YEAR 4 UNITS SEM 1
RPS Prescribing Competency Framework
PIP vs PSP:
PIP (Independent Prescriber): Can prescribe any medicines within their scope practice, excluding specific controlled drugs (CDs) and unlicensed cannabis products.
PSP (Supplementary Prescriber): Prescribes under a defined Clinical Management Plan (CMP) alongside a medical or dental practitioner, without independent prescribing authority.
Legislation Governing Prescribing:
The Medicines Act 1968: Regulates manufacture and supply of medicines.
Misuse of Drugs Act 1971: Details controls around controlled drugs regarding manufacturing, supplying, and possession.
Human Medicines Regulations 2012: Consolidates laws regarding medicinal products for human use.
Competency Framework for Prescribers: Provides guidelines for prescriber competencies.
Principles of Prescribing
Guidance from Professional Bodies: Organizations like RPS, GMC, and RCN publish best practice guidance on prescribing.
Ten Principles of Prescribing:
Clarity of reasons for prescribing.
Consider patient medication history.
Account for factors affecting treatment risks/benefits.
Discuss patient expectations and concerns.
Choose safe and effective treatments tailored to the patient.
Follow national and local guidelines.
Complete clear, legal prescriptions.
Monitor medicines’ effects.
Document decisions and rationale.
Prescribe within own competence.
Deprescribing and Social Prescribing
Deprescribing: Defined as a planned process of reducing or stopping medications causing harm or no longer beneficial.
Social Prescribing: Connects patients with community activities and resources to support their health and wellbeing.
Documentation in Prescribing
Patient Information: Demographics, medical history, lifestyle factors.
Consultation Reason: Record visit reasons, symptoms, and concerns.
Clinical Assessment: Details from physical examinations and test results.
Clinical Reasoning and Treatment Plans: Justification for treatment and follow-up arrangements.
Patient Consent and Communication
Provide comprehensive information about treatment benefits, risks, and alternatives.
Ensure patient understanding and consent for proposed treatments.
Communication and Records
Document all communications with healthcare professionals and maintain confidentiality in patient records.
Ensure records are accurate, legible, and comply with data protection laws.
Prescribing Challenges
Ethical Considerations: Legal responsibility for prescriptions lies with the prescriber, especially when patients miss monitoring appointments.
Valproate Use: Strong guidelines around prescribing valproate due to risks in specific populations, particularly women of childbearing age.
Private and NHS Care: Complexity in managing prescriptions when patients engage in both private and NHS services.
Pharmacovigilance and Safety Measures
Adverse Events Reporting: Importance of documenting and reporting any adverse drug reactions (ADRs) or medication errors.
Pharmacy Order 2018: Protects pharmacists from prosecution for inadvertent dispensing errors under specific conditions.
Patient Safety
Just Culture: Promote an environment where incidents are reported and learned from without punitive implications.
Risk Management: Regular audits and updates in policies to prevent future incidents and ensure patient safety.
Transition of Care and Patient Management
Shared Care: Involves transferring clinical responsibility from specialists to GPs for stable conditions under a shared agreement.
Drug Diversion: Awareness about the unauthorized removal of controlled substances and safeguarding against it.