By Kirsty Chambers (Clinical & Operational Lead Pharmacist GP Connect) & Ravi Sharma (Head of General Practice Pharmacy at Green Light and Senior Clinical Practice Pharmacist at Honeypot Medical Centre)
Over the last two decades non-medical prescribing has undergone something of a revolution. 1986 was the breakthrough year when district and community nurses were granted limited prescribing rights; through the 1990’s the Nurse Prescribing Formulary was developed and when the new millennium dawned pharmacists started to get involved. Presently, the list of allied healthcare professionals (AHPs) that have some level of prescribing privileges is almost unrecognisable from when the concept of non-medical prescribing was born.
As the new Prescribing Competency Framework is published, more and more people are undertaking their prescribing qualifications in response to the huge increase in demand for prescribers. As NHS burdens intensify on a daily basis we must utilise each profession’s skill to their maximum level. Whilst trying to fulfil the almost impossible task of providing more by spending less, there needs to be an acceptance and push for more integrated working and an awareness of how to extract the most out of the available skill mix.
New ways of working and developing models of care via the standardisation of prescribing amongst healthcare professionals should lead to an increase in quality, safety, efficiency and ultimately better patient outcomes. The Prescribing Competency Framework incorporates ‘shared decision making’ and ‘prescribing as part of a team’ as key components. This is about building a relationship with both the patient and other colleagues that are involved in their prescribing journey. Continuity of care and mutual understanding of each other’s purpose can only enhance the services and quality of care we are offering.
In our workplaces there are multiple prescribers – nurses, GPs and pharmacists. We have established an excellent relationship that allows each of us to contribute effectively to the patients without duplication or omission. A number of examples where as a collaborative team of prescribers we have been able to provide better support and management to those with complex long term conditions as well as some of our most vulnerable patients (elderly, housebound, mental health). This framework will allow us to develop our understanding further and learn to work in partnership even more effectively. It can also be straightforwardly used to support yearly appraisals and eventually revalidation.
The NHS values of person-centred care and ‘no decision about me without me’ are prominent throughout the framework. It ensures prescribers work safely and effectively while allowing development of scope and the ability to work at maximum skill level by having competencies underpinning your professional responsibility as a prescriber.
Medicines have the potential to significantly improve the quality of lives and patient outcomes if prescribed appropriately. We have been given a chance to get this right with the framework as a fundamental tool to encourage higher standards for prescribing and united working between professions. The future of prescribing looks bright.