http://www.kirklees.nhs.uk/uploads/tx_galileodocuments/Non-medical_prescribing_policy2008_10

Non-Medical Prescribing Policy

Approved by: PEC Date: 13th February 2008

Table of Contents

Table of Contents

Title Contributors and Acknowledgements Introduction Healthcare Commission Standards: Forms of Non-Medical Prescribing Training for Non-Medical Prescribing Nurses and Midwives Pharmacists Allied Health Professionals All Applicants Medical Mentor Support for the Medical Mentor Support from an experienced Non Medical Prescriber The Course Qualification as a Non-Medical Prescriber Actions by the Individual Non-Medical Prescriber Actions by the Line Manager Actions by the PCT Non-Medical Prescribing Lead Actions by Human Resources Employment of a Non-Medical Prescriber Practice as a Non-Medical Prescriber Support for non-medical prescribing Provision of support Buddying for Non-Medical Prescribers Supplementary prescribing for nurses, midwives and pharmacists Clinical Supervision Non-Medical Prescribers Network Accountability and responsibility as a non-medical prescriber Professional Accountability and Responsibility Employer Accountability and Responsibility Continuing Professional Development PCT Performance and KSF Development Review Audit Change of role within the PCT Return to Practice as a Non-Medical Prescriber Leaving a Non-Medical Prescribing Role within the PCT Prescribing of: Unlicensed Medicines Off-licensed Medicines Controlled Drugs Independent Nurse Prescribing of Controlled Drugs Supplementary Prescribing of Controlled Drugs

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Table of Contents

Patients Patient Involvement Patient Information Patient Consent General Guidance/Summary of Action What can be prescribed Writing prescriptions Record keeping Obtaining prescription pads Storing prescription pads Security of prescription pads Disposal of prescription pads Loss or theft of Prescription pads Appendices Course Details, Yorkshire and Humber SHA Independent Prescribing Proforma Independent Prescribing Proforma – Additions Form Clinical Management Plan Template Prescription Pad Order Form Individual Non Medical prescriber Prescription record form

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11 A B C D E F

29 30 32 34 36 37

Contributors and Acknowledgements

Contributors: Neill McDonald

Assistant Director Medicines Management and Prescribing Kirklees PCT

Lucianne Ricketts

Senior Medicines Management Adviser - Strategy and Operational Development.

Linda Fox

Specialist Technician – Community and Support Services Kirklees PCT

Karen McLean

WYCSA Support Services Officer St Lukes House Huddersfield

Acknowledgements: All Kirklees PCT staff who have contributed towards this and earlier versions of the policy.

Val Mills

Senior Lecturer and Non-Medical Prescribing Lead The University of Huddersfield

Sue Walker

Deputy Chief Nurse Mid Yorkshire Hospitals NHS Trust

The Non Medical Prescriber Network

Mid Yorkshire Hospitals NHS Trust

Section 2 Page 3

Introduction

3 – Introduction This policy provides operational procedures and a clinical governance framework to support non-medical prescribing within Kirklees Primary Care Trust (PCT) The policy covers: • Community Nurse Prescribers • Nurse Independent/Supplementary Prescribers • Pharmacy Independent/Supplementary Prescribers • Allied Healthcare Professional Supplementary Prescribers (Physiotherapists, Podiatrists, Radiographers and Optometrists).This list may expand to cover other Health Care Professionals given prescribing rights by the Department of Health.

It replaces the former Huddersfield Central and South PCT (2006) and the North Kirklees PCT (2005) Non Medical Prescribing Policies. It will operate as a stand alone policy and will be included as an appendix in the Kirklees PCT Medicines Code.

Purpose The purpose of this policy is to provide guidance for non medical prescribers, and to inform PCT employed staff and those contracted to provide services for the PCT, of the organisational processes involved. This includes: • Forms of Non Medical Prescribing • Selection/ identification of those to be trained • Qualification as a Non Medical Prescriber • Practice as a Non Medical Prescriber • Accountability • Prescription writing requirements and processes • Record keeping • Adverse Reactions • Prescription queries • Prescription pad security • Continuing Professional Development/Competencies • Administration and Management Processes for NMP • Appendices

The policy relates to the following Healthcare Commission Standards: First Domain – Safety Core Standard C4d Health care organisations keep patients, staff and visitors safe by having systems to ensure that: d) Medicines are handled safely and securely;

Section 3 Page 4

4 - Forms of Non-Medical Prescribing Non medical prescribing is the term used to describe prescribing by health care professionals other than doctors and dentists. Non medical prescribers must comply with the current legislation for prescribing and be accountable for that practice.

Non Medical Prescribers include: Community nurse practitioners Nurse Independent Prescribers Pharmacist Independent Prescribers It also covers Supplementary Prescribing by: Nurses, Pharmacists, Physiotherapists, Chiropodists/Podiatrists, Radiographers and Optometrists.

Full details on the mechanisms for non-medical prescribing can be found at: http://www.dh.gov.uk/assetRoot/04/13/77/24/04137724.pdf Furthermore the Department of Health (2006) guidance1 should be referred to for Independent Nurse and Pharmacist Prescribing at: http://www.dh.gov.uk/assetRoot/04/13/37/47/04133747.pdf Finally for guidance on Supplementary Prescribing the Department of Health (2005)2 should be consulted at: http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidan ce/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4110032&chk=c4V6nR

1

Department of Health (2006) Improving Patients Access To Medicines: A Guide to Implementing Nurse and Pharmacist Independent Prescribing within the NHS in England. London: DH http://www.dh.gov.uk/assetRoot/04/13/37/47/04133747.pdf 2 Department of Health (2005) Supplementary Prescribing by Nurses, Pharmacists, Chiropodists/Podiatrists, Physiotherapists and Radiographers within the NHS in England: a guide for implementation. London: DH http://www.dh.gov.uk/assetRoot/04/11/00/33/04110033.pdf

Section 4 Page 5

5 - Training for Non- Medical Prescribing Before individual non-medical prescribers apply for training to become a non-medical prescriber, they and their supporting manager must confirm the following criteria.

5.1 • • •

5.2 • • • •

5.3 • •

5.4 •

•

The DH (2006) and the Nursing and Midwifery Council (2006)3 state that nurses and midwives should: have the ability to study at Level 3 (degree level). normally have at least three years’ post-registration clinical nursing experience, of which at least one year immediately preceding their application to the training programme should be in the clinical area in which they intend to prescribe. be assessed as being competent to take a history, undertake a clinical assessment and make a diagnosis. For example, they must be able to carry out a comprehensive assessment of the patient’s physiological and/or psychological condition, and understand the underlying pathology and the appropriate medicines regime.

