1. Supplementary prescribing by pharmacists
What it will mean in practice?
Gul Root
Principal Pharmaceutical Officer
Public Health and Community Services
Department of Health
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

2. Supplementary prescribing
Improve patient experience
- better access to care
- better quality of care
- improved patient safety
Patient safety is paramount
Increased and flexible use of professional
skills
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

3. Background Crown Report: recommended extension of prescribing
2 categories of prescriber:
Independent and
Dependent ( supplementary)
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

4. Definitions Independent Prescriber
responsible for the initial clinical
assessment and preparation of a plan
for the clinical management of an
individual patient
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

5. Definitions Supplementary Prescriber can take responsibility for the
management of a patient who has been
assessed by the IP
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

6. Supplementary prescribing
Issues:
Voluntary partnership
Doctor/pharmacist/patient
Level of delegation will depend on:
professional relationship
skills/expertise of pharmacists
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

7. Clinical management plan
Format
Templates
Joint plan
Annual review - at least
Involvement of the patient
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

8. Issues access to patient’s records
separation of prescribing/dispensing
recording contemporaneously
being aware of one’s own limitations
when to refer back to IP
professional accountability/clinical
responsibility
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

9. Issues Black  “Less suitable for prescribing”
“Off-label” medicines - proposed
unlicensed medicines- excluded except as
part of clinical trials
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

10. Competence Framework Behavioural framework
Process used for developing framework
Tool for CPD & learning needs
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

11. Training
Length
Nurses - at least 26 days + 12 days supervised practice
Pharmacists - open learning
Commission 4 CPPEs and NPC
Liaison between HEIs and CPPEs + NPC essential
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

12. How will it work in practice
Primary care
Who:
Primary care pharmacists/sessional CPs
Where:
GP practice
Primary Care Centre
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

13. How will it work in practice
Hospitals:
individual CM plans
teams of doctors/pharmacists
who will write CM plans in reality?
How will SP work for discharge prescribing?
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

14. Supplementary prescribing by pharmacists
Appropriate nominations early on:
Benefit to patients - faster access medicines
Benefit to local NHS services
Willing and able to undertake training
Best value from training resources
Opportunity to prescribe
Employer agreement
Patient safety paramount
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

15. Support for implementation
Announcement and regulations
Website -
Roadshows - strategic/operational
Guidance - early 2003
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

16. Opportunity  Demarcation of Better patient care
Increase job satisfaction
New ways of working
Improved relationships
with other HCPs
 Demarcation of
traditional professional
boundaries
Innovation is rewarded
Better patient care
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

17. Threat Nothing new so why bother? Will the changes bring
about better patient care?
Increased workload
Dissolution of the traditional roles
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002

18. Supplementary prescribing
Improve patient experience
- better access to care
- better quality of care
- improved patient safety
Patient safety is paramount
Increased and flexible use of professional
skills
Gul Root, Principal Pharmaceutical Officer, Department of Health - Dec 2002