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Advisers warn over nurse prescribing

The Government has ploughed ahead with a dramatic expansion in non-medical prescribing without putting in place monitoring to ensure it is safe, advisers have warned.

The Commission on Human Medicines said its members were 'still unclear, and therefore remained concerned' about the arrangements for assessing the new system, writes Gareth Iacobucci.

The commission, in minutes from a meeting in October, noted a recent evaluation at the University of Reading finding nurse prescribers were not receiving sufficient long-term training.

A second new study, published this week in Nurse Education Today, reveals only half of nurse independent prescribers are receiving professional development opportunities.

The University of Southampton study concluded there were 'issues which need addressing as the rollout of nurse prescribing continues'.

The CHM said the purpose of new prescribing initiatives was to provide patients with 'timely and safe access to medicines', but that 'there appeared no arrangements for monitoring whether this is in fact happening'.

No member of the commission was available for comment. But Professor Hugh McGavock, a former member of the CHM's predecessor body, the Committee on Safety of Medicines, said it was now too late to be registering concern.

Professor McGavock, visiting professor of prescribing science at the University of Ulster, said: 'There was an opportunity lost when the Department of Health agreed to a grossly inadequate training programme. The CHM is shutting the stable door after the horse has bolted.'

Dr Charles Simenoff, a GP in Manchester and member of the GPC prescribing subcommittee, insisted a national auditing scheme was essential to ensure patients had safe access to medicines. 'We didn't think unrestricted access was the best way to go, but we were ignored. It's ironic that a Government body is now expressing doubts.'

• The latest on evidence-based medicine –

Growing doubts over

prescribing expansion

• Nov 2005: plans announced for an extension of nurse and pharmacist prescribing powers to cover almost all drugs in BNF

• Jan 2006: nurses prescribers also given access to some controlled drugs

• May 2006: powers come into force

• June 2006: University of Reading study finds continuing development needs of nurse prescribers are 'frequently


• October 2006: Pulse survey finds 89 per cent of doctors believe safeguards are insufficient to protect patients

• November 2006: CHM expresses concerns over Government's failure to monitor prescribing plans

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