The DH (2006) and the Royal Pharmaceutical Society of Great Britain (2006)4 state that pharmacists should: have the ability to study at Level 3 (degree level). have at least two years’ experience practicing as a pharmacist in a clinical environment, in a hospital or a community setting, following their pre-registration year after their graduation. be competent to prescribe in the area in which they will prescribe following training. demonstrate how they will develop their own networks for support, reflection and learning, including prescribers from other professions.

The DH (2005) and the Health Professions Council (2005)5 state that allied health professionals should: have the ability to study at Level 3 (degree level). normally have at least 3 years relevant post-qualification experience.

For all applicants the PCT needs to: approve the designated medical practitioner, hereafter referred to as the medical mentor, and ensure the mentor is willing and able to contribute to and supervise 12 days of learning in practice. It is the responsibility of the applicant to identify this mentor.

See below for further requirements and guidance. verify that the member of staff’s post is one in which they will have the need and the opportunity to act as an independent prescriber immediately upon qualifying. Those members of staff interested in applying for non-medical prescribing training and their managers must confirm that they meet the requirements identified in the

3

Nursing and Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife Prescribers. London: NMC http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=1645 4 Royal Pharmaceutical Society of Great Britain (2006) Outline Curriculum for Training Programmes to prepare Pharmacist Prescribers. London: RPSGB http://www.rpsgb.org/pdfs/indprescoutlcurric.pdf 5 Health Professions Council (2005) Standards for Education and Training. London: HPC http://www.hpcuk.org/assets/documents/10000BCF46345Educ-Train-SOPA5_v2.pdf

Section 5 Page 6

•

• • • •

section entitled ‘priority clinical areas for non-medical prescribing’ in the PCT nonmedical prescribing policy ascertain whether the individual will need to prescribe for children and young people on qualification. If the individual is to prescribe for children and young people the PCT must ensure only non medical prescribers with relevant knowledge, competence, skills and experience in treating children and young people should prescribe for children and young people. This is in compliance with NMC Circular 22/2007 http://www.nmc-uk.org/prescribing for children and young people agree with the individual non-medical prescriber the therapeutic area in which they will prescribe. support staff undertaking their course whist training support continuing professional development (CPD) opportunities related to their prescribing role on completion of the course through the local Trust training programme (for more details contact the PCT training department).

Provide written confirmation to the Higher Education Institution providing the training that the applicant has had a recent Criminal Records Bureau Check within the previous 2 years.

5.5 Medical Mentor The medical mentor has a crucial and highly responsible role in teaching and assessing the non-medical prescriber and assuring competence in prescribing as identified by the Higher Education Institution providing the training.

The Medical Mentor: • has normally had at least 3 years medical, treatment and prescribing responsibility for a group of patients/clients in the relevant field of practice.

• Is within a GP practice and is either vocationally trained or is in possession of a certificate of equivalent experience from the Joint Committee for Post-graduate Training in General Practice Certificate or is a specialist registrar, clinical assistant or a consultant within Kirklees PCT • For those non medical prescribers intending to prescribe for children and young people, should be experienced and competent in prescribing for children and young people to confirm the demonstration of competence for those wishing to prescribe for this age group on qualification.

• has some experience or training in teaching and/or supervising in practice 5.6

Support for the Medical Mentor

The National Prescribing Centre (2005)6 has produced a guide to help doctors prepare for and carry out the role of the medical mentor. This guide can be found at: http://www.npc.co.uk/pdf/designated_medical_practitioners_guide.pdf The University chosen for non-medical prescribing training may also provide medical mentor training as well as support by the course leader.

6

National Prescribing Centre (2005) Training Non-Medical Prescribers in Practice: A guide to help doctors prepare for and carry out the role of designated medical practitioner. Liverpool: National Prescribing Centre http://www.npc.co.uk/pdf/designated_medical_practitioners_guide.pdf Section 5 Page 7

5.7

Support from an Experienced Non Medical Prescriber

The Nursing and Midwifery Council states that practice assessment in Independent/Supplementary prescribing programmes is the legal responsibility of a designated medical practitioner who supports, teaches and supervises the student with, where possible, an experienced non medical prescriber who should ensure that the learning is applied to specific areas of practice. The PCT supports this statement and will where possible seek to allocate an experienced non medical prescriber to assist non medical prescribing students in the PCT to apply their learning to their specific area of practice.

5.8 The Course Course details can be obtained from the Higher Education Institution to which the applicant wishes to apply. See section 11, appendix A for course details within the Yorkshire and the Humber Strategic Health Authority.

Once agreement to train as a non medical prescriber has been reached, the applicant must apply for study leave as per PCT policy.

Without management agreement, study leave approval and an agreed mentor, application to the non medical prescribing courses must not be made.

Section 5 Page 8

6 - Qualification as a Non-Medical Prescriber The following subsections describe the actions to be taken when an individual non-medical prescriber successfully completes their prescribing training by: • The individual non-medical prescriber • Their line manager • The Specialist Technician – Community and Support Services at Kirklees PCT • Human Resources by completion of a ‘Changes to Staff Contract Form’ with their line manager.

6.1

Actions by the Individual Non-Medical Prescriber

Once the individual non-medical prescriber has successfully completed their prescribing training, they will be notified by the relevant Higher Education Institution. The Higher Education Institution also notifies: • • •

The Health Professions Council in the case of Physiotherapists, Podiatrists, Radiographers, and Optometrists The Nursing and Midwifery Council in the case of Nurses and Midwives The Royal Pharmaceutical Society of Great Britain in the case of Pharmacists

The relevant regulatory body will then make the appropriate non-medical prescribing annotation on the register for the individual non-medical prescriber. Any costs associated with recording their qualification with the appropriate regulatory body will be met by the individual non-medical prescriber. The individual non-medical prescriber cannot legally prescribe until this annotation has been made.

Once the individual non-medical prescriber has received notification from the relevant regulatory body that an annotation has been made on the register they must provide a copy to: • Their line manager • The PCT non-medical prescribing lead • Human Resources by completion of a ‘Changes to Staff Contract Form’ with their line manager They will also need to provide a specimen copy of their signature to the Specialist Technician – Community and Support Services.

