The overall aim of the study was to evaluate nurse and pharmacist independent prescribing in order to inform planning for current and future prescribers. Two discrete choice experiment surveys to quantify patients' preferences for alternative nurse and pharmacist prescribing service models were compared with usual care.
Over the past few years, the Government has introduced a number of policies to enable nurses and pharmacists to prescribe medicines directly to patients. These changes have been introduced in order to help patients have quicker access to medicines & more choice over where they obtain medicines from. The Government also wants to ensure that better use is made of all health professionals' skills. However, it is important to ensure that these changes do not compromise patients' safety. Additionally, the Government also needs to know how well the policy aims are working.
In this study, we provide a national picture of nurse and pharmacist prescribing by carrying out a number of surveys across England and talking to people (lecturers and doctors) who train nurse and pharmacist prescribers. We analyse the quality and safety of nurse & pharmacist prescribing through analysing their prescribing consultations with patients. We ask patients about their experiences of nurse and pharmacist prescribing, including its impact on their medicine taking and their preferences for the different health care professionals who can now prescribe medicines for them.
The results have enabled the Government to plan the future of prescribing services to ensure that patient preferences for where and from whom they obtain medicines are taken into account. The study allowed us to determine what patients like and dislike about nurse, pharmacist and doctor prescribing, how these compare, and what they would like to see developed. It told us whether nurses & pharmacists are prescribing medicines safely for patients, whether trusts are monitoring this properly and whether prescribing education is satisfactory. The findings have informed Government and local trust planning of prescribing services for patients. We hope that this will mean that patients will have choice and access to medicines and medicines advice in a way that is best for the management of their health.
In the modernisation of the NHS, a number of key policies on non-medical prescribers (NMP) have been introduced. By 2007 there were over 9,000 nurse and 140 pharmacist independent prescribers. There has been some research into pharmacist supplementary prescribing (PSP) and the first cohorts of nurse independent prescribers (NIPs) prescribing from a limited formulary. However, little is known about the impact of recent policy changes e.g. to open up the formulary, and there has been no substantial research into the experience & impact of pharmacist independent prescribing. Research is therefore urgently required into the impact of NIP & PIP* on the key policy indicators of improvements in patient care, choice & access, patient safety, better use of health professionals' skills, & more flexible team working across the NHS.
Professor Sue Latter
Professor Alison Blenkinsopp (University of Keele)
Dr Steve Chapman (University of Keele)
Dr Karen Gerard, Reader in Health Economics and NIHR Career Development Fellow
Professor P Little (University of Southampton)
Dr P Nichols
Policy Research Programme Nurse Prescribing, Department of Health
Service evaluation