1. Non-Medical Prescribing
Practice Based Learning and Assessment

2. NMP course: overview Theory: Practice: 12 days (90 hours)
9 days classroom attendance
16 days virtual attendance
½ day Viva/Practical Skills examinations
Practice: 12 days (90 hours)
Total 38 days over a 18/19 week period

3. Points to consider…
Blended learning course, students require to fulfil all elements totalling 38 days
Generic course
Principles to be applied to student’s area of practice

4. Assessments Nurses and AHPs: Pharmacists:
Pharmacology - Numeracy and pharmacology exam
Work Based Learning - OSCE and viva
Principles of Prescribing module - Competency Profile and portfolio
Pharmacists:
Practical Skills assessment / viva
Competency Profile
Portfolio

5. What is a designated medical practitioner expected to do? (NPC, 2005)
Provide dedicated time and opportunities for student’s observation of the DMP’s own expert conduct of a consultation with patients and/or carers and the development of a management plan
Allow opportunities for the student to carry out consultations whilst supervised by the DMP and suggest clinical management and prescribing options, which are then discussed with the DMP
Plan a learning programme with opportunity for the student to meet learning objectives and gain competency – confirm this using learning contracts

6. What is a designated medical practitioner expected to do? (NPC, 2005)
Facilitate learning by encouraging critical thinking and reflection by the student on their own practice
Take opportunities to allow discussion of clinical management, when patient care and prescribing behaviour can be examined further
Help ensure that the students integrate theory with practice

7. What is a designated medical practitioner expected to do? (NPC, 2005)
Assessment
Verification of competence of student to assume a prescribing role
All practice documentation is retained for 7 years

8. DMP Mentor Role supporting Learning in Practice
Personal formulary development
Clinical skills (pharmacists only)
Learning contracts
Practice log
Assessment of supervised consultations
Competency profile

9. Legal parameters for Non-Medical Prescribing
Independent Nurse prescribers (V300) – BNF (with exceptions for treatment of addiction)
Independent Pharmacist prescribers – BNF (with exceptions for treatment of addiction)
Supplementary prescribing
AHP Supplementary prescribers
AHP Independent prescribers (restrictions on use of CDs)
Independent Community Nurse (V100, V150) prescribers - Nurse Prescribers’ Formulary

10. Supplementary prescribing
Independent Prescriber (doctor or dentist)
Supplementary (initially non-medical, dependent) Prescriber
Tri-partite agreement including patient
Clinical Management Plan Template
Supplementary Prescriber prescribes within range stated on CMP
Periodic review by Independent Prescriber

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

12. 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

13. 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

14. Supervised clinical consultations
Mid-point formative
DMP must be present
Opportunity for formative feedback
Use guidelines provided
Complete assessment record provided
DMP to elicit patient views and record
End-point summative (pharmacists) or
OSCE (nurses and AHPs)
DMP must be present
Opportunity for assessment of competence
Must be video-recorded
Use guidelines provided
Complete assessment record provided
DMP to elicit patient views and record

15. Practical skills (pharmacists only)
Identify clinical skills required
(may include e.g. hand washing, accurate recording of temperature, pulse and blood pressure, venepuncture, respiratory examination)
Theoretical principles
Practise
Confirmation of competence

16. DMP Mentor Role supporting Assessment in Practice
Completion of practice logs
Supervised consultation records
Mid-point formative
End-point summative (pharmacists) or
OSCE (nurses and AHPs only)
Competency profile

17. OSCE assessment in practice (nurse and AHP students only)
Patient consultation
Assessed by DMP (therefore DMP must be present)
Video recorded
Write accompanying prescription (marked by tutors)
Submit by 26th April 2017
Programme team to review (prep for viva)

18. Competency profile
Initial development by National Prescribing Centre (2012)
Recent review published in July 2016
Competencies as:
combinations of knowledge, skills, motives and personal traits
related to effective performance

19. A competency framework for all prescribers (RPS, 2016)
THE CONSULTATION
PRESCRIBING GOVERNANCE
Assess the patient
Consider the options
Reach a shared decision
Prescribe
Provide information
Monitor and review
Prescribe safely
Prescribe professionally
Improve prescribing practice
Prescribe as part of a team

20. Student Competency Profile
All competencies to be achieved
Initial review by 6th February 2017
Mid-point, formative assessment by 20th March 2017
End-point, summative assessment by 16th May 2017
Submission by 16th May 2017
Is this completed appropriately for external scrutiny... ? (consider external examiners, investigating managers, courts...)

21. Role of the DMP mentor: summary
Clinical expert, teacher and supervisor
Supporting appropriate levels of confidence
Formative feedback
Assess competency as a prescriber in practice by Competency Profile
(Nurse and AHP students only) - assess student’s competency as a prescriber in practice by O.S.C.E.

22. 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??

23. Resources available Flow chart (timeline)
OSCE criteria and guidelines (for nurses and AHP students only)
NPC medical mentor’s guide (previously under review)
Webfolio:
Student - who should be able to guide DMP
Other DMP mentors
Programme team

24. NMP Course Team
Claire Callaghan, Nurse, Programme Leader
Anna Billing, Nurse
Kay Donnellon, Nurse
Janine Hill, Nurse
Mark Magas, Pharmacist
Mark Stigant, Physiotherapist

25. Information sources
Supplementary prescribing
Prescribing controlled drugs changes
Pharmacist independent prescribing FAQ (online archive)
Nurse prescribing FAQ (online archive)
Outline Curriculum Framework for Education Programmes to prepare Physiotherapists, Podiatrists and Therapeutic Radiographers as Independent/Supplementary prescribers and to prepare Diagnostic Radiographers and Dieticians as Supplementary Prescribers
A Competency Profile for all Prescribers
Training Non Medical prescribers in practice