Extending Independent Nurse Prescribing within NHSScotland
WHO MAY PRESCRIBE AND WHAT MAY BE PRESCRIBED IN EXTENDED NURSE PRESCRIBING
Categories of nurses and midwives who may prescribe
Amendments to the Prescription Only Medicines (POM) Order, NHS (Pharmaceutical Services) (Scotland) Regulations, NHS (Charges for Drugs and Appliances) (Scotland) Regulations, came into force on 1 April 2002. This means that it is not necessary for a nurse to hold a district nursing or health visiting qualification in order to prescribe from the Nurse Prescribers' Extended Formulary, or to be eligible to undertake the specific programme of preparation.
Under the provisions of the amended regulations, to be legally eligible to prescribe from the Extended Formulary:
(a) prescribers must be a 1st level Registered Nurse or Registered Midwife; and
(b) in each case the nurse's or midwife's name must be held on the NMC professional register with an annotation signifying that the nurse has successfully completed the specific programme of preparation for extended nurse prescribing approved by NHS Education for Scotland (previously National Board for Nursing, Midwifery and Health Visiting for Scotland), and is qualified to order medicines and medical devices from the Extended Formulary.
Nurse Prescribers' Extended Formulary and the Scottish Drug Tariff
Nurses who have undergone extended training to prescribe may only prescribe on the NHS from the items listed in the Nurse Prescribers' Extended Formulary (NPEF) or the Nurse Prescribers' Formulary (NPF). The list will be published quarterly in the Scottish Drug Tariff and incorporated every 6 months into the British National Formulary (BNF). Nurses able to prescribe from the Extended Formulary will receive a centrally-funded copy of the BNF every 6 months. The NPF for district nurse and health visitor prescribers will continue to be published biennially with amendments published annually. [This will also be made available to nurses prescribing from the Extended Formulary.] A copy of the Scottish Drug Tariff will be supplied to all nurse prescribers every 6 months through Information and Statistics Division of the Common Services Agency (ISD). These publications will be alternated so that nurses receive either a BNF or a Scottish Drug Tariff every 3 months. Nurse prescribers should have access to an up-to-date copy, if required. The Nurse Prescribers Formulary is given in part 8B of the Scottish Drug Tariff. The Nurse Prescribers Extended Formulary will be published as part 8C.
Nurse prescribers should not prescribe medicines for uses outside of their licensed indications ('off licence'). Guidance in the Nurse Prescribers' Extended Formulary will list the indications for which nurses may prescribe each medicine. Nurses' prescribing may also be limited by locally agreed formularies, where these apply to other prescribers. In prescribing as in other areas of practice, nurses and midwives are bound by the NMC Code of Professional Conduct to act only within their competence, and for this reason many practitioners will not prescribe from all sections of the NPEF.
The extension of nurse prescribing to include midwives does not affect the exemptions under Medicines Act legislation, which allow midwives to supply or administer certain listed medicines.
Nurses may continue to use Patient Group Directions for the supply and administration of named medicines, where this is a more appropriate response to patients' needs.