Scottish Government

Scottish Executive Health Department

ISBN 0 7559 5137 9

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Contents

Introduction
Scope of this guidance and the effect of devolution

Background to Independent Nurse Prescribing in Scotland
Brief history of nurse prescribing in Scotland
Extending nurse prescribing
Current nurse prescribers
Definition of independent prescribing
Legal basis of independent prescribing by nurses
Aims of independent prescribing by nurses
Different categories of nurse prescribing:
Community Practitioner Nurse Prescribers'
'Nurse Independent Prescribers'

Nurse Independent Prescribers
Which nurses can act as 'nurse independent prescribers'?
Selection of nurses for an approved programme of preparation
Central funding for approved education programmes for nurse independent/supplementary prescribing
Non- NHS staff
Funding from other sources

Educational Preparation for Nurse Independent Prescribing
Supervising and the Designated Medical Practitioner ( DMP)
Continuing Professional Development ( CPD)
Buddying and mentorship

Medicines Prescribable in Nurse Independent Prescribing
Prescribing within competence
Controlled Drugs
Prescribing medicines used outside the terms of their licence (off-label)
Unlicensed medicines (products without a marketing authorisation)
Borderline Substances
Appliances and dressings in the Scottish Drug Tariff

Clinical Governance in Independent Prescribing
Role of the employer in NHS organisations
Independent and the private sector

Good Practice and Ethical Issues for all Nurse Independent Prescribers
Informing patients
Responsibility for prescribing decisions
Prescribing for self, family and friends
Stock items
Gifts and benefits
Guidance on Controlled Drugs

Patient Records
Access and updating
Clinical Management Plans

Adverse Drug Reaction Reporting: How to Report a Suspected Adverse Reaction to a Medicine Prescribed by a Nurse
MHRA/ CHM Yellow Card Scheme
The role of NHS Quality Improvement Scotland

Legal and Clinical Liability
Liability of prescriber and professional indemnity
Liability of employer

Prescribing
Prescribing and administration

Dispensing
Nurses required to dispense in primary care
Prescribing and dispensing
Nurse prescribing in dispensing practices in primary care
Dispensing by appliance contractors
Urgent dispensing
Dispensing of items in England, Wales, and Northern Ireland
Dispensing items against a nurse independent prescriber/pharmacist independent prescriber prescription in hospital pharmacies

Monitoring

Appendices
Appendix 1: Notification of nurse prescriber details to employer in local NHS Board
Appendix 2: Actions for employer: notification of qualification to prescribe
Appendix 3: Actions for employer: notification of change of nurse prescriber details
Appendix 4: Obtaining prescription forms for nurse prescribers
Appendix 5: How to complete the prescription form
Appendix 6: Role of the pharmacist - advice on medicines
Appendix 7: Security and safe handling of prescription forms
Appendix 8: Loss of prescription forms
Appendix 9: Controlled Drugs
Appendix 10: Provision of formularies and drug tarriffs for non-medical prescribers
Appendix 11: Legal classification of medicines
Appendix 12: Useful websites/resources
Appendix 13: Glossary
Appendix 14: History of nurse prescribing