Non-Medical Prescribing Practice Based Learning and Assessment

NMP course: overview 26 days theoretical attendance 9 days classroom attendance 16 days virtual attendance 2 x ½ days examinations 12 days (90 hours) in practice Total 38 days over a 18/19 week period

Points to consider… Generic course Theoretical knowledge base NOT therapeutics course Principles to be applied to student’s area of practice Blended learning course, students require to fulfil all elements totalling 38 days

Assessments Pharmacology (nurses and AHPs) Exam – numeracy and pharmacology or Consultation Skills (pharmacists) Written critique Work Based Learning (all) OSCE and viva Principles of Prescribing Practice (all) Portfolio and Competency Profile

DMP Mentor and Learning in Practice webfolio Flow chart (timeline) OSCE criteria and guidelines Competency Profile NPC medical mentor’s guide (currently under review) Personal Formulary template

Personal (P) formulary Negotiate and identify priorities for prescribing practice During the programme develop competence and confidence in prescribing these medicines Identifies specific drugs (or may identify groups) No minimum or maximum number Add to this list by continuing negotiation

Personal (P) formulary Focus for learning during the programme Portfolio evidence should present only drugs identified in Personal formulary Formulary relates to role and competence, registrant’s own boundaries to practice Cognisant of legal parameters for prescribing

Legal parameters for Non-Medical Prescribing Independent Nurse prescribers (V300) - BNF Independent Pharmacist prescribers - BNF Supplementary prescribing AHP Supplementary prescribers AHP Independent prescribers Independent Community Nurse (V100, V150) prescribers - Nurse Prescribers’ Formulary

Supplementary prescribing Independent Prescriber (doctor or dentist) Supplementary (non-medical) Prescriber Tri-partite agreement including patient Clinical Management Plan Template Supplementary Prescriber prescribes within range stated on CMP Review by Independent Prescriber

Student Competency Profile All competencies to be achieved Initial review by 1st February 2016 Mid-way, formative assessment by 14th March 2016 End, summative assessment by 9th May 2016 Submission by 9th May 2016 Is this completed appropriately for external scrutiny... ? (consider external examiners, investigating managers, courts...)

Competency profile Developed by National Prescribing Centre Most recent publication in May, 2012; currently being reviewed Competencies as: combinations of knowledge, skills, motives and personal traits related to effective performance

The single competency framework for all prescribers (NPC, 2012) - The consultation - Prescribing effectively - Prescribing in context

OSCE assessment in practice Patient consultation Assessed by DMP Video recorded Submit by 15th April 2016 Programme team to review (viva) Write a prescription (marked by tutors)

What is a designated medical practitioner expected to do? (NPC, 2005) Allow opportunities for the trainee to carry out consultations and suggest clinical management and prescribing options, which are then discussed with the DMP Help ensure that the trainees integrate theory with practice Take opportunities to allow in-depth discussion and analysis of clinical management using a random case analysis approach, when patient care and prescribing behaviour can be examined further Assessment and verification of competence to assume the prescribing role

What is a designated medical practitioner expected to do? (NPC, 2005) Establish a learning contract Plan a learning programme which will provide the opportunity for the trainee to meet their learning objectives and gain competency Facilitate learning by encouraging critical thinking and reflection Provide dedicated time and opportunities to observe how the DMP conducts a consultation / interview with patients and / or carers and the development of a management plan

Learning contracts Identify: What the student needs to know How they will acquire knowledge How new knowledge / new skill will be recognised and evaluated Suggest start with Learning Outcome 1 Develop a learning contract for each of the Learning Outcomes

Role of the DMP mentor: summary Clinical supervisor Supporting appropriate levels of confidence Formative feedback Assess student’s competency as a prescriber in practice by O.S.C.E. Assess competency as a prescriber in practice by Competency Profile

What should a DMP with doubts about the student’s competence? Discussion with student Contact with the student’s Personal Tutor Formation of action plan in conjunction with PT and student Review of action plan at specified intervals Discussion with student’s manager and / or NMP Lead Failing to fail??

NMP Course Team Claire Callaghan, Programme Leader, Nurse Senior Lecturer Anna Billing, Nurse Janine Hill, Nurse Sessional Lecturer Mark Magas, Pharmacist Senior Lecturer, Mark Stigant, Physiotherapist

Contacts claire.callaghan@cumbria.ac.uk anna.billing@cumbria.ac.uk janine.hill@cumbria.ac.uk mark.magas@cumbria.ac.uk mark.stigant@cumbria.ac.uk

Information sources Supplementary prescribing http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Medicinespharmacyandindustry/Prescriptions/TheNon-medicalPrescribingProgramme/Supplementaryprescribing/index.htm Prescribing controlled drugs changes http://www.dh.gov.uk/health/2012/04/prescribing-change/ Pharmacist independent prescribing FAQ (online archive) http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Medicinespharmacyandindustry/Prescriptions/TheNon-MedicalPrescribingProgramme/Independentpharmacistprescribing/DH_4133943 Nurse prescribing FAQ (online archive) http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Medicinespharmacyandindustry/Prescriptions/TheNon-MedicalPrescribingProgramme/Nurseprescribing/DH_4123003 Outline Curriculum Framework for Education Programmes to prepare Physiotherapists and Podiatrists as Independent/Supplementary prescribers and to prepare Radiographers as Supplementary Prescribers http://www.csp.org.uk/documents/outline-curriculum-framework-education-programmes-prepare-physiotherapists-podiatrists-ind A single competency profile for all prescribers http://www.webarchive.org.uk/wayback/archive/20140627112901/http://www.npc.nhs.uk/improving_safety/improving_quality/resources/single_comp_framework_v2.pdf Training Non Medical prescribers in practice http://www.webarchive.org.uk/wayback/archive/20140627112130/http://www.npc.nhs.uk/non_medical/resources/designated_medical_practitioners_guide.pdf