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Nurse independent prescriber qualification has had little overall impact on prescribing



The proportion of primary care prescribing undertaken by nurses rose just 0.4% in the first five years after the introduction of nurse independent prescribing, researchers have reported.

The team from University of London looked at how nurse prescribing in primary care changed after the introduction of the nurse independent prescriber qualification in 2006, which enables qualified nurses to prescribe any licensed drug – including some controlled drugs – for any medical condition within their clinical competence.

The community practitioner nurse prescriber qualification, first introduced in 1992, enables nurses to prescribe only from a more limited list of medicines.

As reported in the journal BMC Health Services Research, the researchers found the proportion of items prescribed by nurses in primary care has risen only slightly since nurse independent prescribing came in, from 1.1% of all items in 2006 to 1.5% in 2010.

Overall, the number of nurses registered to prescribe rose by 18%, from 30,753 to 36,281.

In line with this, the number or nurses issuing prescriptions increased from 13,391 in 2006 to 15,841 in 2010.

However, this still meant the number as a proportion of all those qualified and authorised to prescribe remained static over the five-year period, at 43%.

It found that while nurse independent prescribers contributed most towards prescribing of emergency contraception, community practitioner nurse prescribers mainly contributed to prescriptions of dressings, stockings and incontinence appliances.

The team concluded: ‘The percentage of prescriptions written by nurses in primary care in England is very small in comparison to GPs and there has been little change in that over five years.’

‘Our findings suggest that nurse prescribing is used where it is seen to have relative advantage by all stakeholders, in particular where it supports efficiency in nursing practice and also health promotion activities by nurses in general practice. It is in these areas that there appears to be flexibility in the prescribing role between nurses and general practitioners.’

BMC Health Services Research 2014