Pharmacists can attain two types of prescribing qualification: independent and supplementary. Independent prescribers, or non-medical independent nurse prescriber (NMPs), are in a position to give patients timely access to pharmaceuticals and are in a perfect world put to streamline and individualize treatment.

The NMP takes responsibility for the clinical evaluation of the patient, including establishing a diagnosis and prescribing the necessary medicines. Supplementary prescribing, on the other hand, is a voluntary partnership between a doctor or dentist and a supplementary prescriber, who can prescribe medicines within an agreed patient-specific clinical administration plan with the patient’s assention.

How to Become a Nurse Prescriber In UK

Education and training requirements to become a nurse prescriber

Requirements for admission to approved education programmes leading to a recordable qualification for nurse prescribers

a) Eligibility to undertake the preparation programme for Nurse Prescribers 

Candidates must provide evidence of meeting the NMC criteria for qualification to attempt a coordinated recommending program as a major aspect of the Specialist Practitioner/Specialist Community Public Health Nursing Award. The criteria are:

  • You must be a registered nurse and/or midwife, and
  • You intend to practise in an area of clinical need for which prescribing from the Community Practitioner Formulary will improve patient/client care and service delivery.
b) Eligibility to undertake the preparation programme to prescribe as a nurse independent/supplementary prescriber.

Candidates must give proof that they have met the NMC’s criteria for eligibility to undertake a nurse independent/supplementary prescribing programme. The criteria are:

  • You must be a registered first level nurse, midwife and/or specialist community public health nurse
  • You must have at least three years’ experience as a practising nurse, midwife or specialist community public health nurse and be deemed competent by your employer to undertake the programme. Of these three years, the year immediately preceding application to the programme must have been in the clinical field in which you intend to prescribe.
  • You must provide evidence via the Accreditation of Prior and Experiential Learning (APEL) process of your ability to study at minimum academic level three (degree).
Eligibility for a recorded qualification as a nurse prescriber

Notification of successful completion of an approved preparation programme will use the same process as for all other NMC approved programmes. The registrant will then be issued with the relevant documentation to record the qualification on the NMC register.

The registrant’s capability to recommend as either a community practitioner nurse prescriber or a nurse independent/supplementary prescriber will be clearly identifiable by anyone seeking confirmation of qualification on the register.

Registrants may be eligible to prescribe from the Community Practitioner Formulary only or may do so in addition to being a nurse independent/supplementary prescriber. However, it is not possible to prescribe as a without undertaking readiness to be a nurse independent prescriber first.

Supplementary prescribing is a voluntary prescribing partnership between an independent prescriber and a supplementary prescriber, to implement an agreed patient-specific Clinical Management Plan, with the patient’s assention. In this unique circumstance, an independent prescriber is a doctor or dentist and the supplementary prescriber is a nurse or a pharmacist. The conditions for supplementary prescribing are that:

  • The independent prescriber must make the diagnosis;
  • The supplementary prescriber must be a registered nurse, registered midwife, or enlisted drug specialist;
  • There must be a composed Clinical Management Plan particular to a patient and to that patient’s condition(s);

The benefits of supplementary prescribing are that:

  • There should be good communication among all prescribers and ready access to the patient’s records;
  • Prescribing and dispensing responsibilities should be separate;
  • The Clinical Management Plan ought to be basic.

Independent Prescribing

Nurse independent prescribers are nurses who have successfully completed an NMC Independent Nurse Prescribing Course (also known as v200 or v300 courses). They are able to prescribe any medicine provided it is in their competency to do so.

Non-medical prescribing (NMP) is an area of professional development, which may be an essential component of specialist and advanced practice for health professionals. As such it forms part of career structures and is commissioned by organisations that require NMP for job roles.

Designated prescriber

A person who can prescribe medicines inside their scope of practice, for patients under their care, from the list of medicines specified in their designated prescriber regulations.

Designated prescribers are not allowed to:

  • Prescribe prescription medicines that are not specified under regulations.
  • Issue standing orders.
  • Sign prescriptions for patients who are not under their care.
  • Prescribe a controlled drug for a person you believed to be dependent on
    controlled drugs or for treatment of dependency.
  • Dispense prescription medicines.

Nurse Prescribers must have sufficient knowledge and competence to:

  • Assess a patient/client’s clinical condition
  • Undertake a thorough history, including medical history and medication history,
    and diagnose where necessary, including over-the-counter medicines and
    complementary therapies
  • Decide on the management of presenting condition and whether or not to prescribe
  • Advise the patient/client/client on effects and risks
  • Prescribe if the patient/client agrees
  • Monitor response to medication and lifestyle advice.

Independent prescribing means that the prescriber takes full responsibility for:

assessing the patient clinically;

  • Establishing a diagnosis;
  • Establishing the clinical management of the patient’s condition(s);
  • Prescribing when necessary;
  • Determining the appropriateness of any prescription.

Trained nurses can use two formularies.

  • The Nurse Prescribers’ Formulary, a limited formulary for Community Nurses. It consists primarily of appliances and dressings plus a few Prescription-only Medicines (POMs).
  • The Nurse Prescribers’ Extended Formulary, a formulary from which independent nurse prescribers can prescribe medicines for conditions in the following categories: minor ailments; minor injuries; health promotion; palliative care. These nurses can prescribe all Pharmacy-only medicines and General Sales List (GSL) medicines that are prescribable by doctors for conditions within the above categories, together with about 140 POMs.
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