The Journey of Nurse Prescribing: From History to Practice.

by Barry Strickland-Hodge, Rebecca Dickinson, and Helen Bradbury

Nurse prescribing has undergone a remarkable transformation in the landscape of healthcare delivery over the past two decades, reshaping the roles and responsibilities of nurses in the UK. This evolution, driven by the recognition of nurses' expertise and the increasing demands of the healthcare workforce, has paved the way for thousands of nurses to gain authorization to prescribe medicines. This surge in prescribing nurses is not only meeting the needs of the National Health Service (NHS) but also revolutionizing patient care and service accessibility.

The origin of nurse prescribing in the UK traces back to 1992, prompted by reports highlighting the potential for prescribing to enhance efficiency and quality in healthcare. This marked a pivotal moment in history, culminating in the establishment of legislation granting nurses the authority to prescribe medicines. Despite taking six years for the legislation to take effect, its impact was significant. Initially, this privilege was limited to specialised community practitioners, such as health visitors and district nurses, who could prescribe from a designated range of items outlined in the Nurse Prescribers' Formulary (NPF). Over time, legislative amendments expanded prescribing rights, leading to a well-established practice with approximately 90,000 prescribers registered with the Nursing and Midwifery Council (NMC) today.

Two primary types of nurse prescribing emerged: community practitioner nurse prescribers (V100/V150) and nurse independent prescribers (V300), each characterised by unique qualifications and responsibilities. Community practitioner nurse prescribers operate within specific specialties, while nurse independent prescribers enjoy broader prescribing capabilities, including the authority to prescribe from the comprehensive British National Formulary (BNF).

Regulatory considerations have played a pivotal role in shaping the practice of nurse prescribing, ensuring that nurses possess the requisite knowledge and skills to prescribe safely and effectively. The Nursing and Midwifery Council (NMC) sets stringent standards for proficiency, underpinned by the adoption of the Royal Pharmaceutical Society's Competency Framework for All Prescribers. This framework underscores the importance of interdisciplinary collaboration and prescribing proficiency across various healthcare sectors, reflecting a commitment to ensuring optimal patient care.

The integration of prescribing knowledge and skills into pre-registration nursing programmes represents a significant milestone, enabling aspiring nurses to be 'prescribing ready' at the point of registration. This proactive approach empowers newly qualified nurses to embark on prescribing qualifications immediately after qualifying, thereby facilitating a seamless transition to prescribing responsibilities in clinical practice.

However, the journey towards nurse prescribing proficiency is not devoid of challenges. Governance structures must be robustly established to support practitioners throughout their prescribing journey, encompassing comprehensive training, supervision, and ongoing professional development. Furthermore, the dynamic nature of prescribing practice necessitates continuous adaptation and learning to stay abreast of emerging developments and best practices.

In response to the evolving landscape of nurse prescribing, a new textbook "Practical Prescribing for Nurses: Developing Competency and Skill" has been published to offer invaluable support to nurses at every stage of their prescribing journey. Edited by well-regarded professionals Barry Strickland-Hodge, Rebecca Dickenson, and Helen Bradbury, the textbook provides practical insights and guidance on essential prescribing topics.

To dig deeper into the book's content and gain additional insights from its contributors, tune in here to listen to a podcast in which the editors of the book Barry Strickland-Hodge and Rebecca Dickenson, discuss the essential content coverage of this comprehensive guide for nurses. Gain insight into the motivations behind writing and editing this book, designed to assist aspiring nursing professionals in navigating the world of prescribing. In this illuminating conversation, our expert authors explore the evolution of nurse prescribing practice, recent changes mandating graduate nurses to train as prescribers immediately after qualification, and the fundamental role of the patient in practice. Don't miss out on invaluable insights into the Competency Framework and nurse prescribing.

In conclusion, nurse prescribing in the UK has undergone a profound evolution, driven by a commitment to enhancing patient care and service accessibility. By equipping nurses with the requisite knowledge and skills to prescribe safely and effectively, nurse prescribing has emerged as a cornerstone of modern healthcare delivery. To explore further insights into nurse prescribing, gain a deeper understanding of the new textbook, and request an instructor’s inspection copy visit the book’s webpage here.

learn more about the book

Book Details
Practical Prescribing for Nurses: Developing Competency and Skills
Barry Strickland-Hodge, Rebecca Dickinson, Helen Bradbury
May 2024
ISBN: 9781529679434

About the Editors

Featured

Barry Strickland-Hodge MSc, PhD, FRPharmS, FHEA, Visiting Professor of Prescribing Practice at the University of Leeds and a doctoral supervisor for students at the university of Derby. He was a prescribing adviser to GP practices in Newham and Belfast for 15 years. He developed the prescribing course for pharmacists at the University of Leeds in 2003, with the first intake in 2004. Barry has an interest in the history of medicine and pharmacy and became an apothecary in 1990. He has written a number of books and papers on prescribing and information systems.

Featured

Rebecca Dickinson PhD, RGN, is programme lead for adult nursing at the University of Leeds and Chair of the School Ethics Committee. She supports teaching on the independent and supplementary prescribing course for nurses and midwives. Rebecca is interested in how to optimally support patients with understanding about taking their medicines and has a particular interest in promoting understanding of how risk of harm, likelihood of benefit and uncertainty about medicines are communicated to patients. Rebecca's PhD was jointly supported by the University of Leeds and the MHRA and focused on the provision of a headline section and additional benefit information in regulated patient information leaflets.

Featured

Helen Bradbury BSc., (Pharm)., MEd., FRPharmS., FHEA,. Visiting Associate Professor at the University of Leeds. Helen worked in the NHS as a hospital pharmacist for 20 years before commencing her academic career. Helen's subject specialities are clinical education, with an interest in pharmacy education, personal and professional development and interprofessional education. In her last role as professional lead for pharmacy she advised on the delivery of the independent prescribing programmes for nurses, midwives, pharmacists and allied healthcare professionals. She has published on reflective practice, interprofessional education and prescribing for medical students.