Effective governance for non-medical prescribing is paramount, which is why in 2014 NHS Arden & GEM Commissioning Support Unit (CSU) proactively approached South Warwickshire Clinical Commissioning Group (CCG) to develop, deliver and monitor a non-medical prescribing (NMP) policy in line with both medicines legislation and national and local guidelines.
To develop an effective NMP policy and associated processes we successfully overcame several challenges, not least undertaking a major data cleansing exercise for 36 GP practices and their Non-Medical Prescribers (NMPs).
We also needed to provide assurance to the CCG that all NMPs would prescribe within their sphere of competence, appropriately against the CCG’s prescribing budget and within a proper legal framework.
All this activity took place at a time when CCG responsibilities around Non-Medical Prescribing were still being clarified with NHS England.
Led by our Associate Director: Medicines Optimisation, our Medicines Optimisation team comprising both pharmaceutical experts and proven medicine administration officers, began by listening to South Warwickshire CCG to understand their current position. We then produced a draft policy and associated processes which were subsequently signed off by their Governing Body.
We established Standard Operating Procedures for our staff to work with our CCG colleagues and GP practice staff, ensuring that all NMPs understood the policy and its governance framework, whereupon they were signed up and correctly registered with the NHS Business Services Authority.
The NMP policy is very broad, covering over 20 circumstances including adverse drug reactions and clinical incidents as well as appropriate working with the pharmaceutical industry and ensuring the secure and safe handling of prescription forms.
South Warwickshire CCG now has a robust, effective and appropriately governed NMP policy, which is being used throughout its 36 GP practices to the benefit of its patients.
The CCG now has clarity over its NMP activities, being able to ensure the appropriate allocation of prescribing spend against budget. This also ensures the correct funds are matched to the practice, with minimum variability.
In addition, the CCG is also assured that the appropriate governance is in place for NMP.
The policy developed by Arden & GEM is very much a living document and every six months we receive detailed prescribing data which, as an additional service, our pharmaceutical experts translate into meaningful intelligence. This intelligence is subsequently shared with each of the NMPs working at GP practices, giving them an opportunity to fine tune their NMP activity to reflect the very latest guidance.
As well as the GP practices, this policy has been successfully adopted by Myton Hospice who approached the CCG to prescribe against their primary care budget. Subsequent authorisation of the hospice NMPs to prescribe has resulted in a much better service for patients who were previously experiencing a more complex route through the system.
Through operating at scale with experienced professionals, we are able to identify and share best practice amongst our client base.
We continue to closely monitor developments from NHS England and legal instances as they progress, plus importantly we network with colleagues around the world to listen, learn and act.
NHS South Warwickshire CCG has appreciated the support of Arden & GEM CSU in managing its non-medical prescribers list. The CSU was proactive in identifying the need for the policy, developing and implementing it across all GP practices, as well as Myton Hospice, and is efficient in the management of the process for ongoing registration and deregistration of NMPs. The CSU supports regular provision of prescribing data to all NMPs to enable reflection.
Alison Walshe, Director of Quality and Governance (Executive Nurse), South Warwickshire CCG
The budget definitely has been helping us to be creative, to look at her as a whole person, to look at her physical, social and psychological needs.