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Non-medical Prescribing in the United Kingdom | Penelope Mary Franklin

The Association for Prescribers are pleased to advise was written by our very own Committee Member Penny Franklin.  Penny Franklin is a  UK National Expert in Non-medical Prescribing and has published widely. She is an Executive Member of the Association of Prescribers and is Prescribing Lead for the Community Practitioners and Health Visitors Association.  She is a member of the Nurse Prescribers Advisory Group for the British National Formulary. Penny is a Registered General Nurse and a Health Visitor by background and is an Independent and Supplementary Prescriber.  She is a Fellow of the Institute of Health Visiting and the Higher Education Academy. She links to the University of Plymouth, UK as an Associate Professor and Senior Associate Lecturer.

Chapters also provided by AFP committee members Eleri Mills, Andrew Rideout, Sally Jarmain, Alan Borthwick, Sarah Kraszewski and our previous chair member Dr Barbara Stuttle CBE.

This book explores key developments in Non-medical Prescribing in the UK. Addressing the needs of countries in the European Market and beyond, which have been closely watching UK developments and would be interested in embedding or developing counterparts of their own.

Featuring chapters by clinicians, leaders and practitioners in the UK Non-medical Prescribing arena, it identifies both current and potential future developments. Attention is paid to the different prescribing practices and governance within the four countries constituting the United Kingdom.  Many lessons have been learned along the way and the purpose of this book is to share these lessons, together with best practice examples in connection with the implementation of nurse/health professional led patient care, implementation of patient centered practice, and governance.

Designated Registered Practitioners who have completed an enhanced training now receive a professional body qualification which enables them to prescribe within their scope of practice as Non-medical Independent Prescribers and, providing that they are competent, from anywhere within the British National Formulary independently of doctors; for Nurses, this also includes most controlled drugs.

The book will be of interest to policy makers and to forward-looking professionals and practitioners in the diverse European Health and Social Care market.

A 20% discount will be available to members of the AFP when this book is released.

Inspiring new nurses to go into general practice

Written by: Crystal Oldman

|Dr Crystal Oldman

I am inspired to see and hear about the work going on across the UK to promote community and primary care as an excellent place to work for newly qualified nurses. The early indications of the career outcomes are really positive.

Many of the examples I have learned about were highlighted in 2016, when the QNI was commissioned by Health Education England to undertake a project exploring examples of good practice and innovation in supporting student nurses on practice placements in the community and primary care.

In doing this work, the QNI also explored the barriers to expanding placement experiences and how these may be overcome.

There were fabulous examples of university programmes that provided a full simulation of delivering care to patients, families and carers in their homes, with the realistic challenges that nurses face in this care environment.

The results of the project were shared at the QNI conference in 2016 and inspired many delegates to explore the potential to replicate the innovations in their own areas.

The project also identified the potential for more practice placements in the private, voluntary and independent sectors, including residential and nursing homes.

In many areas, general practice has been supported to develop a range of student nurse placements, with the support of practice learning facilitators across a locality.

When politics and care collide

We need ‘strong and stable nursing’, ‘for the many not the few’.

Sorry about that; I think I have contracted a nasty bout of election-itis.

The bad news is, no matter who wins the NHS faces more years of austerity, as none of the main political parties is promising to spend enough to close the gap between the amount of work the NHS is obliged to do—and the amount of work it is paid to carry out.

Just to cheer you up: health spending as a percentage of GDP is set to fall. Things are going to get tighter. So, who should nurses vote for?

There is an acid test. A test that takes us to a place none of us want to remember. It takes us to a time and events that were painful, beyond belief and that NHS still struggles to live down. Events where nurses where were at the very centre.

The place I am talking about is very different now. It is a very fine, well run hospital, staffed with skilled and enthusiastic nurses. I know, I’ve been there. I’m talking about Mid-Staffs.

The hospital wrote its name in the history books, but not because people were uncaring or stupid. It was because they were driven, by political imperatives, to abandon their purpose—targets instead
of tenderness. Counting the bottom line meant it was no longer possible to count on compassion.

The politicians of the day wanted all hospitals to segue from NHS Trusts to Foundation Trusts. That required a financial rigour they are unable to deliver without cuts, and a focus on the demands of the regulators and not the needs of the patients, relatives and carers. Staffing—the biggest cost—was cut, shortcuts taken.
The front line’s voice could not be heard above the din of the management bugle. So morale plummeted, standards dropped and everyone became inured to suffering.

What turned good, honest, educated, well-trained people into an army of job-fillers?

Pay restraint: time for action?

Ask any nurse what the worst part of their job is, and you’ll likely get a spread of answers. Some might cite long hours, a lack of resources, or understaffing. However, where the profession will be united nationwide is in their discontent over the continuing pay cap.

In March 2017, the NHS Pay Review Body decided to continue the 1% pay cap for NHS staff in England, leading to outrage in the nursing profession – who constitute the largest workforce in the NHS. According to the Royal College of Nursing (RCN), continuing pay restraint in the NHS has led to a 14% real-terms cut in nurse pay since 2010.

