A Review of the Legal Framework for Accountable Nurse Prescribing

A rapid expansion of nursing prescribing as part of the new role of the nurse in primary hospital care is a clarification. This book summarizes the history and key elements of its development. This is not a book on clinical pharmacology and therapies for nurses, and it also avoids a detailed study of how a prescribing nurse would be trained to diagnose and treat patients with more complex diseases. It could also be shortened by merging several chapters. The next issue will be very interesting and hopefully contain more case histories based on the expanded formula and the results of prospectively planned research. This article examines some current legal issues related to non-medical prescribing and highlights some cases where prescribing physicians have come into conflict with the law and its consequences. It will also examine some of the recent case law that influences the provision of safe and well-informed care. These cases affect all types of prescribers and ignorance of these requirements is not a legal defence. The Second Crown Report, 1999, covers a much broader mandate than that of community nurses, detailing the importance of appropriate professional training to be prescribed not only to nurses, but also to pharmacists, optometrists, podiatrists and others. This will lead to a fundamental change in prescribing practices, enshrined in the National Health Services Plan of July 2000 and published in Reform for NHS Staff – Taking Forward the NHS Plan. In this regard, prescription by nurses is only part of the new forms of teamwork described in this report.

Unfortunately, the preview is currently not available. You can download the document by clicking on the button above. NMSs have reported that prescribing power increases their job satisfaction and confidence, makes them more independent, and allows them to make better use of their skills [George et al., 2007; Courtenay and Berry, 2007; Watterson et al., 2009]. They also reported that they feel it improves their relationships with patients [Latter et al. 2005]. However, while MPNs clearly benefit from the prescribing authority, some nurses who prescribe have highlighted the increased pressure and workload that prescribing requirements entail [Watterson et al., 2009]. Under English and Welsh law, a patient can remedy the situation if the care given (or not given) is negligent and causes foreseeable harm. The remedy is made in a procedure known as “tort law”, which is usually dealt with by the civil courts. Most cases are settled by a civil court and, if liable, the health professional may be awarded financial damages. However, if cases of professional negligence are so extreme and considered “criminal negligence,” they can be tried by a criminal court and carry a prison sentence if it is decided that the medical professional is guilty of the crime, such as manslaughter. The recommendations of the Cumberlege Report (DHSS, 1986) were reviewed by an advisory group chaired by Dr.

June Crown and published in the Crown`s First Report [Department of Health, 1989]. However, it took another 3 years until 1992 for legislative amendments allowing community nurses to prescribe as part of a care plan the Expanded Form for Prescribing Nurses [DHSS, 1992]. In 1998, after the apparent success and acceptance of the prescription of community nurses in this way and the testing and evaluation of the independent prescription, the Secretary of State announced that district nurses and health visitors were now legally able to prescribe Formily independently of the prescribing nurse renamed Nurse Prescriber. Patients report benefits similar to those of non-medical prescribing as those of doctors and NPMs. Specific benefits of contacting independent prescribers in dermatology and diabetes care included greater flexibility and access to appointments, better continuity of care, and a perception of a more attentive counselling style [Courtenay et al., 2011; Stenner et al., 2011]. Patients also reported feeling that their condition was better controlled and that they were happier with their medications since they saw an NMP [Latter et al. 2010]. This is despite initial concerns among some patients that physicians provide safer care than MFNs [Stewart et al., 2008; The latter et al., 2010].

If a patient has suffered damage or loss as a result of the actions of a prescribing physician, they can file a civil lawsuit to be compensated, especially if they have become too ill to work. The applicant (patient) would only have to prove by means of a “balancing of probabilities” that the prescribing physician is to blame. The Royal Pharmaceutical Society (2016) has established a competency framework for all prescribers that governs all prescribing physicians, including medical and non-medical prescribers, and is the standard by which all prescribing physicians are tried in civil law. If it could be proven that a prescribing physician was below the expected standard, for example by not being able to know if a patient was allergic to penicillin or if he had prescribed a drug that interacted with his existing drugs, the prescribing physician would be liable. Students who participate in a non-medical prescribing program are already health professionals with some degree of experience and therefore already have existing knowledge and skills in their areas of work. It is therefore important that the DMP and the student are actively involved throughout the training in order to be aware of the student`s existing skills and identify the student`s learning needs. It should therefore be considered that health professionals undergoing training to become prescribers should be considered competent in their field of activity as prescribing physicians at the end of the programme. During the 2016/17 period, 53,967 pharmacists were registered in the register of the General Pharmaceutical Council (GPhC). A total of 1889 concerns were raised, resulting in the dismissal of 17 registrants. Several isolated cases have highlighted problems related to unsafe practices; poor record of medications received or dispensed, including controlled medications; and incidents of drug diversion, including pharmacists or pharmacy technicians, who illegally supply or sell drugs such as fentanyl for recreational purposes (GPhC, 2017). A non-medical prescriber is liable to his employer through the employment contract.

The contract set out the conditions of employment and the level of work expected of the employee (Rideout, 1983). An employer is liable on behalf of the actions of its employees and should pay compensation. Employers minimize the likelihood of liability by holding their employees accountable through appropriate contractual disciplinary procedures.