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Nurse prescribing data is flawed

The figures quoted in your article ‘Huge explosion in nurse prescribing (Pulse, 23 August) should be taken with a pinch of salt.

Our practice nurse has completed her prescribing course and is now an independent prescriber.

After we set her up on our computer system we realised the stamp appearing on prescriptions did not necessarily indicate the prescriber of a particular item.

Although she is keen to audit her prescribing activity,

it is clear any PACT data we receive will not give a true reflection of her prescribing habits just as previously. Similarly, it hasn't been possible to audit individual doctors' prescribing.

Our clinical system suppliers have advised us there is no easy way around this.

The figures which you have obtained presumably came from centralised prescribing data and are therefore likely to be seriously flawed.

Each prescription for antidepressants, for example, does not necessarily represent an independent prescribing decision made by a nurse, as much of this activity will be through repeat prescribing, which may have originated from a clinician.

We think the only sensible approach is to look on our nurse as part of the practice prescribing team, rather than worrying too much about who prescribed what.

Rather than singling out nurse prescribers for special scrutiny, perhaps Professor Hugh McGavock should accept that modern primary care is no longer an entirely doctor-led service and good quality care is best delivered through an effective primary care team.

Dr Tim Hooson, Sheffield

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