For nurses, midwives and pharmacists seeking to prescribe as Independent Prescribers an Independent Prescribing proforma (see appendix b), must be completed and submitted to the PCT Non Medical Prescribing Lead. This must demonstrate how non medical prescribing will complement their role and what the benefits will be for the patients and for Kirklees PCT. For Nurses, Midwives, Pharmacists and Allied Health Professionals seeking to prescribe as Supplementary Prescribers their competencies will be agreed by their medical mentor. As long as the individual non-medical prescriber has notified their line manager and the PCT Non Medical Prescribing Lead of their notification of annotation to the register from the relevant regulatory body, no separate approval is required. They can commence Section 6 Page 9

supplementary prescribing in line with the requirements of the DH (2005) They must however use the PCT clinical management plan template, see appendix D. 6.2

Actions by the Line Manager

The line manager will ensure that they: • •

•

6.3

view a copy of the individual non-medical prescriber’s course results letter and notification of annotation to the register from the relevant regulatory body. complete a ‘Changes to Staff Contract Form’ and submit to Human Resources. ensuring that the individual non-medical prescribers job description refers to their non-medical prescribing role. The Job description MUST state that Non medical prescribing is a requirement for the post.

The completed independent prescribing proforma ( See appendix B) should be submitted to the Non Medical Prescribing Lead.

Actions by the PCT Non-Medical Prescribing Lead or Specialist Technician – Community and Support Services

The PCT Non Medical Prescribing Lead and/or Specialist Technician – Community and Support Services will ensure that they view and retain a copy of the individual non-medical prescriber’s course results letter and notification of annotation to the register from the relevant regulatory body. They will also verify this annotation as follows: The Health Professions Council http://www.hpcheck.org/lisa/onlineregister/MicrositeSearchInitial.jsp The Nursing and Midwifery Council (caller code and pass number required) http://www.nmc-uk.org/aSection.aspx?SectionID=19 The Royal Pharmaceutical Society of Great Britain http://www.rpsgblist.org/membership.asp

The PCT Non Medical Prescribing Lead and/or Specialist Technician – Community and Support Services will be responsible for: • Registering the non medical prescriber with the NHS Business Services Authority • Entering the individual non-medical prescriber’s non-medical prescribing status on the non-medical prescribing data base, in accordance with Appendix B Independent Prescribing Proforma • Sending the independent prescribing proforma to the newly qualified non medical prescriber.

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6.4

Actions by Human Resources

Human Resources will be responsible for receiving and retaining on file the individual nonmedical prescriber’s: • ‘Changes to Staff Contract Form’ • revised job description • Proof of CRB check if appropriate.

6.5

Employment of a Non-Medical Prescriber

When the PCT employs a non-medical prescriber that they have not supported through training, the individual non-medical prescriber, their line manager, the PCT Non Medical Prescribing Lead and Human Resources need to act in accordance with sections 6.1 to 6.4 of this policy. The individual MUST demonstrate they have completed the appropriate training and have their competencies assessed before applying to be registered as a non medical prescriber within Kirklees PCT

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7 - Practice as a Non-Medical Prescriber The following subsections deal with aspects of practice as a non-medical prescriber namely: • •

Support for non-medical prescribing Accountability and responsibility as a non-medical prescriber

7.1

Support for Non-Medical Prescribing

This sub-section is further divided as follows: • • • • •

Provision of support Buddying for Non-Medical Prescribers Supplementary prescribing for nurses, midwives and pharmacists Clinical Supervision Non-Medical Prescribers Network

7.1.1 Provision of Support The following table details the support for non-medical prescribing and the responsibilities of key personnel in the provision of this support: Support Provision of a current BNF/NPF

Information relating to pharmacovigilance and other non-medical prescribing related updates Medicines information Prescription pads

Information on non-medical prescribing network meetings Arrangement for cross boundary prescribing including service level agreements.

Process to be agreed within local health economy..

Responsibility Medicines Management Team when editions are delivered normally in March and September of each year. Nurse prescribers will be provided with an NPF when published, normally biannually in September.

PCT non-medical prescribing lead when notified.

Medicines Management Team or Individual Practice Support Pharmacists.

Sourced by WYCSA and delivered to either Locality Bases or Practice. PCT Individual non-medical prescribers collect from Locality Base.

PCT non-medical prescribing lead when meetings arranged.

PCT non-medical prescribing lead when requested by individual non-medical prescriber.

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7.1.2 Buddying for Non-Medical Prescribers The DH (2006) recommends buddying for non-medical prescribers. The PCT accepts this recommendation. Support from other professional colleagues is invaluable to non-medical prescribers, especially to those who are newly qualified. A buddy or mentor could be a doctor or another non-medical prescriber. The PCT will encourage the engagement of newly qualified non-medical prescribers with buddying and furthermore will encourage doctors, non-medical prescribers and line managers to provide this role.

7.1.3 Supplementary Prescribing for Nurses, Midwives and Pharmacists The DH (2006) notes that supplementary prescribing is a useful mechanism to enable new non-medical prescribers to develop their expertise and confidence in prescribing. The PCT accepts this recommendation. Non-medical prescribers will be encouraged to prescribe following qualification as a supplementary prescriber to gain expertise and confidence and will also encourage doctors and managers to assist with this process.

7.1.4 Clinical Supervision The DH (2006) recommends that nurse and pharmacist independent prescribers should use clinical supervision arrangements or equivalent as an opportunity for reflection on prescribing, as well as other aspects of practice. The PCT accepts this recommendation for all of its non-medical prescribers. The model of clinical supervision should be agreed at local level, taking into account Clinical Supervision is regular, protected time for facilitated, in-depth reflection on clinical practice. It aims to enable the supervisee to achieve, sustain and creatively develop a high quality of practice through means of focus, support and development (Bond,1998).

7.1.5 Non-Medical Prescribers Network It may be helpful for PCT Non-Medical Prescribers and those undergoing training to form network links. Any issues can be discussed and concerns taken forward to the Non Medical Prescribing Sub Committee which is responsible to the Kirklees PCT Medicines Management Committee 7.2 Accountability and Responsibility as a Non-Medical Prescriber This sub-section is further divided as follows: • Professional Accountability and Responsibility • Employer Accountability and Responsibility • Continuing Professional Development • PCT Performance and KSF Development Review • Audit • Change of Role within the PCT • Returning to Practice as a Non-Medical Prescriber • Leaving a non-medical prescribing role within the PCT

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7.2.1 Professional Accountability and Responsibility All non-medical prescribers must work within their own level of professional knowledge and competence, and must seek advice and make appropriate referrals to other professionals with different expertise. Non-medical prescribers are accountable for their own actions, and must be aware of the limits of their knowledge and competence.

