The Pharmaceutical Journal
Vol 278 No 7442 p271
10 March 2007

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First independent prescriptions written in hospitals

This week saw the first prescriptions written by pharmacist independent prescribers working in secondary care. This follows the first prescriptions written independently in primary care last month (PJ, 24 February, p209).

Annette Fitzsimons, lead pharmacist prescriber, HIV, at Royal South Hants Hospital, has written her first prescription as an independent prescriber in an HIV clinic that she has been running as a supplementary prescriber for the past three years. Ms Fitzsimons passed the University of Reading’s conversion course last month. The first prescription she wrote was for Combivir (zidovudine plus lamivudine) and nevirapine tablets.

Ms Fitzsimons told The Journal that she experienced a sense of freedom when writing the prescription because she was not restricted by a clinical management plan. “I am therefore of more use to the department and to my colleagues,” she said.

Mark Tomlin, consultant pharmacist in critical care at Southampton General Hospital, wrote his first independent prescription this week for parenteral nutrition. He believes that independent prescribing in this area will improve the quality of junior doctors’ prescribing because it will allow him to demonstrate the correct way to write complicated prescriptions. He added that his independent prescriber status will also allow him to do more ad hoc prescribing for acute conditions. However, Mr Tomlin emphasised the importance of supplementary prescribing as a practice ground for independent prescribers. “Supplementary prescribing builds confidence and competence and I hope it will be retained,” he said.

Nicola Stoner, lead cancer pharmacist at the Churchill Hospital, Oxford Radcliffe Hospitals NHS Trust, has also started prescribing independently this week. Dr Stoner specialises in antiemetics in cancer chemotherapy and prescribes for patients attending a breast cancer clinic.

Several other hospital pharmacists plan to start prescribing independently within the next few weeks. A total of 24 pharmacists are now registered as independent prescribers with the Royal Pharmaceutical Society.

To date, seven universities in Britain have been accredited to provide independent prescriber conversion courses: Bath, Brighton, Keele, Leeds, Reading, King’s College London and Robert Gordon.