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Major study acclaims nurse prescribing success

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Have you trained as an independent nurse prescriber?

The introduction of independent prescribing by nurses has been hailed a success and is now a “widely integrated form of health service delivery”, according to a major study for the government.

But it cautions that the practice is too often focused on single conditions at a time when patients are increasingly being treated for co-morbidities, and has not been widely used to redesign services.

Researchers from Southampton and Keele universities evaluated the impact and safety of independent prescribing by nurses and pharmacists since its introduction five years ago.

A report on the evaluation published last week by the Department of Health, said between 2% and 3% of both the nursing and pharmacist workforce was qualified to prescribe medicines independently.

Of these, 93% of nurse prescribers had used their independent prescribing qualification and 86% were currently prescribing. This compares to 80% and 71%, respectively, for pharmacists.

The report said: “Nurse, and to a lesser extent pharmacist, independent prescribing is becoming a widely integrated feature of health service delivery.

“Study results indicate that nurse and pharmacist prescribing is currently safe and clinically appropriate,” it added.

The report said there are now around 16,000 nurse prescribers, working mostly in primary care but some also in hospitals and other settings.

“They are working in the vast majority of trusts in England and work in approximately one in three GP practices in primary care and one in four wards and outpatient departments in secondary care settings,” it said.

“Results suggest that most nurse independent prescribers are prescribing reasonably regularly, with an overall volume of prescribing suggestive of at least daily prescribing.”

However, the report calls for better support for newly qualified prescribers, saying: “Attention needs to continue to be given to nurses’ assessment and diagnostic skills which underpin their independent prescribing role.”

It also cautioned that nurse prescribing was generally confined to particular areas of practice. The report said the “majority” of nurse prescribers were not confident prescribing for co-morbidities and a third “did not consider they could meet all of a patient’s prescribing needs, at a time when our population is living longer with multiple long-term conditions”.

Another shortcoming highlighted by the report was that nurse prescribing has largely “been used to increase the quality of existing services, as opposed to enabling service redesign”. It said it had not been used “strategically” to “fill gaps in service provision or to plan ahead to meet future service needs”.

However, lead author Sue Latter, Southampton University professor of nursing, said: “Our research shows that the practice is becoming a well–integrated and established means of managing a patient’s condition.”

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Have you trained as an independent nurse prescriber?

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  • 7 Comments

Readers' comments (7)

  • So where is the 'Not yet but will in the future' choice?

    Very accurate poll.

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  • Could you do a poll that asks if not an independent presriber, would you like to be .... YES!!!

    Is your employer supportive in independent prescribing? NO!!!!

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  • The prescibers course is a very robust one - as indeed it should be as the addition responsibilities and opportunities to be held accountable are profund and far reaching. Ideally, such a nurse prescriber should carry her own indemity insurance.

    I will not be doing this course until its true worth is recognised: time off for study (and not just in the classroom) and an incremental extra pay rise (at least) for taking on the responsibility of the job which will cover the cost of indemity insurance.

    I can see how being an independant prescriber is good for the employer and the patient but what does the practitioner get out of it?

    If this couse is held in such high esteem then that should be reflected in one's pay packet

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  • pharmacology has become extremely complex and nurses simply do not have the same academic background or training as doctors and i certainly would not entrust my health to them or have confidence in their prescriptions.

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  • an article about the nmc protecting the public on one page and then nurses prescribing drugs on the next!

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  • I think pharmacology has always been complex. There are strict entry criteria and a great deal of study involved. I agree that nurses often don't have the same academic background, however that doesn't preclude nurses from developing the capacity and skills to prescribe safely. No-one would expect a newly qualified prescriber to be as adept as an experienced doctor and I wonder how a nurse with long years of experience and a prescriber would compare to a FY1 or FY2?

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  • Anonymous | 20-May-2011 10:39 am that is utter rubbish of the highest order. Simple as that.

    The prescribing course, if you remember, is POST degree, with academic qualifications that will lead up to a Masters and even a Doctorate (which after all, is still superior to a medical Degree). The course is no worse than what is studied on a medical degree, and the practitioners who obtain it are as academically highly qualified as any Doctor to prescribe medications.

    Anonymous | 20-May-2011 10:26 am you make an excellent point. The skills and qualifications we develop, not to mention the responsibility and accountability we take on as a result, SHOULD be recognised in our status and pay packets.

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