Non-medical prescribing was introduced in 1992 and has developed over the last 30 years (Cope, Abuzour & Tully, 2016. Ther Adv Drug Saf. 7:165). It was originally introduced to improve patient care, choice and access to medicines whilst developing the workforce (Graham-Clarke, Rushton, Noblet et al., 2019. PLoS One. 14: e0214630). Osborne and Kerr (2021. Int J Palliat Nurs. 27: 205) identify how the role of non-medical prescribers has evolved within the specialism of palliative care, having a positive impact on the patient journey and end of life experience. The hospice identified a need to support the non-medical prescribers across the organisation in developing their prescribing practice once they had successfully registered as an independent prescriber.
A competency framework for all prescribers was developed by the Royal Pharmaceutical Society (2021) to support professionals to prescribe safely and effectively through expanding their knowledge and skills. The hospice used this framework as the basis for a model, which would support the non-medical prescribers in developing their role, skills and knowledge. The model facilitates good prescribing practice across services and ensures patients receive the same high quality care irrespective of the prescriber’s background. The model includes the following aspects:
Self–assessment competencies as part of appraisal process.
Completion of an opioid workbook.
Annual completion of Observed Structured Clinical Examinations (OSCE).
Observation in practice.
Case presentation at the prescribing forum.
Alongside the model, a prescribing forum was set up for all prescribers across the organisation to come together and learn as a team creating a community of practice. Initial feedback from non-medical prescribers is that the model and the forum support them in their role and ensures their practice remains current through peer reflection and education. Further evaluation is to be undertaken to identify the benefits and areas for improvement of the model.
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