Legislative Essay: Impact of Non-Medical Prescribing Changes

This essay delves into the recent legislative changes concerning non-medical prescribing, with a specific emphasis on the implications for accountability and responsibility within healthcare practice. The essay begins with an introduction that sets the context for the development of non-medical prescribing and its impact on practice. The main body of the essay explores the evolution of non-medical prescribing in the United Kingdom, detailing the expansion of prescribing rights to various healthcare professionals, including nurses, pharmacists, and allied health professionals. It examines the legislative changes that have facilitated this expansion, referencing key reports and policy changes. The essay also highlights the impact of these changes on patient care, healthcare professionals, and the healthcare system as a whole. The essay concludes by summarizing the key points and emphasizing the positive impact of these legislative changes on the practice of aesthetic medicine nurses. The provided references support the claims made throughout the essay.

COURSEWORK PROJECT SUBMISSION AND RESPONSE SHEET
Short Course Programme in Prescribing Leader:
Title of Coursework: Legislative Essay
Coursework is receipted on the understanding that it is the student’s own and that it has not, in
whole or in part been presented elsewhere for assessment. Where material has been used from
other sources it has been properly acknowledged in accordance with the School of Pharmacy’s
Regulations regarding Cheating and Plagiarism.
Tutor’s comments
– you have a lot to do to get this to a pass.
You need to think about the structure of the essay in order for it to make sense and
flow logically. As you have not applied the criteria for a draft (see information on
how to submit a draft on moodle) I have not been able to feedback on this entirely.
You will see that I have only given feedback on the first section.
You must reference every claim. You need to improve your citation which is not
accurate. There is plenty of guidance on moodle so use it to get this right.
Have the essay question next to you to help you stay focussed and to make sure you
answer it.
Make sure that you write about what your job is and how it will change once you are
a prescriber. So explain how your patients get their medicines now and how that will
improve once you are a prescriber. Then you need to say how your responsibilities
and accountability will change once you are a prescriber and apply the points to
your own practice.
You need someone to proof read your essay because your grammar is weak. Try to
improve this before you submit.
Try to avoid arbitrary statements which do not answer the question and are not
analysed or applied to your own practice.
Your reference list also needs improvement – see my comments.
Use and apply the feedback from your case study, to this essay to help you improve.
Next time you submit a draft, please follow the guidance rather than submitting what
is almost a complete essay.
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Grade Awarded______
Tutor’s signature _____________________ Date___________
Moderation required: yes/no Moderator_____________ Date__________
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INTRODUCTION
This is an essay report reviews the recent legislative changes in context of the
development of non-medical prescribing and its impact on practice with specific emphasis on
accountability and responsibility (Surratt, and et. al., 2014).
MAIN BODY
Recent legislative changes in relation to prescribing and the impact of these changes on
practice with a particular focus on accountability and responsibility
Louise, Aseel and Mary, (2016), In United Kingdom, the non-medical prescribers
currently involved nurses, pharmacist and some allied health professionals, who all are
registered with relevant professional regulatory body (Cope, Abuzour, and Tully, 2016). Since
1992, non-medical prescribing has been allowed, the types of professionals who are eligible to
become non-medical prescribers, the number of non-medical prescribers as well as range of
medicines they are able to prescribe legally has grown (Louise, Aseel and Mary, 2016). In
clinical commissioning program for National Health Services in United Kingdom, the non-
medical prescribers play a significant role (Nonmedical prescribing: where are we now? (2016).
According to the Cumberlege Report, it has been reviewed the care which was given to
patients by health visitors and district nurses in their homes. It has been suggested in the report
that the access of patients to treatment could be improved, the resources could be used more
effectively and the patient care could be enhanced if community-based nurse were allowing to
prescribe from some items like ointments and wound dressings. Previously, the community
nurses often wasted time waiting for prescriptions to be signed by general practitioners. There
are some changes which have been made to improve the situation. This enable community
nurses to prescribe medicine (Haegerich, and et. al., 2014).
After apparent success as well as acceptability of community nurse as prescribers in
year 1998, the health visitors and district nurses were also legally allowing to prescribe
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independently. The nurses were now allowing to prescribe from Nurse Prescribers Formulary,
plus general sales list medicines, selected prescription only medicines and all licensed
pharmacy medicines. In period between year 1999 and year 2002, the several published reports
by Department of Health as well as other agencies allowed government to extend
responsibilities of supplementary prescribing to other health professions involving pharmacist.
It was announced in year 2005 that, from spring 2006, the qualified Extended Formulary Nurse
Prescribers would enable to prescribe any licensed medicine, with exception of controlled drugs
(Cope, Abuzour, and Tully, 2016).
The independent prescribing is referred as prescribing through a practitioner,
accountable and responsible for assessment of patients with diagnosed or undiagnosed
conditions as well as for decisions regarding clinical management needed, involving
prescribing. The department of health in year 2005, permitted introduction of supplementary
prescribing through podiatrist and physiotherapist. After 2 years, optometrists joined health
care professionals are able to prescribe medicines independently (Webster, and Grabois, 2015).
