Ministers act over out-of-hours
The Government's drug watchdog has come under fire from drug safety experts after agreeing to radically extend supplementary prescribing powers.
Pulse has learned the Committee on Safety of Medicines has decided to allow supplementary prescribers to prescribe off licence, despite initially rejecting the proposals over safety fears.
A former member of the CSM attacked the plan, claiming it would exacerbate a 'scandalous pandemic' of adverse events.
Medical defence bodies and the Department of Health warned doctors would remain legally responsible for errors made by nurse prescribers.
The committee initially considered the proposals in March 2002, but decided off-licence use of drugs should be excluded from supplementary prescribing except as part of a clinical trial.
But members overturned the decision at a recent meeting after consulting with interested parties, and despite admitting a minority of res- pondents were concerned over 'dilution of expertise'.
The CSM is also considering plans for an expansion of the nurse prescribing formulary.
Professor Hugh McGavock, professor of prescribing science at the University of Ulster and a member of the CSM until 2001, warned extending nurses' powers would worsen the existing 'pandemic' of adverse events.
He said palliative care drugs would be an area of particular danger. 'It is unbelievably risky to let nurses loose with these drugs. God knows what will happen with 10,000 more prescribers.'
Professor McGavock call-ed for current training to be replaced with a year-long university equivalent prescribing course. GPs also expressed concerns over the adequacy of nurse training.
But Dr Peter Fellows, chair of the GPC's prescribing subcommittee, said he supported supplementary prescribing and believed nurses should be allowed to prescribe off licence.
Dr Fellows added: 'It is inevitable that there will be iatrogenic problems, especially when we're dealing with an ageing population and the targets we are being asked to hit are ever higher.'
Dr Nick Norwell, medico-legal adviser for the Medical Defence Union, said GPs would have vicarious responsibility where nurses were employed as supplementary prescribers by the practice.
·Letters, page 23
By Rob Finch