The Pharmaceutical Journal
Vol 276 No 7400 p557
13 May 2006

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DTB raises concerns about pharmacist prescribing

Concerns are raised about the safety of non-medical prescribing in the latest issue of the Drug and Therapeutics Bulletin (2006;44:33).

“We have concerns about safety, including lack of access to complete medical records, the brevity of prescribing training, the potential for adverse drug reactions and the possibility of prescribing outside areas of competence or expertise,” says the DTB.

Concerns about non-medical prescribing are partly prompted by the fact that doctors’ prescribing can be associated with high rates of adverse drug reactions, some of which might be avoidable, says the DTB. It adds that there is a lack of comparative data on prescribing errors or safety of prescribing by different professional groups.

The bulletin also highlights reservations aired at a Committee on Safety of Medicines meeting in October 2005 relating to the importance of prescribers developing diagnostic competence, and training and governance issues within and outside the NHS. The DTB picks up on the fact that the CSM emphasised the need for non-medical prescribers to have access to patients’ records and says that this is a key point given that electronic medical records are not expected to be fully rolled out in England until 2010.

Although the DTB acknowledges the importance of independent prescribing, it concludes: “It is therefore crucial that non-medical prescribing occurs within the context of rigorous clinical governance frameworks, close monitoring of safety, and ongoing training and professional development.”

Commenting on the DTB review, David Pruce, director of practice and quality improvement at the Royal Pharmaceutical Society, told The Journal: “We are pleased that the DTB recognises the potential of pharmacist prescribing and we want to reassure it and the public that pharmacist prescribing will be safe and the training is adequate to prepare pharmacists to be independent prescribers. We concur fully that non-medical prescribing needs to occur within the context of a rigorous clinical governance framework and this is why we developed a clinical governance framework, which we have published on our website.

“We are confident that pharmacists will only prescribe within their areas of competence just as other prescribers with similar prescribing rights also limit their prescribing to their areas of competence.

“We feel that pharmacist independent prescribing fulfils one of the key aims of ‘Pharmacy in a new age’ and it is an exciting and momentous new era for pharmacy.”