The National Health Services England announced new legislation which permitting
supplementary prescribing by dietitians and independent prescribing through therapeutic
radiographers. Currently, only nurses and pharmacists have been provided with the authority to
prescribe medicine outside the United Kingdom, and not allied health professionals.
In United States of America, Florida is the only state which has permitted independent
prescribing to pharmacist from limited list of medicine. The pharmacists prescribe alongside
doctors in collaborative drug therapy management clinics in at least 16 other states in America.
All the other states operate either independent prescribing utilizing locally agreed protocols or
dependent prescribing with an agreed management plans. Other than the United Kingdom,
prescribing through pharmacist is not currently permitted anywhere else in Europe (Non-
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medical prescribing in the United Kingdom National Health Service: A systematic policy
review, 2019).
The influence of non-medical prescribing can be analyzed from the perspectives of non-
medical practitioners, patients and other health care professionals or from the perspective of
results of prescribing. Currently, the influence of prescribing practices of podiatrists,
optometrists and physiotherapist is very limited, but must be expected to maximize when
evaluations of recently gained prescribing authority have been performed. Non-medical
prescribing makes the healthcare professionals more independent and enable them to better use
their skills. Apart from this, it increases self-confidence as well as job satisfaction of the
healthcare professionals (Fink, and et. al., 2018). It improves their relationship with patients
and non-medical prescribers benefit from prescribing authorities. It contributes in improving
the quality of care for patients and provide them with more convenience and choice.
Prescribing is complex skill which is the error prone and highly risky. The influences on
prescribing are multifactorial, however could be categorized subjectively as attitudes, skills and
knowledge of individual and the context in which prescribing takes place. The factors which
influence on the practical element of prescribing involves time since qualifying, good
grounding in knowledge, training, continuous practice, use of formularies or guidelines and
multidisciplinary support (Lyapustina, and et. al., 2016). The emphasis of government policy in
regards of non-medical prescribers is the desire to enhance access of patient to medicines. The
change in government also explains delay in extending control drug describing for pharmacist
independent prescribers and nurses. The impact of these changes in legislation on the practice
of an aesthetic medicine nurse is positive. These changes enable to prescribe medicines to
patients according to agreed clinical management plan and permitted through professional
relevant legislation. In independent and supplementary prescribing, the nurse is accountable for
care, diagnose and confirm the diagrams, assess to patient, plan clinical management and
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prescribed range of medications (Non-medical prescribing within the context of aesthetic
practice, 2017).
CONCLUSION
As per the above provided essay, it has been concluded that some legislative changes were
made in relation to non-medical prescribers. It impacts optimistically on the practice as an
anesthetic medicine nurse.
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References
Surratt, H.L., O'grady, C., Kurtz, S.P., Stivers, Y., Cicero, T.J., Dart, R.C. and Chen, M., 2014.
Reductions in prescription opioid diversion following recent legislative interventions in
Florida. Pharmacoepidemiology and drug safety, 23(3), pp.314-320.
Haegerich, T.M., Paulozzi, L.J., Manns, B.J. and Jones, C.M., 2014. What we know, and don’t
know, about the impact of state policy and systems-level interventions on prescription
drug overdose. Drug and alcohol dependence, 145, pp.34-47.
Cope, L.C., Abuzour, A.S. and Tully, M.P., 2016. Nonmedical prescribing: where are we
now?. Therapeutic Advances in Drug Safety, 7(4), pp.165-172.
Webster, L.R. and Grabois, M., 2015. Current regulations related to opioid
prescribing. PM&R, 7, pp.S236-S247.
Fink, D.S., Schleimer, J.P., Sarvet, A., Grover, K.K., Delcher, C., Castillo-Carniglia, A., Kim,
J.H., Rivera-Aguirre, A.E., Henry, S.G., Martins, S.S. and Cerdá, M., 2018. Association
between prescription drug monitoring programs and nonfatal and fatal drug overdoses: a
systematic review. Annals of internal medicine, 168(11), pp.783-790.
Lyapustina, T., Rutkow, L., Chang, H.Y., Daubresse, M., Ramji, A.F., Faul, M., Stuart, E.A.
and Alexander, G.C., 2016. Effect of a “pill mill” law on opioid prescribing and
utilization: the case of Texas. Drug and alcohol dependence, 159, pp.190-197.
Online
Nonmedical prescribing: where are we now?, 2016. [Online]. Available through:
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959632/>
Non-medical prescribing in the United Kingdom National Health Service: A systematic policy
review, 2019. [Online]. Available through:
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6663007/>
Non-medical prescribing within the context of aesthetic practice, 2017. [Online]. Available
through: <https://www.magonlinelibrary.com/doi/abs/10.12968/joan.2017.6.1.8?
mobileUi=0&journalCode=joan>
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