Achieving and maintaining competency as a nurse independent non-medical prescriber

The role of nurses and other non-medical healthcare professionals in prescribing has expanded dramatically in the United Kingdom (UK) since the Cumberlege report, which recommended nurses in the community should take on the role of prescribing to improve patient care (Community Nursing Review Team For England et al, 1986).

In 1992, primary legislation (Medicinal Products: Prescription by Nurses etc, 1992) was passed, allowing district nurses and health visitors to prescribe independently from a limited formulary. Following an extensive review of prescribing, supply and administration of medicines in 1999, nurses were permitted to prescribe from the nurse prescribers' formulary, which included all licensed pharmacy and general sales list medicines plus selected prescription-only medicines (Department of Health (DoH), 1999). This was known as dependent prescribing and was later renamed as supplementary prescribing (Cope et al, 2016). In 2006, legislation was passed allowing nurses who had successfully completed an approved prescribing course to independently prescribe any licensed medicines for any condition and a number of controlled drugs within their field of practice and competence (DoH, 2006). In 2009, further changes enabled independent non-medical prescribers (INMPs) to prescribe unlicensed medicines for their patients and to mix medicines themselves or direct others to do so (Medicines and Healthcare products Regulatory Agency (MHRA), 2009).