Nurses and Midwives must act according to the: •

Nursing and Midwifery Council (2004) Code of Professional Conduct: Standards for Conduct, Performance and Ethics. (To be revised 2007) http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=201

•

Nursing and Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife Prescribers http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=1645

Pharmacists must act according to the: •

Royal Pharmaceutical Society of Great Britain’s (2006) Code of Ethics and Standards. (To be revised 2007) http://www.rpsgb.org/pdfs/coe060524.pdf

Allied Health Professionals must act according to the: •

Health Profession Council’s (2003) Standards of Conduct, Performance and Ethics. http://www.hpcuk.org/assets/documents/1000062CHPC034HPCA5_Standards_of_conduct_perfor mance_and_ethics.pdf

Furthermore Allied Health Professionals must abide by their respective Standards of Proficiency as thus: Physiotherapists http://www.hpcuk.org/assets/documents/10000DBCStandards_of_Proficiency_Physiotherapists.pdf Podiatrists http://www.hpcuk.org/assets/documents/10000DBBStandards_of_Proficiency_Chiropodists.pdf Radiographers http://www.hpcuk.org/assets/documents/10000DBDStandards_of_Proficiency_Radiographers.pdf

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7.2.2 PCT Accountability and Responsibility All non-medical prescribers should abide by the non-medical prescribing related PCT policies and procedures available within the PCT Medicines Code: Finally should independent prescribers seek to prescribe additional items not approved in their independent prescribing proforma, they should complete an additions form, see section 11 appendix C. This should be submitted to the Non Medical Prescribing Lead Vicarious Liability/ Indemnity Insurance Where a PCT employed nurse, midwife, pharmacist or Allied Healthcare Professional is appropriately qualified and prescribes as part of their professional duties with the consent of the PCT, the PCT is vicariously liable for their acts and omissions.

For Non Medical Prescribers who are directly employed by GPs or other commissioned services, the responsibility lies with the individual prescriber and their employer. It is the personal responsibility of each individual to ensure this provides a suitable level of protection for their intended prescribing practice.

7.2.3 Continuing Professional Development (CPD) The PCT accepts the recommendation from the DH (2006) that non-medical prescribers must keep up to date with evidence and best practice in the management of the conditions for which they prescribe, and in the use of the relevant medicines.

Furthermore the respective regulatory bodies all stipulate CPD requirements and nonmedical prescribers must fulfill these obligations in terms of both their prescribing role and their wider practice.

Therefore the PCT requires each non-medical prescriber to use CPD as a means of enhancing their professional knowledge and competence related to their non-medical prescribing role.

To assist non-medical prescribers review their competency, the National Prescribing Centre have produced a series of competency frameworks which can be found at the following link: http://www.npc.co.uk/non_medical/competency_frameworks.htm The PCT will encourage non-medical prescribers to use these frameworks to review their competence in non-medical prescribing.

CPD takes a variety of forms7. Examples of how individual non-medical prescribers may undertake CPD include: 7

Bramley, I (2006) Continuing Professional Development: what is it and how do I get it?

Nurse Prescribing, Volume 4, Number 3, Pages 117 -121

Section 7 Page 15

• • • • • • •

Attendance at external formal events such as conferences or events delivered by Universities Attendance at PCT study events Attendance at non-medical prescribing network meetings Buddying Time spent with medical colleagues on relevant prescribing activities.

Reviewing their competence using the National Prescribing Centre competency frameworks Undertaking audit

CPD remains the responsibility of the non-medical prescriber. Individual non-medical prescribers will negotiate their CPD requirements using the PCT performance and KSF development review process.

7.2.4 PCT Performance and KSF Development Review The PCT Performance and KSF Development review will facilitate non-medical prescribing in two key ways: • •

The identification of individual non-medical prescribers suitable to train as nonmedical prescribers.

The ongoing review of performance related to non-medical prescribers once trained. Non-medical prescribers should include prescribing as part of their review annually in order to continue in this role. Once such a review has been undertaken, non-medical prescribers should notify the PCT Non-Medical Prescribing Lead and the date should be recorded on the non-medical prescribing database.

7.2.5 Audit Audit is an essential element of the clinical governance of non-medical prescribing. Within the organisation audit will operate at two levels as thus: • •

PCT level. The PCT will audit non-medical prescribing as a means of determining the standard of current non-medical prescribing practice and future service requirements.

Non-medical prescriber level. Non-medical prescribers will audit their own prescribing practice as a means of demonstrating its quality. However non-medical prescribers can fulfill such audit requirements by participating in audit being undertaken within their prescribing team.

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7.2.6 Change of Role Within the PCT A non-medical prescriber may change their role in the PCT as a result of: • Their career development • Service redesign • Succession planning If a non-medical prescriber moves to another area of practice he/she must consider the requirements of their new role and only ever prescribe within their own level of knowledge and competence.

•

•

•

•

Existing prescribing competence. If a non-medical prescriber moves to a new area they can prescribe within their expertise gained in their previous prescribing area, for example if from a dermatology background the non-medical prescriber can prescribe within this area for patients with these conditions if this is appropriate within the new team.

Continuing professional development (CPD) needs.

The non-medical prescriber and their new manager must work in partnership to identify individual non-medical prescribing CPD needs within their new area of practice. Individual CPD needs will determine the length of time it takes for a non-medical prescriber who has moved practice areas, to feel confident and competent to prescribe in their new area of practice. This must be incorporated into the Performance and KSF Development Review process. The non-medical prescriber is responsible for attaining the knowledge and competence that will give them the skills to apply the principle of prescribing in a new area. It would be good practice to undertake reflective supervision with the prescribing team in practice, which should include the lead clinician.

Independent prescribing. Before independent prescribing can take place a new independent prescribing proforma (see section 11, appendix b) must be completed and submitted to The Non Medical Prescribing Lead. The non-medical prescribing data base will then be amended by the PCT Non Medical Prescribing Lead or Specialist Technician – Community and Support Services to reveal the individual non-medical prescriber’s new prescribing area.

Supplementary prescribing. Before supplementary prescribing can take place the non-medical prescriber and the independent prescriber involved must be satisfied that the individual non-medical prescriber has achieved the necessary knowledge and competence in their new area of prescribing practice. A clinical management plan must then be completed as required by the DH (2005) (see appendix D). For those only prescribing on a supplementary basis, the non-medical prescribing data base will be amended by the PCT Non Medical Prescribing Lead or Specialist Technician – Community and Support Services to reveal the individual non-medical prescriber’s new prescribing area.

