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7. Summary of recommendations
Culture
Governance
1. NHS boards should have robust systems in place to report and respond to medication "near misses", errors and adverse drug reactions.
2. Appropriate mechanisms should be in place to ensure NMAHP prescribers can rapidly access the information they need to prescribe effectively and protect patients' safety.
3. Appropriate mentoring, supervision and line management structures should be in place for NMAHP prescribers.
4. A senior member of management should be identified and prepared at NHS board level to manage the NMAHP prescribing service across the board area.
Policy
5. NHS boards should review current Medicines Management Policy and ensure that there is a NMAHP Prescribing Policy in existence/being developed.
6. The NMAHP Prescribing Policy should be developed by a multi-disciplinary group and should be reviewed regularly.
7. An assessment of local service needs, detailing the patient groups and clinical conditions for which NMAHP prescribing would be appropriate, should be carried out at regular intervals
Monitoring
8. NHS boards should build on their existing systems of auditing and quality monitoring to ensure effective scrutiny of the NMAHP prescribing service, consequently protecting patients, the public, the prescriber and the board. The system should be properly governed, properly organised and properly reported, and should build on existing resources such as NHSNSS data.
9. The lead person for NMAHP prescribing should have in place effective communication mechanisms and strategies with all relevant stakeholders, including service agreements with higher education institutions ( HEIs) regarding provision of the education programme.
Resourcing
10. Existing mechanisms should be used for sharing good practice and innovative solutions to resourcing issues within NHS Scotland.
11. Processes should support and facilitate the NMAHP prescribing service, rather than delay and obstruct it.
Informing
12. The Scottish Government should develop information materials/resources on NMAHP prescribing that can be used by NHS board leads to disseminate to patients, carers, the public, managers, professionals and the media.
Capability
Leadership
13. NHS boards should appoint a Strategic Lead for NMAHP Prescribing with clearly defined roles and responsibilities. The Strategic Lead should report to the board at regular intervals.
14. NHS boards should appoint Local NMAHP Prescribing Leads with clearly identified roles, responsibilities and reporting lines.
Information Technology
15. NHS boards should ensure that NMAHP prescribers using IT systems in relation to their NMAHP prescribing work comply with legislation on data protection and information governance and with NHS Quality In Scotland standards on handling patient information ( NHSQIS, 2005).
Capacity
Service Development and Service Redesign
16. All new service developments and service redesign initiatives should include consideration of the most appropriate professional(s) to prescribe medicines for patients affected by the development/redesign.
17. Workforce/succession planning for NMAHP prescribing should be an integral part of business plans developed for all new service developments and service redesign initiatives.
Education Preparation
18. NHS boards should have strategies and service agreements in place to ensure ongoing dialogue and partnerships with HEIs in relation to NMAHP prescribing education.
19. A system should be in place for predicting future needs for training places.
20. A robust selection procedure should be in place to ensure the appropriate selection of candidates.
21. Flexible means of delivering the theoretical and practical aspects of the programme should be considered.
22. The clinical elements of the programme should be considered to have equal standing to the theoretical components.
23. NHS boards should support and encourage the Higher Education Institutions' Prescribing Network to continue its excellent work.
Ongoing professional development and support
24. NHS boards should be prepared to ensure a range of appropriate sources of support are in place for NMAHP prescribers to enable them to identify and meet ongoing development needs. Central to this is the PDP process, through which NMAHP prescribers can be supported to meet mandatory ongoing professional standards and other development needs.
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