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Preparing guidance for community and primary care non-medical prescribers

How a Wessex healthcare forum got together to provide support for nurse prescribers

Three representatives from a Wessex healthcare forum explain how they support non-medical prescribers 

  • Non-medical prescribing (NMP) is now an integral part of healthcare professionals' jobs
  • Health Education England – Wessex has secured funding for NMP courses and training
  • A forum in Wessex has developed guidance to support non-medical prescribers
Picture shows tablets and prescription. Wessex has produced new guidance for non-medical prescribers
Picture: Alamy

Community and primary care organisations have to provide a range of services, in a variety of settings. Care arrangements vary according to population, geography and organisational structure but share a vision for holistic preventive health. Nurse prescribing is a welcome positive step towards making this a reality. 

Non-medical prescribing shifts care from the hospital to the community

Over the past five to ten years healthcare professionals such as specialist nurses, advanced nurse practitioners, pharmacists, paramedics, musculoskeletal practitioners and mental health workers have been prescribing medicine, and it has proven to be an effective and appropriate use of time and knowledge. To ensure the provision of safe, appropriate and effective care to patients, healthcare professionals have developed their knowledge of disease processes, making a diagnosis and managing conditions that fall within their scope of practice and competencies. Non-medical prescribing (NMP) is an integral part of their job.

People present with complex physical and mental health needs and co-morbidities, and are seen in a variety of settings. Care provision depends on a sustainable yet diverse health and social care system, designed to be flexible and accessible at the point of need and contact. There has been a shift of care from the hospital to the community setting with clinicians developing transferable skills including prescribing.

Health Education England – Wessex secured funding for NMP courses for clinicians in Wessex, and a forum has been set up involving representatives from community and hospital providers, primary care, Wessex local medical committees (LMCs) and university educational establishments across the region to draw on their expertise and experience.

Guidance document for non-medical prescribers in primary care

One outcome from the forum was guidance for non-medical prescribers employed in primary care, written by Wessex LMCs.

Secondary care colleagues had developed a system of clinical governance and support for non-medical prescribers, but this was not available for non-medical prescribers employed in primary care.

A group of forum members from primary care, assisted by prescribing leads at local clinical commissioning groups, developed the guidance to support non-medical prescribers employed in general practice. It is designed to promote good practice, improve service delivery and ensure patient safety, and it is anticipated that the guidance will be updated on an annual basis. 

It is anticipated that every non-medical prescriber in general practice will identify a clinical colleague to supervise as well as jointly complete and sign a competency framework annually. This is to ensure that non-medical prescribers are competent to prescribe safely, identify any gaps in their knowledge, clarify any further training required and provide evidence for Nursing and Midwifery Council revalidation.

Implications for community care

It is a challenging and exciting time for the development of clinical practice in community and primary care, especially for qualified non-medical prescribers. The forum has produced further guidance for the community and hospital care settings to ensure that if staff move between organisations the clinical governance principles and provision of a quality safe service for patients remains the same.

Our guidance aims to standardise best practice for non-medical prescribers employed across Wessex and link with the portfolio development of such prescribers to:

  • Promote quality and patient safety in relation to prescribing by non-medical prescribers.
  • Support professional development and competency in prescribing practice through education and clinical supervision.
  • Assure good governance.

Further information


About the authors

Helene Irvine, nurse adviser at Wessex Local Medical Committee; Debbie Streeter, consultant nurse and non-medical prescribing lead, Dorset Healthcare University NHS Foundation Trust; Sue Hill, workforce transformation lead, Health Education England – Wessex

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