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Extending Independent Nurse Prescribing within NHSScotland
IMPLEMENTATION STRATEGY
Selection of nurses and midwives to be trained
The selection of individuals who will receive prescribing training from amongst those eligible will be a matter for local decision in the light of local NHS needs and circumstances. It is likely that early candidates will include nurse consultants, nurse practitioners and specialist practitioners. No nurse shall be required to undertake training unless he/she wishes to do so.
In addition to fulfilling the legal criteria for eligibility to prescribe, applicants for the prescribing preparation will need:
The ability to study at Level 3 (degree level)
At least 3 years' post-registration clinical nursing experience (or part-time equivalent): nominees will usually be at E grade or above
A medical prescriber willing to contribute to and supervise the nurse's 12-day learning in practice element of preparation (see below)
The support of their employer to confirm that
- their post is one in which they will have the need and opportunity to prescribe from the NPEF;
- for nurses in primary care, confirmation of access to a prescribing budget on completion of the course;
- they will be able to access continuing professional development (CPD) opportunities on completion of the course.
There are likely to be many nurses in any local health system who meet these criteria. The three key principles that should be used to prioritise potential applicants are:
The extension of nurse prescribing is intended to extend the benefits of nurse prescribing beyond community and primary care, and it is expected that nominees for the centrally-funded preparation will come from secondary care as well as primary care settings.
Central funding for extending nurse prescribing
Central funding will be made available to train nurses in prescribing. This will be allocated on the basis of named lists of nurses Trusts' have prioritised for training. The Scottish Executive will also take account of remoteness and rurality issues when allocating funding. Central funding currently includes a contribution to other costs, in addition to the course fees. However, this funding is not guaranteed, and depends upon the fees set by Higher Education Institutions.
The central funding allocated for the extension of nurse prescribing is intended to benefit patients and their access to medicines in the NHS. Training for nurses employed by NHS bodies (including Primary Care Trusts, Acute Trusts, GP practices, and Personal Medical Services pilots, amongst others) can therefore be funded from this resource.
Non-NHS staff
Nurses employed by non-NHS organisations, and who provide the majority of their services to NHS patients (e.g. nurses working in hospices), may also have their training funded from central funds.
In nominating for training any nurses whose posts are directly or indirectly funded by pharmaceutical and other companies whose products may appear in the Nurse Prescribers Extended Formulary, employers should be aware of, and take any necessary steps to ameliorate, any conflicts of interest that may subsequently arise in the nurse's practice. Nurses are reminded of clause 16 in the Code of Professional Conduct which states that, in the exercise of his/her professional accountability, a registered nurse must 'ensure that your registration status is not used in the promotion of commercial products or services, declare any financial or other interests in relevant organisations providing such goods or services and ensure that your professional judgement is not influenced by any commercial considerations'.
Funding from other sources
There is no reason why an NHS organisation or private organisation should not pay for the preparation of more nurses and midwives by identifying other sources of funding (e.g. existing training budgets). But see para 48 re non-NHS nurses using NHS community pharmacy dispensing services.
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