NES Pharmacy Advisory Group (PAG) Non Medical Prescribing (NMP) Subgroup

Guide for board policies

Non-medical Prescribing

The following information has been put together by the NES PAG Non Medical Prescribing Subgroup, as recommendations for the Directors of Pharmacy in Scotland for inclusion within their individual NHS Board policies. The following recommendations for each group of individuals highlighted below have been based on current Board Pharmacy NMP policies and feedback on experience from the NES Pharmacy Regional NMP Leads.

Directors of Pharmacy (DoP)

It is recommended that the following are the responsibilities of the DoPs and should be included in each Board NMP policy for pharmacist prescribing :

  1. Each DoP should identify a Non-medical prescribing Lead for Pharmacywithin their Board.The DoP should appoint aBoard Operational Lead for Non-medical prescribingwho should beresponsible for implementation and development of Non Medical Prescribing at operational level.
  2. If the Board Operational Lead for Non-medical prescribingis not a pharmacist, then aNon-medical prescribing Lead for Pharmacyshould be appointed by the relevant DoP through the NES Regional agreements/monies. The Non-medical prescribing Lead forPharmacy should then link with the Board Operational Lead for Non-medical prescribing, to ensure consistency of approach and developments. They should be given a remit for pharmacist prescribing within the specific Board and should also be linked in with the appropriate NES PAG NMP Regional lead (North, West or East).
  3. The Board non medical prescribing policy should encompass practice in both primary and secondary care and all types of NMPs (nurses, pharmacists and other HCPs).
  4. A Board Strategy for NMP is recommended for future development and implementation of NMP within Boards, and should include identification of clinical areas where patients could benefit as a part of the service re-design processand should be discussed at Board and CHCP level.
  5. Each DoP should include, in their policy, a system which should be implemented to allow assessment ofcandidates clinical competence prior to submission of their application for NMP funding. The assessment (preferably by interview) should be undertaken jointly by the NES Pharmacy Regional NMP Lead and the Board NMP Operational lead and/or NMP Lead for Pharmacy in each Board. Further guidance to be developed.
  6. Supplementary prescribing (SP) may be a useful mechanism to enable new prescribers to develop expertise and confidence. It is recommended that all NMPs practise as an SP,for a minimum of 6 months, prior to practising as an independent prescriber (IP), to gain experience, competence and build appropriate relationships.
  7. Each pharmacist prescriber should have an agreed(with the Clinical Lead Physician) core personal formulary to cover the pharmacist prescribers area of clinical competence, prior to implementation of independent prescribing.
  8. DoPs should ensure that their policy addresses ongoing training and support for NMPs. This should be identified through an appropriate annual performance appraisal and the Knowledge and Skills Framework, depending on their area of practice, by their line manager.
  9. An NMP Forum should be developed in each Board to support ongoing clinical supervision and training post qualification for pharmacist prescribers along with other NMPs. The Forum should be multidisciplinary and include designated medical practitioners (DMPs).
  10. The appropriate Pharmacist Regional Lead for NMP should organise peer review sessions within each Board on a regular basis.
  11. Electronic prescribing by NMP pharmacists should be implemented in all care settings to minimise clinical risk and allow monitoring and review of NMP.
  12. A Board database should be developed and continuously updated by the Non-medical prescribing Lead for Pharmacyand communicated with the appropriate Regional Lead to feed into the NES Regional and NES National databases for Pharmacist NMP.
  13. DoPs should ensure that Clinical Management Plans used by pharmacist prescribers in their Board are reviewed on a regular basis (as defined by a local policy) for clinical governance purposes. CMPs used as `Good Practice` examples should be reviewed on a regular basis by the Non-medical prescribing Lead for Pharmacyand the Board Operational Lead for Non-medical prescribing

It is recommended that the following are the responsibilities of the :

NES Pharmacist Regional Lead for NMP

  1. NES Pharmacy NMP Regional Lead remit :
  1. They should identify and link with the appropriate Board Operational Leads for NMP (which may not be a pharmacist) within their Region and where possible the NMP Lead for Pharmacy and NMP Strategic Lead (usually DoP) for each of the relevant Boards.
  2. In conjunction with the DoP and CHCP lead, review the need for a particular pharmacist prescribing service to be developed before applications are forwarded to NES for funding
  3. Assess clinical competence of applicants before funding approved
  4. Assist applicants with their application process
  5. Assist in setting up a mentor/peer coach for applicants for their training period
  6. Assist applicants in developing an appropriate PLP plan (based on standards)
  7. Assist successful pharmacists in the process of registration with the RPSGB and the Board.
  8. Either assist or identify an appropriate peer coach for pharmacists to set up their prescribing practice
  9. Link the pharmacist prescribers in their Region to appropriate local/ regional / national Champions and Clinical networks to provide Good Practice guidance and improve pharmacist prescribing practice.
  10. Provide support to peer coaches.

Board Operational Lead for NMP

  1. The NES Pharmacy NMP Regional Lead should work with the appropriate Board NMP Operational lead, NMP Strategic Lead (usually DoP) and potentially the Board NMP lead for Pharmacy to identify:
  1. Appropriate Peer coaches
  2. Appropriate Champions
  3. Good practice models for the PLP
  4. Good practice for service implementation and delivery
  5. Good practice example Clinical Management Plans (CMPs)

Board Pharmacy Lead

16. Assist in identifying a suitable DMP and informing the DMP of their role.

17. Assist successful pharmacists in their application for prescription forms from ISD.

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