‘This deals a bitter blow to nursing staff across England,’ said Janet Davies, chief executive of the RCN. ‘The nursing profession is rightly held in high regard but kind words don’t pay the bills. With this announcement, the Government will deter new people from joining the nursing profession at the very moment it is failing to retain staff and European colleagues in particular head for the door.’

Nurses, however, have not taking the decision lying down. The RCN recently conducted a ballot on NHS pay. Chair of RCN Council Michael Brown said that the 52 000 members who returned the recent pay poll had sent a strong message to Council.

RCN Congress 2017: Party leaders make their bids for the nursing vote

Labour leader Jeremy Corbyn and Lib Dem leader Tim Farron both appeared at the Royal College of Nursing’s (RCN) Congress 2017 in Liverpool to stake their claim for the nursing vote in 8 June’s general election.

Speaking to a packed hall on 15 May, delegates heard the Labour leader pledge to allow NHS unions to negotiate on pay with independent pay review body decisions being respected.

‘We want nurses to be paid properly,’ he said.

Mr Corbyn endorsed the RCN’s work as a union and professional body and said he understood why the pay poll action had to be taken, as nurses working in the NHS continue to face a real terms pay cut while the country is facing a future with 40,000 fewer nurses.

He said he was determined to reintroduce the student bursary in England and recounted his experience of speaking to a group of student nurses. They told him that the only way they could afford to train without a bursary would be by having a partner to fund them.

He described this situation as ‘utterly short sighted and counterproductive,’ and said that restoring the bursary would protect the future of nursing. Mr Corbyn also promised his government would legislate for legally enforceable safe staffing levels in hospitals and introduce equal status for mental and physical health. He said his government would bring in a Minister for Mental Health.

But when asked about retirement ages for nursing staff, he left Congress waiting, saying all would be revealed in Labour’s manifesto, launching on 16 May.

RCN Congress 2017: Nurses can send ‘powerful message’ to government in RCN chief’s speech

Nursing is still the best profession in the world, according to the Royal College of Nursing’s (RCN) chief executive.

Speaking in her keynote speech at the RCN Congress, Liverpool, on 14 May, Janet Davies reflected on a variety of issues currently concerning nurses nationwide but praised staff for their continuing dedication to their work.

She referred to nurses’ efforts to assist victims of the Westminster attack in March, as well as a nationwide poll which showed 93% of people say they trust their nurses.

However, a recurring theme in Ms Davies’ speech was pay – which has been capped by 1% rises on the NHS for seven years running. She said 41,000 RCN members – 78% of those who voted – were willing to go on strike over pay.

A ‘summer of protest action’ has now been announced in response to the mandate.

Ms Davies said: ‘The RCN has never been on strike. We’ve never even balloted our members. But 41,000 of you feel so strongly about the way you’re being asked to pay for the UK’s economic problems that you’re prepared to take this historic, unprecedented step.

‘That’s a powerful message from you. The next government must surely have to listen.

‘But the truth is, the Trade Union Act means we need an even stronger mandate if we’re to consider any action. And while 41 thousand is a lot, it doesn’t give us that.

Primary care nurses ‘must make their voice heard

Primary care nurses (PCNs) who feel ignored or sidelined must make their voices heard over pay and staffing complaints, according to the chief executive of the Royal College of Nursing.

Speaking exclusively to Independent Nurse, Janet Davies urged PCNs to mobilise and form or join groups in order to have a presence in the disputes over nursing pay and staffing the RCN is set to engage in with the government over its ‘summer of protest’.

While PCN pay is usually set by the providers and trusts they work for individually, rather than decided by the government, their pay levels are usually kept in line with national policy – meaning the 1% cap in pay rises which has dominated discussions at the RCN Congress 2017 in Liverpool has a knock-on effect on primary care pay rates.

RCN members voted by a large majority to mobilise into industrial action in protest to the cap and the college announced it will be devising a programme of protest activity for the summer. A mandate for a formal strike has yet to be established.

Ms Davies said: ‘While we can’t act exactly like a trade union we will be advising primary care nurses individually, guiding them through our actions over the pay cap and getting it reversed by the government.

‘We understand PCNs might feel like they don’t have a voice in the RCN but to that I would say join us. Become a member, join a primary care group of nurses, put motions forward for meetings and Congress. If you feel you don’t have a voice, mobilise and get one. You are always welcome in the RCN.’

According to Ms Davies, the RCN cannot carry out activities in the same way as a trade union but would still be confronting primary care providers on their pay rates as they will the government, though specific approaches would be figured out on a local level tailored to each provider.

Expansion in Drug & Alcohol Prevention Programme

The Alcohol and Drug Education and Prevention Information Service (ADEPIS), run by charity Mentor UK, is set to receive a boost in funding, Public Health England has announced.

The programme takes a novel direction in discussing drugs and alcohol with young people. It moves away from ‘hard-hitting’ messages, which have the potential to be counter-productive in trying to improve young people’s attitudes and behaviour toward drugs and alcohol.

‘Only by building children and young people’s resilience and life skills can we expect education programmes to be truly effective at preventing harms later on’ said Mentor UK’s chief executive, Michael O’Toole. He stressed that it is also important to establish local services to ensure the developments of effective ‘ecosytems of prevention’.