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3 June 2004
Supplementary prescribing is a new term by which the responsibility for prescribing prescription-only medicines within the NHS has been extended beyond registered medical and dental practitioners to include pharmacists and nurses. It is a major legal change in the UK and the NHS is ahead of any such changes in Europe. The fundamental aim of supplementary prescribing is to provide better and quicker patient care, fully utilise the skills of pharmacists & nurses while safeguarding patient safety.
The Strathclyde course received confirmation of recognition by the Royal Pharmaceutical Society of Great Britain after a visit by an accreditation panel in December 2003. In February 2004 the first cohort was enrolled and that group undertook the first residential course on March 29th April 2nd 2004. The successful graduates of the (20 ScotCat credit) course will be recognised as supplementary prescribers on the register of pharmacists. Only pharmacists completing the necessary requirements will be accredited and will be readily identified on the RPSGB Register.
The course is delivered partly by distance learning, partly through a residential period and partly through a medically supervised period of learning in practice (12 days) that follows the residential course. The basis of the residential course was to develop and test the combined theoretical knowledge and practical skills required of the supplementary prescribing pharmacist. Pharmacists engaged in supplementary prescribing will be required to establish a voluntary partnership and written agreement, on an individual patient basis, with their patients medical practitioner. In full agreement with the patient, the supplementary prescriber will take over the future management of the patients specified condition, according to the agreed treatment plan. The residential course was based on a series of workshops, culminating in practical skills demonstration by the participants of their ability to design and negotiate a clinical management plan for a patient with a medical practitioner and with the patient. The participants were partly taught and tested by medical practitioners engaged by Strathclyde in the design of this course. The course team, led by Course Director Prof Steve Hudson and Course Organiser Ms Derna Campbell say that the use of medical practitioners in the design and delivery of the course is a feature of the course that will be of increasing importance in future developments.
This first Strathclyde course saw 38 pharmacists attend the residential period, approximately 90% of who were from hospital practice. They came predominantly from the Central belt and the Scottish Executive funded almost all. Having completed their residential period, they will now undertake their 12 days of learning in practice at their work base. Pharmacists are expected to show increasing interest in the course as the new contract for community pharmacists in Scotland is expected to include more explicit chronic disease management roles for community pharmacists. Supplementary prescribing practice should offer benefits to the patient, the healthcare system and to the pharmacy profession.
Successful completion of the course requirements (in the next 6 months or so) will allow the pharmacists to have their registered citation as a practising pharmacist appended with the recognition that they are legally entitled to be delegated prescribing responsibility within a defined form of written agreement with a doctor that is filed for each patient. For some this will be simply legitimising what they are doing already in hospital. For others, this will be an opening into a stronger formalised relationship with doctors and more independent decision-making on a patient-by-patient basis. For all of them it will be formal recognition of the future path for their profession giving them a more clinically involved practice which has until 10-15 years ago perhaps been championed by a few but has now become the professional direction of most pharmacists.
For more information on the course please contact Derna Campbell, Principal Pharmacist / Research Fellow in Supplementary Prescribing .
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