7.2.7 Return to Practice as a Non-Medical Prescriber A non-medical prescriber may complete return to practice requirements laid down by their regulatory body and wish to resume non-medical prescribing. The individual non-medical prescriber and their line manager will need to:

Section 7 Page 17

•

•

•

•

Assess prescribing competence. This will be undertaken using the PCT performance and KSF development review process. The individual non-medical prescriber’s personal portfolio will also be of use in determining existing competence and continuing professional development needs. Individuals will be encouraged to review their prescribing competency using the National Prescribing Centre competency frameworks detailed in section 7.2.3 of this policy. The nonmedical prescriber and new manager must work in partnership to identify individual non-medical prescribing CPD needs within their new area of practice.

Continuing professional development (CPD) needs. Individual CPD needs will determine the length of time it takes for a non-medical prescriber who has returned to practice to feel confident and competent to prescribe in their area of practice.

This must be incorporated into the Performance and KSF Development Review process. The non-medical prescriber is responsible for attaining the knowledge and competence that will give them the skills to re-apply the principle of prescribing. It would be good practice to undertake reflective supervision with the prescribing team in practice, which should include the lead clinician.

Independent prescribing. Before independent prescribing can take place an independent prescribing proforma (see section 11, appendix b) must be completed and submitted to the Non Medical Prescribing Lead. The non-medical prescribing data base will then be amended by the PCT Non Medical Prescribing Lead to reveal the individual non-medical prescriber’s prescribing area following return to practice.

Supplementary prescribing. Before supplementary prescribing can take place the non-medical prescriber and the independent prescriber involved must be satisfied that the individual non-medical prescriber has achieved the necessary knowledge and competence in their new area of prescribing practice. A clinical management plan must then be completed as required by the DH (2005) (see appendix D). For those only prescribing on a supplementary basis, the non-medical prescribing data base will be amended by the PCT Non Medical Prescribing Lead or Specialist Technician – Community and Support Services to reveal the individual non-medical prescriber’s prescribing area following return to practice.

7.2.8 Leaving a Non-Medical Prescribing Role Within the PCT The following actions must be undertaken when a non-medical prescriber leaves the PCT. •

•

Line manager. The line manager will be responsible for notifying o The PCT Non Medical Prescribing Lead and Specialist Technician – Community and Support Services o Human Resources. o And must ensure all unused FP10 prescription forms are returned to the Locality Managers PA for recording and shredding PCT Non Medical Prescribing Lead or Specialist Technician – Community and Support Services . o The PCT Non Medical Prescribing Lead or Specialist Technician – Community and Support Services will remove the individual non-medical prescriber from the non-medical prescribing database. The NHS Business Services Authority and WYCSA Support Services will also be notified to request the non medical prescriber is removed from their databases.

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8

Prescribing Guidance for:

•

Unlicensed Medicines

•

Off-licensed Medicines

•

Controlled Drugs

8.1 Unlicensed Medicines Unlicensed medicines can only be prescribed by non-medical prescribers using supplementary prescribing. The status of unlicensed medicines must be recorded on the clinical management plan.

Independent nurse and pharmacist prescribers must never prescribe unlicensed medicines.

Non-medical prescribers must abide by the PCT policy for unlicensed medicines. Patients must be informed of any unlicensed medicines being prescribed to them.

8.2 Off-licensed Medicines Off licensed medicines can be prescribed by both independent and supplementary prescribers. Before prescribing a medicine off license, it is best practice to: • • •

Ensure a licensed alternative is not available Ascertain the evidence base Ensure patients are informed of any off-licensed medicines being prescribed to them

Non-medical prescribers must abide by the PCT policy for off-licensed medicines.

8.3 Controlled Drugs All non-medical prescribers must abide by the PCT policy for controlled drugs.

8.3.1 Nurse Independent Prescribers Only nurse independent prescribers may prescribe some Controlled Drugs independently.

However the nurse independent prescriber must have specified which of the following controlled drugs he/she intends to prescribe on the independent prescribing proforma (see appendix B). This proforma will need to be submitted to the Non Medical Prescribing Lead.

Nurse Independent Prescribers are able to prescribe independently the following list of Controlled Drugs for the medical conditions indicated:

Section 8 Page 19

Drug

Indication

Buprenorphine

Transdermal use in palliative care Treatment of initial or acute withdrawal symptoms caused by the withdrawal of alcohol from persons habituated to it.

N/A N/A Use in palliative care, pain relief in respect of suspected myocardial infarction or for relief of acute or severe pain after trauma, including in either case postoperative pain relief Use in palliative care, treatment of initial or acute withdrawal symptoms caused by the withdrawal of alcohol from persons habituated to it, tonic-clonic seizures N/A Transdermal use in palliative care Use in palliative care, tonic-clonic seizures Use in palliative care, tonic-clonic seizures Use in palliative care, pain relief in respect of suspected myocardial infarction or for relief of acute or severe pain after trauma, including in either case postoperative pain relief.

Use in palliative care, pain relief in respect of suspected myocardial infarction or for relief of acute or severe pain after trauma, including in either case postoperative pain relief.

Use in palliative care

Chlordiazepoxide hydrochloride

Codeine phosphate Co-phenotrope Diamorphine hydrochloride

Diazepam

Dihydrocodeine tartrate Fentanyl Lorazepam Midazolam Morphine hydrochloride

Morphine sulphate

Oxycodone hydrochloride

Section 8 Page 20

Route of administration Transdermal Oral

Oral Oral Oral or parenteral

Oral, parenteral or rectal

Oral Transdermal Oral or parenteral Parenteral or buccal Rectal

Oral, parenteral or rectal

Oral or parenteral administration in palliative care

For the purposes of nurse independent prescribing, palliative care means the care of patients with advanced, progressive illness.

Currently the Home Office are consulting on independent prescribing of controlled drugs by nurse and pharmacist independent prescribers. This consultation will end on June 15th 2007. Should the legislation be amended which permits changes to controlled drug prescribing by independent nurse and pharmacist prescribers, this policy will be amended.

8.3.2 Supplementary Prescribing of Controlled Drugs All controlled drugs can be prescribed by supplementary prescribers. Supplementary prescribers must abide by the requirements of DH (2005) when prescribing controlled drugs using this arrangement.

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9

Patients

The DH (2006) asserts that non-medical prescribing provides benefits to patients as follows: • • • •

improved patient care without compromising patient safety; easier and quicker access for patients to the medicines they need; increased patient choice in accessing medicines; better use of the skills of health professionals;

For the PCT, non-medical prescribing would assist the provision of more patient-centred services. It would enable rapid access to medicines with the use of less health care professionals in the patient journey, thus enhancing the patient experience.

