Non Medical Prescribing .


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Non Medical Prescribing. Alison Hogg. DRIVERS FOR CHANGE. Cumberlidge report The NHS Plan – 2000 Modernising the NHS Patient centred services More flexible Improved access Better use of resources Challenge existing roles Change to junior doctors working hours Change to GP contracts
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Non Medical Prescribing Alison Hogg

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DRIVERS FOR CHANGE

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Cumberlidge report The NHS Plan – 2000 Modernizing the NHS Patient focused administrations More adaptable Improved get to Better utilization of assets Challenge existing parts Change to junior specialists working hours Change to GP contracts Change to Community Pharmacists contracts

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Overview of Community Pharmacy Services New Contract Started 1 st Apr 2005, Benefits Improve access to group drug store Expand scope of administrations gave Make better utilization of drug specialist aptitudes Help diminish workload weights on GPs and Dentists 3 levels of administration: Essential, Advanced, Enhanced

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Enhanced Services Suggested Enhanced Services Minor Ailments Smoking Cessation Supervised Administration of Medicines Anticoagulant Monitoring Needle Exchange Schemes Care Home Support Emergency Hormonal Contraception Schemes Medicines Review Primary Care Trusts [PCT\'s] may commission to address neighborhood issue May actualize perceived administrations or build up claim activities

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Patient Group Directions A strategy composed by Dr, Senior Manager, Pharmacist, and Senior expert from Profession utilizing the PGD. Power originates from the association – responsibility likewise falls with association Not recommending

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Patient Group Directions Legislation to enhance access to solutions No individual remedy however Dr signs guidelines for Specific Patient Group Named wellbeing proficient approved to: Supply a pre-named, settled amount prescription or Administer altered amount drug

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Specific exceptions Specific exclusions in pharmaceuticals enactment to supply or oversee medications e.g. birthing specialists, podiatrists, paramedics Not endorsing

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EARLY PRESCRIBING

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THE HISTORY 1986 Recommendation for medical caretakers to go up against recommending part [Cumerlidge Report ] 1998 DOH presented the Nurse Prescribers model for District Nurses and Health Visitors in England.

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THE HISTORY 1999 Crown Report perceived potential for expanding attendant recommending 2002 Nurse Prescribers Extended Formulary (extended again in 2003 and 2004)

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THE HISTORY Meanwhile – in 1999 Suggestion of supplementary endorsing

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THE HISTORY 2003 Supplementary recommending preparing for medical caretakers and drug specialists started 2005 Supplementary recommending preparing for united wellbeing experts started

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THE HISTORY 1 st May 2006 Prescribing powers stretched out for medical caretakers, birthing assistants and drug specialists Independent endorsing

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Independent Prescribing DH definition Independent endorsing implies that the prescriber assumes liability for the clinical appraisal of the patient, building up a conclusion and the clinical administration required, and additionally duty regarding endorsing where fundamental and the propriety of any remedy. Specialists, dental specialists and a few medical caretakers are free prescribers.

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Supplementary Prescribing DH definition \'… a willful recommending organization between a free prescriber and a supplementary prescriber, to actualize a concurred tolerant particular clinical administration arrange with the patient\'s understanding .\'

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Doctor BNF Dentist Dental Formulary [NHS] Community Specialist Nurses, District Nurses, Health Visitors, Practice Nurses, School Nurses Nurse Prescribers\' Formulary for Community Practitioners Nurse/Midwife/Pharmacist qualified as an Independent Prescriber Any Licensed Medicine including a few CDs (nurture no one but) Who can endorse solutions? (Autonomous Prescribing)

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Who can recommend meds? Supplementary Prescribing Nurse, Midwife, Pharmacist Allied Health Professional General Sales List Pharmacy Only Drugs Prescription Only Medicine Controlled Drugs General Sales List Pharmacy Only Drugs Prescription Only Medicine

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Non Medical Prescribers DoH 2006

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EDUCATION

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Entry Requirements Registration Practice Support Approved therapeutic expert Relevant post qualifying knowledge Academic capacity

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Curricula advancement Department of Health Nursing and Midwifery Council Royal Society Pharmacists Great Britain Health Professions Council

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ALISON HOGG DIANNE BOWSKILL Inter proficient instruction 3 Universities cooperating to create one bury proficient program to be conveyed at the three Universities PETRA CLARKE

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AHP\'S NURSES PHARMACISTS Non Medical Prescriber

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Barriers to Overcome WORKING WITH OTHER UNIVERSITIES VALIDATION AND PROFESSIONAL BODIES FIT FOR PRACTICE PROFESSIONAL DIFFERENCES

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Programs Developed Undergraduate Practice Certificate in Non Medical Prescribing Independent and Supplementary Prescribing for Nurses Supplementary Prescribing for Pharmacists and Allied Health Professionals

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Programs Developed Post Graduate Practice Certificate in Non Medical Prescribing Independent and Supplementary Prescribing for Nurses Supplementary Prescribing for Pharmacists and Allied Health Professionals

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Perceived shared proficient substance Influence on and the brain science of endorsing Prescribing in a group setting Evidence based practice and clinical administration in connection to nurture recommending Legal strategy and moral perspectives Professional responsibility and duty Prescribing in a general wellbeing setting Supplementary endorsing

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Perceived proficient substance contrasts Consultation, basic leadership hypothesis, including referral Clinical pharmacology, including the impacts of co-bleakness

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Assessment Course Work 1 Practice OSCE on meeting abilities Clinical Management arrange Course Work 2 MCQ Poster presentation Short answer addresses Course Work 3 Reflective task

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STUDENT DATA

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Cohort Profiles June 05 - 07

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Professional Profiles Nurses

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Professional Profiles AHP\'s

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Professional Profiles Pharmacists

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ISSUES

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The Issues Previous limitations Relaxing of directions Service necessity for fitness Challenge of administration discharge Varied foundations of understudy Varied recommending parts Joint enlistment for IP & SP CPD

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Future Issues Extension of free and supplementary recommending to other expert gatherings Pre enrollment training Role/aptitudes improvement Role/aptitudes weakening Level of endorsing training Clinical administration CPD

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