PJ Online | P&MM: Short delay expected in launch of training for pharmacist prescribers

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Prescribing & Medicines Management
Issue no 1, p5-6
January/February 2003

Features

Short delay expected in launch of training for pharmacist prescribers

Debbie Andalo brings readers up-to-date with the latest developments in supplementary prescribing for pharmacists

Debbie Andalo is a freelance writer

Government plans to create 1,000 pharmacists with the authority to prescribe by the end of next year have been slightly delayed despite the commitment of all involved in the initiative to meet the target.

Regulations that should have been laid before Parliament before Christmas and which will legally allow pharmacists to take on this new role, never appeared because of a squeeze on parliamentary time. Now this is not expected to take place until the end of February. Department of Health guidance for the profession that will spell out the details about how pharmacists can become supplementary prescribers was originally due to be published at the beginning of February. That deadline has now slipped back to the end of the month as well.

At the same time universities which are expected to train the first cohort of supplementary prescribers admit that it is unlikely that they will be able to have courses running by April.

But despite these minor setbacks the profession, its educators and doctors — who are crucial to the scheme's success — are willing the scheme on.

Key features of supplementary prescribing

• A supplementary prescriber (SP) will be either a pharmacist, nurse or midwife

• They must work in partnership with an independent prescriber (IP) who must be a doctor

• They must work according to a clinical management plan which should be drawn up and agreed by the SP, IP and patient

• Both the IP and SP will share a common patient record

• Supplementary prescribing will apply to the management of chronic conditions such as diabetes, asthma and hypertension.

• SPs will have clinical responsibility for their prescribing decisions

• SPs will be able to prescribe all medicines from the BNF

• They will not be able to prescribe controlled drugs

• Community pharmacists working in health centres or GP practices are expected to become the profession’s first supplementary prescribers

• The Government wants training courses running by April with 1,000 supplementary prescribing pharmacists in place by 2004

The Government's intention is that from later this year pharmacists will be able to train as supplementary prescribers. Working to an agreed clinical management plan they will be able to prescribe following diagnosis by an independent prescriber who must be a doctor (see Panel).

John Moores University in Liverpool is keen to train pharmacists to take on this new role. Dr David Armstrong, reader in physiology in the school of pharmacy said: "This has been a long time coming and if pharmacists don't jump on board now they are going to be left behind."

According to government guidance it is anticipated that pharmacists will require 25 days of tuition followed by another 12 days of training in practice to become prescribers. The training and education curriculum has already been jointly agreed by the Royal Pharmaceutical Society of Great Britain, the Committee on Safety of Medicines and the Medicines Commission (see The Pharmaceutical Journal, January 4, 2003).

Plans to introduce the supplementary prescribing course for pharmacists at John Moores University will be brought in after a similar course for nurses is introduced at the end of April. Details of the course are still being negotiated but it is anticipated that places will be available for around 30 students.

Dr Armstrong said: "We are still negotiating on the course for pharmacists. It will be brought in on the back of the nurse prescribing course so it's going to be later in the year than April."

In Cambridge, chief pharmacist at Addenbrooke's Hospital, Helen Remington (who is also a member of the RPSGB's supplementary prescribing task force set up in May 2001 to oversee the profession's new prescribing responsibilities) anticipates that around six pharmacists will train as supplementary prescribers at her trust in the first instance.

Mrs Remington, who is also immediate past president of the Guild of Health Care Pharmacists, said: "Clearly the providers of the training will be anxious in terms of the original time scale and there may well not be so many providers in the market place to deliver."

Claire Grout, head of pharmacy education and training for the Greater Manchester Workforce Confederation, thought it unlikely that training courses would be up and running to meet the Government's April deadline. She admitted: " I think the deadlines are very short in terms of establishing a course and getting accreditation."

The Workforce Confederation is now identifying the need for supplementary prescribing within its region, rather than looking for individuals who are keen to take on the new role. She explained: "We are looking across primary and secondary care to see where it is likely people will be able to offer supplementary prescribing.

"There will always be an element who want to take on this role but the priority has to be that they are in a situation where it is possible to do the work. The emphasis has to be on where the need is. I think it is likely that the first pharmacists who will become supplementary prescribers will be those who are already working closely with GPs or working in hospital clinics – where the structures are already in place and they have an existing relationship with the independent prescriber."

Whitley Bay GP Dr George Rae, a member of the BMA prescribing committee, is also a member of the RPSGB supplementary task force group. GPs welcomed the move towards supplementary prescribing and he anticipated it could reduce GP workload particularly if pharmacists were trained to issue repeat prescriptions, which account for around 90 per cent of all GP prescribing.

He said: "As long as the skill is there I think that we are able to move forward with this. It is something which is hugely welcome. I think this is also something which patients will welcome. Long gone are the days where Jo Bloggs the pharmacist just takes the prescription and hands over the tablets in the bottle. And I welcome that – their skills up until now have not been used to their full potential."