This section details how patients’ issues are central in non-medical prescribing.

9.1

Patient and Public Involvement

The PCT is committed to effective communications with patients and local people and will ensure that the patient experience is constantly being evaluated and improved upon.

Furthermore the patient experience of non-medical prescribing will be captured by the audit arrangement of non-medical prescribing described in section 7.2.3 of this policy.

9.2

Patient Information

Patients should be informed of the status of those prescribing medicines to them.

Information leaflets on non-medical prescribing should be produced in different presentational formats to meet the differing language and visual needs of patients.

9.3

Patient Consent

Patients must be informed of the status of those prescribing medicines to them and provide their consent before a non-medical prescriber should proceed. This consent must be recorded in the patient’s notes.

Section 9 Page 22

10 - General Guidance 10.1 What can be prescribed by Non Medical Prescribers?

Community Nurse Practitioners who have completed the necessary training can prescribe only items listed in the Nurse Prescribers’ Formulary for Community Practitioners (NPF). This can be found in the appendix of the British National Formulary (BNF) and in part XVIIB(i) of the Drug Tariff.

Nurse Independent Prescribers who have competed the necessary training programme can prescribe any licensed medicine for any medical condition, including some controlled drugs. The disease management areas that prescriptions are to be issued for, must have been agreed and approved prior to any prescribing taking place. See section 6.1 Pharmacist Independent Prescribers can also prescribe any licensed medicine for any medical condition, but currently cannot prescribe any Controlled Drug independently. See section 6.1 Supplementary prescribing was introduced in April 2003 for nurses and pharmacists. It was extended to physiotherapists, chiropodists/podiatrists, radiographers and optometrists in May 2005.

Supplementary prescribing is a voluntary prescribing partnership between the independent prescriber (doctor or dentist) and supplementary prescriber, to implement an agreed patient-specific clinical management plan (CMP), with the patient’s agreement.

Following agreement of the CMP, the supplementary prescriber may prescribe any medicine for the patient that is referred to in the plan, until the next review by the independent prescriber. There is no formulary for supplementary prescribing, and no restrictions on the medical conditions that can be managed under these arrangements.

Supplementary Prescribers can prescribe Controlled Drugs and unlicensed medicines in partnership with a doctor, where the doctor agrees within a patient’s CMP Non medical prescribers may prescribe only: • For patients they have personally assessed • Using their own prescription pad or personalised computerised prescriptions • With an agreed Clinical Management Plan (CMP) for Supplementary prescribers • Only as described in the formulary or CMP • Within their own agreed level of professional competence and expertise • No more than six repeat prescriptions, and only for patients they have reviewed within the last six months

Non medical prescribers may not prescribe: • Outside their own agreed areas of competence and expertise.

• For themselves, family or friends • On another prescribers prescription pad • On behalf of another person • When an item has been administered to a patient using GP or clinic stock items.

Section 10 Page 23

• •

For patients in GP practices not covered within the PCT, for which a prescribing budget has not been agreed.

For patients they believe may have received a recent prescription for the same product, but have been unable to assess the relevant documentation

10.2 Prescription Writing For further guidance refer to Prescription writing: British National Formulary • Writing must be clear and legible using indelible ink • A line should be inserted between each item being prescribed • Space should be blocked out using a ‘Z’ line • Prescriptions may be computer generated if this facility is available • The prescription must be completed with the following details: Patient Details: • Full Name (forename and surname) • Full Address (including postcode) • Age & Date of Birth should preferably be stated. This is a legal requirement when prescribing Prescription Only Medicines to children under 12 years of age Details of the items to be supplied: • Name, form and strength • Dose and frequency • Directions • Quantity • • •

Signature & date Code for the practice where the patient is registered Non medical prescribers contact telephone number

The names of medicines should be written clearly using approved generic titles, wherever possible.

Prescribers working for more than one organisation or practice will need separate prescription pads corresponding to the organisation or practice for which they are to prescribe.

Prescribers employed by the Primary Care Trust and working across different practices can use one prescription pad, but must add the relevant practice number for each patient for whom they prescribe.

It is the responsibility of the non medical prescriber and employer to ensure the security of the prescription pads at all times.

10.3 Record Keeping Prescription details must be entered immediately into the nurse’s patient records / parentheld child health records / professional record / Medication sheet, as appropriate.

The record should clearly indicate the date, name of prescriber, name of the item prescribed and the quantity prescribed.

Section 11 Page 24

For any medicinal preparations the dosage schedule and route of administration must also be documented.

For topical medicines, the quantity and frequency of application must be included.

GP records should be amended as soon as possible, but within 48 hours In some situations it may be necessary to advise the GP immediately of the prescription.

In these circumstances the action should also be documented in the records.

The GP may be informed: in person by telephone by secure fax

by Nurse Prescribing Communication Sheet by other local protocols agreed with the GPs If a prescription is given to a patient from another community nurses’ caseload. The caseload holder must be informed within 24 hours where possible, but within 48hours of writing the prescription. The caseload holder may be informed by any of the routes above, or by e-mail.

10.4 Recording and Security A permanent record of prescription pad serial numbers must be recorded by the prescriber when prescription pads are received.

Prescription forms must not be pre-signed before use Prescription forms must not be provided for another prescriber When travelling between patients the prescription pad must not be visible and must be locked in the car boot (within the nursing bag for nurses) The nursing bag and prescription pad must always be removed from the car, when the car is unattended (apart from exceptional circumstances where the risks of taking out the bag are deemed to be greater) On leaving the organisation or changing roles where prescribing is not undertaken, ALL remaining prescription pads MUST be returned to the Locality managers PA for secure destruction. They should be annotated as returned on the individual non medical prescribers prescription record log and signed out of the log when shredded.

10.5 Ordering and Supply of Prescriptions The non medical prescriber will receive notification from the Non Medical Prescribing Lead or Specialist Technician - Community and Support Services when the registration process is complete and prescribing can commence.

The non medical prescriber can commence to prescribe electronically with immediate effect. The non medical prescribers details must be added to the system prior to issuing any prescriptions to patients. This is to ensure any prescribing undertaken is attributable to Section 11 Page 25

the individual prescriber and that the regulations for writing prescriptions are complied with.

The following procedure explains how the PCT deals with the ordering and supply of Non Medical Prescribers Hand held prescription pads.

GP employed non medical prescribers Requests for prescription pads should be sent to WYCSA by the non medical prescriber, on a PN FP10 order form (This is available from WYCSA on request) This can either be faxed or posted to WYCSA at St Lukes House as instructed on the form.

