Supplementary prescribing proposals win broad support for pharmacists
Broad support has been found for the introduction of supplementary prescribing
on the National Health Service by pharmacists and nurses following a Medicines
Control Agency consultation on the proposal (PJ, 17 April, p521).
Most respondents to the consultation favoured the introduction of supplementary
prescribing, but 78 of the 765 replies received, including some from pharmacists,
voiced objections in principle.
The proposed changes would allow prescription-only medicines to be prescribed
by supplementary prescribers as part of an agreed clinical management
plan for individual patients. Supplementary prescribers would be responsible
for monitoring and assessing a patient’s progress, and prescribing
medicines within the limits of that plan. Supplementary prescribers would
have to accept clinical responsibility and professional accountability
for their prescribing decisions and practice.
All medicines would be prescribable by supplementary prescribers except
Controlled Drugs and unlicensed medicines outside paediatric care. It
is proposed that all supplementary prescribers should be able to prescribe
pharmacy and general sale list medicines in addition to POMs.
Although most respondents supported supplementary prescribing, many of
them expressed reservations or concerns as well. Some concerns were centred
on excluded medicines that organisations believed should be included.
Few said that specific medicines or conditions should be excluded from
the scheme. For example, the Royal College of Paediatrics and Child Health
was disappointed that the exclusion of CDs meant that supplementary prescribers
would be unable to choose rectal diazepam to terminate convulsions. A
number of pharmacy organisations pointed out that the exclusion of all
CDs meant that pharmacists would not be able to prescribe some products
that they were legally entitled to sell.
However, most of the reservations and concerns were over the detail of
training, drafting management plans and the specific roles and responsibilities
of independent and supplementary prescribers.
Some respondents supported the introduction of supplementary prescribing,
but regretted the fact that the proposal did not include their sectional
interests, eg, dietitians, radiographers and physiotherapists.
Most objections to the principle of supplementary prescribing came from
individual health professionals who believed that they should have full
independent prescribing responsibilities or from doctors who believed
that only they should be allowed to prescribe.
Six pharmacists out of 124 who responded to the consultation personally
were opposed in principle to supplementary prescribing.
For a summary of the responses go to the PJOnline links page (www.pjonline.
com/links).
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