As I am sure many of you already know, 2020 is the World Health Organization's year of the nurse and midwife. As a nurse, this gives me immense pride in my profession, but also reminds me how many professionals can now become prescribers in 2020, an enormous leap forward from the nurse prescribing proposals made in the Cumberledge Report (1986).
Cumberledge (1986) suggested that care could be improved, and resources used more effectively if district nurses, health visitors and community midwives were able to prescribe from a limited list of medicines and adjust dose in line with protocols. How far we have come in just over 30 years!
Just this month, I have had to access our NHS on a regular basis for some ongoing health issues. I have come across a wide range of professionals along this particular journey, starting with my GP who referred me into specialist care. From there, it was a consultant and advanced clinical physiotherapist practitioner, and then onto a specialist nurse and, finally, a specialist pharmacist, before back to my GP. As a non-medical prescribing educator, I have heard that people are concerned that there is a blurring of boundaries because of the sheer number of prescribing professionals. My recent experience has caused me to view this slightly differently. I prefer to think of it as a special and complex Venn diagram. Each professional has their sphere of expertise, which often includes prescribing these days. These spheres overlap in places, as the formation of a cohesive multidisciplinary team emerges. At the centre, in the area of commonality, you find me, the patient, touched and influenced by each professional to provide a holistic package of care with my best interests at heart. The outcome for me (which has been positive on this occasion, I am pleased to say I am regaining health) is access to and involvement of all the relevant professionals who can contribute to my care. This positive outcome would not have been possible without contributions from all of the professionals. It is actually almost irrelevant who generates the prescription in the end (they all could!), what is important is that the prescribing decision was reached through a multidisciplinary approach in which I was fully informed and involved all the way
It makes me so proud of our NHS, which at its best, is unrivalled for patient care at the point of need. What struck me though, was none of the professionals I was seen by saw themselves as doing anything ‘special’ as this team approach seemed embedded in their everyday roles. This is true professional progress and acceptance of the role of each member, recognising the need to understand each other in order to function in the most effective way. I hope you recognise some of this in your everyday practice, and remember how much what you do means to those who receive your care.
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