The prescription pads will be returned to the individual non medical prescriber at the GP practice via the GP post bag system.

PCT employed Non Medical Prescribers Pharmacists and Allied Health Care Professional Non Medical prescribers Currently this cohort of prescribers use electronically generated prescriptions. However in the event of hand held pads being required, a request should be submitted using the order form (see Appendix E) to the relevant Locality Managers PA. See section 10.6.

The pads will be available to collect from the relevant Locality base when notified.

PCT employed Non medical Nurse prescribers Prescription Pads should be ordered using the process described in section 10.6 Responsibilities for Locality managers Personal Assistants (PA) Ordering, receipt, distribution and destruction of hand held prescription pads for PCT employed Non medical Nurse prescribers is the responsibility of the relevant Locality Managers Personal Assistants (PA).

10.6 Requirements for Handling Prescription Pads at Locality Bases Each Locality Base MUST have limited access secure lockable storage for prescription pads. The keys to this location must be kept by the Locality managers PA, or designated deputy, and the keys securely stored at the end of each working day.

Each non medical prescriber must have an individual file within the secure location containing a prescription record sheet (Appendix F) This will allow the following information to be recorded for audit and security: Non Medical Prescribers prescribing code number Base Contact telephone Number Sample signature for non medical prescriber Date and number of prescription pads ordered Name of person ordering Date prescription pads received Quantity of pads received To/From Serial numbers of prescriptions received Date prescriptions taken for use To/From Serial numbers of prescriptions taken for use Signature and name of person removing from file Signature of non medical prescriber collecting prescriptions.

Section 11 Page 26

The To/From Serial numbers of all prescriptions returned for destruction must also be entered on the sheet as ‘returned for destruction’ and signed by the Locality managers PA when securely shredded.

10.7 Ordering Prescription Pads Requests for a supply of prescription pads should be submitted directly to the appropriate locality managers PA. This is done by completing a prescription order form (See Appendix E) The nominated PA will record the order details on the prescription record sheet (see Appendix F) This will be placed in the named individuals folder and the order forwarded to WYCSA. This may be done electronically, by fax or by post.

No more than 2 pads should be ordered for each non medical prescriber. Requests for quantities which exceed this amount should be addressed to the Non Medical Prescribing Lead or Specialist Technician – Community and Support services by the PA before the order is placed.

WYCSA will order the prescription pads from the supplier using the details supplied on the submitted prescription order form.

When the ordered prescription pads are received by WYCSA, they will: • check the order against the delivery note and record the prescription pad details and serial numbers.

• Log out the prescription pads to the non medical prescriber at the relevant Locality base. The prescription pads will be placed in a sealed envelope along with a copy of the delivery note, and addressed for the attention of the named Locality managers PA. The envelopes must be stored securely until collected by the authorised transport driver.

• Ensure the authorised transport driver checks and agrees the number of envelopes against the acknowledgement slip. An acceptance signature will be provided by the driver prior to leaving WYCSA with the envelopes.

When delivering to Locality Bases the authorised transport driver will: • Hand the appropriate envelope to the named individual (or delegated deputy) If neither are available, the receptionist on duty can accept the envelope, and hand to the Locality Managers PA (or deputy) in person. A signature must be provided to the transport driver, against the acknowledgement slip as proof of delivery.

• Return the signed log sheet to WYCSA to complete the audit trail.

The Locality Managers PA will: • accept the relevant envelope, and sign against the appropriate entry on the drivers acknowledgement slip. If the PA is unavailable to personally accept delivery of the envelope, a designated named deputy should be available to accept delivery on behalf of the PA. • The prescription pads should be checked against the copy delivery note, and the to /from serial numbers annotated onto the individual non medical prescribers prescription record form. The delivery note should be retained for 2 years.

• The prescription pads MUST be securely stored in the designated file until the non medical prescriber collects the pads in person.

• The non medical prescriber MUST bring evidence of identity with them and sign for the prescription pads when collecting.

• It is not possible to collect another prescribers prescriptions on their behalf.

Section 11 Page 27

Loss or suspected theft of Prescriptions from community nurse prescribers In the event of loss or suspected theft, the nurse must report this immediately to: Relevant Locality Manager – who will inform: • WYCSA Support Services – SLH – 01484 466138 or 466009 • The police on 0845 606 0606 or Huddersfield 01484 436659 • •

The nurse should inform the GP (where appropriate) as soon as he/she is aware of missing prescriptions.

The prescriber must complete a PCT incident reporting form.

Information required will be the prescribers NMC number and the serial numbers for the prescriptions which have been lost / stolen (from – to). The serial numbers will have been recorded in either the back of the diary or on the WYCSA prescription record form.

Loss or suspected theft of Prescriptions from other non medical prescribers.

In the event of loss or suspected theft, the non medical prescriber must report this immediately to their line manager who will inform WYCSA Support Services, details as above and complete the relevant documentation.

WYCSA will require the prescribers details and the serial numbers for the prescriptions which have been lost / stolen (from – to).

Following loss / theft of prescription forms the prescriber will be requested by WYCSA Support Services to prescribe and sign all scripts in red for a period of 1 month. This information will also be provided to pharmacists within 24 hours5, where possible. The NHS Business Services Authority (NHS BSA) is also notified.

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11.

Appendices

A.

Course Details, Yorkshire and Humber SHA Taught (T) Distance Learning (D) T

University

Course Leader Contact Details

Profession Trained

The University of Bradford

Jenny Adams 01274 236 472 j.adams@bradford.ac.uk

Nurse AHPs

Jeff Pearse 07773 639290 or as above J.A.Pearse@bradford.ac.uk Andrew McEwan 0113 2832600 ex 24413 a.mcewan@leedsmet.ac.uk Catherine Gill 0113 343 1297 (Nurses) C.gill@leeds.ac.uk

Pharmacist***

T

Nurse AHPs**

Dr Barry Strickland-Hodge 0113 343 1346 (Pharmacists) B.Stricklandhodge@leeds.ac.uk Val Mills 01484 473450 v.mills@hud.ac.uk Jan Denton 0114 225 2549 J.V.Denton@shu.ac.uk Jill Davies 0114 222 9681 Jill.Davies@sheffield.ac.uk Gerri Kaufman 01904 3211629 Gk8@york.ac.uk Sandra Burley 01482 464515 S.Burley@hull.ac.uk

Leeds Metropolitan University The University of Leeds

The University of Huddersfield Sheffield Hallam University The University of Sheffield The University of York The University of Hull

* ** ***

Approximate Course Length Course Start Dates *

February October

4-5 months

T

February September

6 months

Nurse

T

January September

3 or 6 months

Pharmacist***

T D

(enquire separately for D)

Nurse AHPs

T

January September

6 months

Nurse AHPs Pharmacist*** Nurse

T

February September

6 months

T

March September

6 months

Nurse AHPs** Pharmacist*** Nurse AHPs** Pharmacist***

T

Sept

6 months

T

January September

6 months

Check with the university for exact dates These universities are developing courses for allied health professionals. Enquire about anticipated start dates Enquire separately to see if the SP to IP conversion course available

Section 11 Page 29

B - Independent Prescribing Proforma Intention to Practice as an Independent Nurse or Pharmacist Prescriber Please complete this form electronically, then print, sign and arrange for manager and lead clinician to sign.

