What's in a name? The complex conundrum of prescribing nomenclature in practice
Health professionals who can legally prescribe medication and medical devices, but who are not doctors or dentists, come from a wide range of backgrounds, including the Nursing and Midwifery Council, General Pharmaceutical Council, and some Health and Care Professions Council registrants. The professionals are often grouped together and defined as ‘non-medical prescribers’. This may or may not be a useful collective term as, depending on professional registration, these professionals may be afforded differing prescribing rights, which may include a combination of independent/supplementary prescribing, independent prescribing (only), supplementary prescribing (only), or community nurse practitioner prescribing activity. This article explores the confusing nomenclature around prescribing, and the impact the names and terms used in practice have on professions. The naming and identification of role should be facilitative, to allow others to understand the legal context of prescribing activity, boundaries, and role expectations.
Prescribing by health professionals other than doctors or dentists in the UK was first proposed in the Cumberledge report in 1986 (Department of Health and Social Security (DHSS), 1986). This was specifically for the nursing profession. The report highlighted that community nurses were wasting a significant amount of time seeking prescriptions from GPs for medications and items for which they had carried out a thorough clinical assessment. The report suggested that increased efficacy of practice, and better use of time, could be achieved if community nurses were able to undertake prescribing from a limited formulary. This recommendation was supported by the government, leading to the Report of the Advisory Group on Nurse Prescribing (Department of Health (DH), 1989), led by Dr June Crown. The report expanded on the Cumberledge report, recommending that district nurses and health visitors should be able to prescribe from a specific nurse formulary.
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