Transcript Prescribing in Practice - Part1d - Slides15

Prescribing in Practice
Part 1 (d)
Regulations and Practitioners
Appropriate Practitioners
Originally there were only three
• A doctor
• A dentist
• A vet
Since non medical prescribing more have been added
• A community nurse practitioner
• A nurse independent practitioner
• A pharmacist & optometrist independent practitioner
• A supplementary prescriber (nurses, physiotherapists,
podiatrists, radiographers)
NHS Regulations (see MHRA)
• Blacklist-a list of substances that are not to be prescribed
under NHS pharmaceutical services. If one is prescribed
and the pharmacist dispenses it he will not be reimbursed
e.g. Otrivine nasal spray
• Borderline substances-substances that the NHS consider
to be less suitable for prescribing and will only pay for if the
Advisory Committee on borderline substances approves
that they are regarded as drugs e.g. specialised enteral
feeds or supplements
• Black triangle-a newly licensed drug that is being
intensively monitored ADR reporting important e.g.
fluticasone furoate nasal spray
Who can prescribe what?
‘Independent prescribing is prescribing by a
practitioner responsible and accountable for
the assessment of patients with diagnosed or
undiagnosed conditions and for decisions
about the clinical management required,
including prescribing’
(DH 2006)
Limitations
• May not prescribe blacklisted drugs
• May only prescribe CDs in certain
circumstances
Legislation on prescriptions
• To be legally valid, prescriptions must
comply with regulations made under the
Medicines Act.
• If an invalid prescription is filed the
pharmacist has committed a criminal
offence
Prescription Writing
Legal Requirements
Good Practice
• Your professional body standards on
prescribing/codes of conduct
• Local guidelines
• BNF guidelines
• DH guidelines
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