The Pharmaceutical Journal
Vol 280 No 7484 p5
5/12 January 2008

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Scottish Government publishes guidance on pharmacist independent prescribing

Guidance on independent prescribing by pharmacists in Scotland was published last week.
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The Scottish Government guidance states: “Independent prescribing builds on the experience of supplementary prescribing and enables pharmacists to make autonomous decisions about the treatment of patients. Independent prescribing requires an initial patient assessment, interpretation of that assessment, a decision on safe and appropriate therapy, and a process for ongoing monitoring of the patient.”

It explains that it will be up to NHS boards to decide which pharmacists — in primary and secondary care — should be trained as NHS independent prescribers in order to deliver services that meet local needs. Independent prescribing services will then be contracted by NHS Boards either by arrangement with a pharmacist prescriber who appears on the pharmaceutical list or by directly employing a pharmacist prescriber.

In primary care, one of the requirements is for pharmacists to “have access to a budget to meet the cost of their prescriptions”. This reflects the model of supplementary prescribing already developed, where a pharmacist works with a GP and the cost of medicines prescribed form part of the GP’s prescribing budget.

Funding for provision of the independent prescribing service itself will be met from existing supplementary prescribing money. The guidance states: “Money has already been allocated to Boards for establishing supplementary prescribing clinics and it is intended that set-up and ongoing provider costs of independent prescribing services be met from these existing funds.”

This funding is £750 for initial set-up costs and £150 per week for providing the service.

The guidance also covers what independent prescribing pharmacists can prescribe (in short, all medicines except Controlled Drugs), requirements on record keeping, how to apply for prescription pads and clinical governance issues. It states that pharmacist prescribers should only dispense their own prescriptions in exceptional circumstances, saying “self-dispensing should never be the norm”.

Exceptional circumstances include cases of urgency or where the patient cannot otherwise obtain the item without excessive inconvenience. If this occurs, the pharmacist must endorse the prescription “self-dispensed”.