and a prescription pad is truly scary. If I want to play at being doctor then I will bloody well go to medical school and become one. What next, part time correspondence courses on how to become an eye surgeon?

    Unsuitable or offensive? Report this comment

  • “Not in my experience they aren't”.

    As you said, this is your experience. From your single experience, you draw the conclusion that Nurses are inept to prescribe. That is a bit odd for a reasoning argument. If more than 5 over 10 events where Prescribed Nurses have shown great deficiency in calculating dosages, maybe you could conclude that training is not robust, hence needs to be reviewed.
    One day I assessed a patient who was unwell and had vomited coffee ground vomitus. What I found is that his GP prescribed 750mg SR qid of Naproxen. I never considered the thought that this GP was incompetent or all GPs had a poor training. I just thought that he had made a mistake. Maybe he wanted to write down 250mg qid.

    “If I want to play at being doctor then I will bloody well go to medical school”

    Well! Who can now consider legitimately and reasonably that taking a blood pressure should be solely Doctors’ prerogative?

    So let’s embrace the future towards expanding Nurses’ competencies! But let’s not be naïve! We will fight for recognition, advancement and pay rise as we have always done in history.
    Abel Sidhoum (RN)

    Unsuitable or offensive? Report this comment

  • Adrian Bolt

    "From your single experience, you draw the conclusion that Nurses are inept to prescribe."

    I draw the conclusion that nurses cannot possibly be competent to prescribe because they do not have a degree in medicine and can't possibly learn all they have to in a six month part time course. My conclusions on nurse training in general are based on my own experience gained at two academic institutions which are that it is generally pretty poor. Not a scientific study granted but then this report states that 2/3 of nurses can't pass a basic maths test with questions as easy as

    Q: WHICH is the lowest temperature: 3ºC, -2ºC or -4ºC?

    http://www.sundaymercury.net/news/tm_objectid=17651151&method=full&siteid=50002&headline=120-out-of-180-nurses-can-t-pass-maths-test-name_page.html

    "Well! Who can now consider legitimately and reasonably that taking a blood pressure should be solely Doctors’ prerogative?"

    There is a world of difference between taking a blood pressure and being given free run of the BNF if you can't see that perhaps you should stick to cleaning bed pans.

    Unsuitable or offensive? Report this comment

  • "From your single experience, you draw the conclusion that Nurses are inept to prescribe."

    I draw the conclusion that nurses cannot possibly be competent to prescribe because they do not have a degree in medicine and can't possibly learn all they have to in a six month part time course. My conclusions on nurse training in general are based on my own experience gained at two academic institutions which are that it is generally pretty poor. Not a scientific study granted but then this report states that 2/3 of nurses can't pass a basic maths test with questions as easy as

    Q: WHICH is the lowest temperature: 3ºC, -2ºC or -4ºC?

    http://www.sundaymercury.net/news/tm_objectid=17651151&method=full&siteid=50002&headline=120-out-of-180-nurses-can-t-pass-maths-test-name_page.html

    "Well! Who can now consider legitimately and reasonably that taking a blood pressure should be solely Doctors’ prerogative?"

    There is a world of difference between taking a blood pressure and being given free run of the BNF if you can't see that perhaps you should stick to cleaning bed pans.

    Unsuitable or offensive? Report this comment

  • Adrian Bolt

    if you can't see that perhaps you should stick to cleaning bed pans.

    My apologies that was uncalled for but this is something I do feel quite strongly about. I am proud to be a nurse and have no problem with extended roles for nurses but I have no intention of being used as a Doctor on the cheap because the NHS want's to save money.

    Unsuitable or offensive? Report this comment

  • Dear Edwin,

    First of all, thank you for your response and sorry for my late reply. Time zone! Interesting! Although I respect your view, I am afraid I cannot agree with you, except on the subject of training that I will cover later.

    “Nurses cannot possibly be competent to prescribe because they do not have a degree in medicine”.

    Having a degree in medicine is not just about prescription. The prescription competency constitutes a small part of medical study. Therefore, you do not need to have a degree to be able to prescribe.
    However, prescribing involves a great understanding and experience in pharmacology, physiology and pathology. On a previous post, I did raise the following question: Do we have enough experienced Nurses in our hospitals with the caliber to comprehend complexities surrounding the act of prescription , given our current workload? I also added: ‘the possibility for Nurses to prescribe drugs could be the way forward to enhance the value of our profession or the dangerous path towards litigations and bad reputation’. Hence, training, selection and support as barriers to overcome the potential public rejection against nursing prescription are of paramount.

    “2/3 of nurses can't pass a basic maths test with questions as easy as Q: WHICH is the lowest temperature: 3ºC, -2ºC or -4ºC?”

    I have plenty of experiences about Nurses correcting medical prescriptions not only in terms of dosages, but also in terms of ‘benefit versus side effects’. Does it mean that Nurses are better than Doctors in prescribing drugs? No! It means that we need each other to deliver the best care possible. Hence, the importance of sharing skills and knowledge.
    I wanted to use the following argument but I find it a bit tricky. Yet, I share it with you. Medicine is not mathematics because it is not an exact science. You do not need to know Thales or Pythagoras’ theories to assess a patient with asthma. Please, forget this argument as it is closer to fallacy than a proper reasoning.

    “There is a world of difference between taking a blood pressure and being given free run of the BNF”.

    Well! This is the same type of argument that we heard in the past from various people, including Nurses when Nursing was advancing in terms of skills and knowledge. I can hear their voices: “there is a world of difference between taking a blood pressure and cleaning the bed pans”.

    No offence Edwin! We are just discussing about accepting changes and adapting to them the best possible way for the best outcome: Patient care and Nursing progress.

    Abel Sidhoum (RN)

    Unsuitable or offensive? Report this comment

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.