Name: Role:

Base: Phone no: undertaken supporting State items to be prescribed and of CPD guidelines worked to, or attach to prescribing within this area protocols. this

Disease Area

Evidence Competence prescribe for disease area

e.g. Asthma

e.g. Asthma Diploma or e.g. Formal updates, courses attended 10 years experience (whatever is applicable) Please give as (whatever is applicable) much information as possible including dates attended etc.

Continued overleaf

Section 11 Page 30

You may list individual items or make reference to guidelines or sections of BNF. Prescribing intentions must be clear and the evidence base identified.

Have you received a prescribing related appraisal in last 12 months?

If so when and with whom If not identify when and with whom this will take place.

Do you receive clinical What plans do you have to supervision for your audit your prescribing?

Please provide a brief description prescribing role?

If so please give brief description If not identify how you will receive clinical supervision for your prescribing role.

Have you identified any CPD needs related to prescribing?

If so how do you plan to address these needs?

Independent Prescribers signature: Date: My intended scope of prescribing practice has been discussed and agreed with my manager and lead clinician Managers Name: Managers Signature: Date: Lead Clinicians Name: Lead Clinicians Signature: Date: Please send the completed and signed form to Lucianne Ricketts Non Medical Prescribing Lead at PRCHC. along with an electronic version to – Lucianne.Ricketts@kirkleespct.nhs.uk A copy should be retained by the Non Medical Prescriber and Manager.

Section 11 Page 31

C - Independent Prescribing Proforma Additions Form Additions to Practice as an Independent Nurse or Pharmacist Prescriber Please complete this form electronically, then print, sign and arrange for manager and lead clinician to sign.

Name: Role:

Base: Phone no: undertaken supporting State items to be prescribed and of CPD guidelines worked to, or attach to prescribing within this area protocols. this

Disease Area

Evidence Competence prescribe for disease area

e.g. Asthma

e.g. Asthma Diploma or e.g. Formal updates, courses attended 10 years experience (whatever is applicable) Please give as (whatever is applicable) much information as possible including dates attended etc.

You may list individual items or make reference to guidelines or sections of BNF. Prescribing intentions must be clear and the evidence base identified.

Independent Prescribers signature: Date: My intended amended scope of prescribing practice has been discussed and agreed with my manager and lead clinician

Continued overleaf

Section 11 Page 32

Independent Prescribing Proforma Additions Form Independent Prescribers Name: Managers Name: Managers Signature: Date: Lead Clinicians Name: Lead Clinicians Signature: Date: Please send the completed and signed form to Lucianne Ricketts Non Medical Prescribing Lead at PRCHC. along with an electronic version to – Lucianne.Ricketts@kirkleespct.nhs.uk A copy should be retained by the Non Medical Prescriber and Manager.

Section 11 Page 33

D – Clinical Management Plan Template

SUPPLEMENTARY PRESCRIBING CLINICAL MANAGEMENT PLAN (CMP) Patient Label / Details

Existing Patient Medication not covered under CMP

Allergies / Sensitivities

Independent Prescriber(s)

Supplementary Prescriber(s)

Condition(s) to be treated

Aim of treatment

Treatment plan

Indication

Preparation & Dosage

Dose Schedule

Section 11 Page 34

Referral back to the Independent Prescriber

Review & monitoring:

Supplementary Prescriber

Independent Prescriber

Process for reporting Adverse Drug Reactions Yellow Card Scheme IR1 if applicable

Documentation & Record Keeping

Guidelines supporting Supplementary Prescriber’s treatment plan

Names of Independent Date Prescriber(s) managing this patient’s CMP

Name(s) of Date supplementary Prescriber(s) prescribing from this CMP

Section 11 Page 35

Date agreed with patient / carer

Appendix E Tel: 01484 466000 Ext: 6094 Fax: 01484 466089

St Luke’s House Blackmoorfoot Road Crosland Moor Huddersfield HD4 5RH

Community Nurse Prescribers and Nurse/Pharmacist Independent Prescribers Hand Held Prescription Pad Order Form (Pads of 50) PCT CODE 5N200 Locality Base Details:

Prescriber to complete details in boxes below and forward to Locality managers PA Prescriber name

Prescriber Registration No

No of pads required

Please State: Community Nurse or Nurse/Pharmacist Independent Prescriber

Locality Manager: ……………………………………………………………………………

PA Name and Contact: ……………………………………………………………………...

Orders can be sent by Fax, Post or E-mail.

Fax No: 01484 466089 Post to: Support Services, St Luke’s House, Blackmoorfoot Road, Crosland Moor, Huddersfield HD4 5RH E-mail: Orders.Huddersfield@wycsa.nhs.uk FURTHER COPIES OF THIS ORDER FORM OR PRACTICE STOCK SHEETS CAN BE REQUESTED BELOW

FORM NUMBER

PLEASE SUPPLY THE FOLLOWING

FP10/C

Request for Prescriptions Form

CN/SCS

Stock Control Sheet for Prescriptions

Section 11 Page 36

QUANTITY REQUIRED

F - Prescription Record Sheet for Non Medical Prescribers (NMP) Order and receipt of prescription pads Name:

Pin Number:

Base:

NMP Sample signature:

Date and Quantity of pads ordered

Date and Quantity of pads received

Serial Numbers From

Serial Numbers to

Serial Numbers From

Serial Numbers to

Signature of PA

Collection of prescription pads Date

Quantity of pads collected

Destruction of prescription pads Date Quantity of Serial Numbers From pads returned

Serial Numbers to

Section 11 Page 37

Reason for return

Signature of NMP and PA’s initials

Signature of NMP returning

Signature of PA when shredded

Section 11 Page 38