Independent nurse prescribers

GP10NSS Orange Supplementary and independent nurse prescriber (community)... 

HBPNSS Blue Supplementary and independent nurse prescribers (hospital)... 

The controlled drugs that independent nurse prescribers are able to prescribe are listed in Part XVIIB(ii) of the Drug Tariff for England and Wales (see Section 2.4.1), along with the indication and route of administration. Independent nurse prescribers may only prescribe those controlled drugs listed in Part XVIIB(ii) and only for the indications listed and for administration via the route(s) listed. 

HS21N Purple Independent and supplementary nurse prescribers... 

There are three types of nurse prescribers community practitioner nurse prescribers (sometimes called district nurses or health visitors) who may prescribe from a restricted list of items, nurses who are supplementary prescribers (see Section 3.2.4) and nurses who are independent prescribers (see Section 3.2.5). 

Nurses who are independent non-medical prescribers (formerly extended formulary nurse prescribers) may prescribe certain controlled drugs for certain medical conditions (see Section 3.2.5). These drugs and the conditions which they may be prescribed within... 

The pharmacist must be satisfied that the supply is being requested by a doctor, community practitioner nurse prescribes supplementary prescribes nurse independent prescriber or pharmacist independent prescriber. 

Extended formulary nurse prescribing was discontinued in 2006 and replaced by qualified nurse independent prescribing. Nurses can now prescribe any licensed medicine, including some controlled drugs, if they are qualified to do so. At the same time, pharmacists became eligible to train as pharmacist independent prescribers, being able to prescribe all licensed medicines but, as yet, no controlled drugs. 

Traditionally, the prescriber would have been a doctor or a dentist, but recent changes to healthcare legislation and the introduction of supplementary and independent prescribers mean that many other healthcare professionals, such as nurses and pharmacists, are now also permitted to prescribe (see Section 3.2). 

Part XVIIB(ii) - Nurse and pharmacist independent prescribing... 

This part provides information on nurse and pharmacist independent prescribing. Further details on independent non-medical prescribing can be found in Section 3.2.5. 

In addition to supplementary prescribing by non-medical practitioners (see Section 3.2.4), independent non-medical prescribing has also recently been introduced. Currently this is limited to suitably qualified nurses and pharmacists, although as with supplementary prescribing, independent prescribing may be extended to other health professional groups in due time. 

Nurse independent prescribers are able to prescribe any licensed medicinal product including some controlled drugs. Pharmacist independent prescribers have similar prescribing rights however, currently they may not prescribe any controlled drugs (although this may change in the future). 

Committee on Borderline Substances (ACBS). A list of ACBS approved products and the circumstances under which they can be prescribed, can be found in part XV of the Drug Tariff. Although this is a nonmandatory list, Nurse Independent Prescribers should normally restrict their prescribing of borderline substances to items on the ACBS approved list. 

Community nurse Supplementary prescriber Independent prescriber... 

Table 6.1 The different controlled drugs, the conditions they may be prescribed for and the administered by nurse independent non-medical prescribers route they can be...

A similar process occurred with podiatry, physiotherapy and radiography and led to extension of supplementary prescribing to these professions in April 2005. In a further development in 2006, nurses and pharmacists became eligible to train as independent prescribers. 

They may only be sold or supplied from a registered pharmacy, by or under supervision of a pharmacist in accordance with the prescription of a doctor, dentist or veterinary practitioner or other qualified prescriber. Nurse independent prescribers, pharmacist independent prescribers and supplementary prescribers can write prescriptions for POM. Given below are examples of the types of drug that are POM ... 

Training for supplementary prescribing is now incorporated into nurse and pharmacist independent prescribing as multidisciplinary training. 

Nurses, midwives and pharmacists can now train to prescribe any licensed medicine as independent prescribers to patients. 

Supplementary prescribing is a form of non-medical prescribing open to qualified, registered, experienced and suitably trained podiatrists, radiographers, physiotherapists, nurses and midwives. Supplementary prescribing is currently defined as a voluntary partnership between an independent prescriber (a doctor or dentist) and a supplementary... 

Supplementary prescribing is likely to be most suitable with patients who have chronic conditions and can be managed by a supplementary prescriber between reviews by the doctor. Legislation may change again in the future to allow other health care professionals, in addition to nurses and pharmacists, to train to become independent prescribers. 

There are a number of criteria that must be met for supplementary prescribing to occur (www.dh.gov.uk/en/Publicationandstatistics/). For instance, the independent prescriber must be a doctor or dentist the supplementary prescriber must be from a professional group that is legally allowed to be a supplementary prescriber (such as radiographer, nurse, pharmacist, chiropodist, physiotherapist, optometrist) and there must a written CMP relating to a named patient and their specific condifion(s). 

The physiotherapy profession could aim to follow the path taken by the nursing profession, from first being able to prescribe a few drugs, to widening access to where they are today with independent prescribing. In 2006, nurses and pharmacists became able to train as independent prescribers. 

This, too, appears unusual since the prescriber has already made this determination. However, the nurse is responsible to independently verify that the dmg is proper for the patient. You do this by reading the patient s diagnosis in the patient s chart and looking up the medication in the drug manual where it will state the approved use of the drug. 

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