The
Pharmaceutical Journal Vol 266 No 7132 p108-109 The Royal Pharmaceutical Society has welcomed proposals
for the extension of nurse prescribing, provided that public safety remains
the paramount consideration.
The Society’s view is that prescribing rights should be extended with the aim
of improving patient care, subject to the principle that all prescribing should
be governed by the management of risk, assessment of competence, the breadth
and depth of knowledge required by the prescriber, and the existence of an appropriate
framework for safe practice.
The Society’s views are contained in its response to a Department of Health
consultation document, which was considered by the Council’s Practice Committee
on January 9, along with a draft response prepared in the practice division.
After the committee had made some amendments to the draft, it was endorsed by
the Council, subject to further minor amendment, at a special Council meeting
on the following day.
Among other things, the Society’s response put forward a list of medical conditions
that could potentially be managed by nurse prescribers. After considering the
options for extending the Nurse Prescribers’ Formulary, the response suggested
that ideally nurse prescribing should be rolled out in stages, so that at each
stage it could be evaluated and problems could be identified and addressed.
The response cautioned against nurses being allowed to prescribe “off-label”
and unlicensed medicines except where such prescribing was appropriate for a
condition that was considered suitable for nurse prescribing and for which national
guidance was available. The response recognised the particular implications
of such prescribing in paediatric care, where it was not uncommon.
The response emphasised the importance of appropriate education and training
for nurse prescribing, pointing out that the contribution of pharmacists to
the training of nurse prescribers to date had been highly valued by the nurses
who had been trained.
In its response to a Medicines Control Agency consultation letter on amendments
to the general sale list (GSL) Order (MLX 267), the Society has expressed concern
about proposals relating to maximum strengths for sodium fluoride in mouthrinses
sold as GSL medicines.
The Practice Committee opposed the proposal on the basis that when purchasing
fluoride-containing products clients benefited from the additional advice and
information available in pharmacies. Although the proposed strengths for mouthrinses
were below that currently permitted in cosmetic products, the committee was
concerned that consumers might use a range of fluoride-containing products concurrently
(eg, toothpaste, mouthrinse and fluoride supplements).
The committee noted that, because advice would depend on the level of fluoride
in local drinking water, it could not be incorporated on product packaging.
It was unlikely that appropriate advice would be available in outlets other
than pharmacies.
The committee agreed that there were no objections to proposals for amending
the GSL Order in relation to clotrimazole powder 1 per cent, cetylpyridium chloride
and gum ammoniacum.
Branch observers The following observers from the Society’s branches attended the meetings of Council committees on January 9: