INTER AND INTRA PROFESSIONAL
PERSPECTIVES OF NON-MEDICAL PRESCRIBING IN HOSPITALS
Buckley
P (1), Blenkinsopp A (2), Grime J (2)
1 Pharmacy Department, Dudley Group
NHS Trust
2 Department of Medicines Management
Keele University paul.buckley@mcht.nhs.uk
Background
There have been numerous publications discussing the introduction of non-medical
prescribing as part of the government’s wider plan to modernise the NHS1,
2. However, there has been little research published to date on the
factors that might enable or inhibit the implementation of supplementary
prescribing. The research reported here forms part of a wider study of
non-medical supplementary prescribing in the hospital setting.
Aim
The aim of the study was to obtain the views of key stakeholders about
non-medical supplementary prescribing in one NHS Trust.
Method
Fifteen semi-structured interviews were conducted using a pre-piloted
interview schedule and involved a purposive sample of Trust stakeholders
including 3 pharmacists, 4 doctors and 3 nurses of different levels of
experience and background, a patient, the Trust Clinical Governance Officer and
3 Trust managers. The interview explored respondents’ understanding of
non-medical prescribing, possible benefits and potential applications to the
Trust, how participants felt that nurses, pharmacists, doctors and patients
would respond to non-medical prescribing and issues relating to resource
implications, training requirements and the organisation e.g. litigation.
Findings
All of the stakeholders thought that the principle of non-medical
prescribing was positive and were supportive of its introduction within the
Trust. However, stakeholders expressed some concerns relating to health care
professionals’ prescribing. Medical staff had reservations about non-medical
prescribing and felt it should operate within tightly controlled protocols .
Nurses were perceived by both doctors and
pharmacists as having close patient contact but insufficient pharmacological
knowledge to prescribe medicines.
Nurse respondents felt that some nurses would want to prescribe whilst others
would prefer to undertake more traditional nursing roles. It was suggested that
this could create friction within nursing ranks. Pharmacists were seen by
doctors and nurses as being experts in drug therapy but lacking diagnostic
skills and knowledge of patients to prescribe. Pharmacist respondents were less
positive about pharmacists prescribing than other stakeholders interviewed who
felt that pharmacists would be very keen to prescribe. Reasons identified for
pharmacist reticence included accountability and the need for financial
remuneration.
Conclusion
There was considerable support for non-medical prescribing within the Trust.
However, the study has identified that inter and intra professional
relationships will be a key factor in the implementation of non-medical
prescribing in hospitals.
References
-
Secretaries of State for
Health, Scotland & Wales Primary Care: Delivering the Future Department
of Health London Stationery Office 1996 CM 3512
-
NHS Executive. Primary Care:
the Future. Leeds Department of Health 1996
Presented at the HSRPP Conference 2005, Reading
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