Submitting Articles

Articles on good practice in medicines optimisation are welcome. The Association would like to use the news page to share information from around the country. If you have a particular article you would like to share please email

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.

Healthcare staff wary of hepatitis B risk in vaccine shortage

A shortage of the hepatitis B vaccine has forced Public Health England (PHE) to limit usage to only those who are at the ‘highest immediate risk’.

Shortages of vaccines all over the world have forced other countries to take similar measures, as manufacturing issues have caused delays in continued production. Measures are expected to continue until 2018.

People travelling from the UK to high-risk countries may not be able to get the vaccine before leaving the country as babies born to hepatitis B-positive mothers, and other high-risk groups are prioritised to limit usage to those who need it most.

Sexual partners of infected individuals, men who have sex with men, healthcare workers, and people who inject drugs are among those deemed at the highest risk of being exposed.

A PHE spokesperson said: ‘The manufacturers are getting more stock in but there has been an issue for a while so that’s why we have put this prioritisation guidance into place. We know that the hepatitis B vaccine takes a long time and is quite difficult to manufacture.

‘We will make sure those who really need the vaccine will get it, and those who are less at risk should get it at a later date. It’s important to note that we are a very low risk country for hepatitis B, and the most at risk group are babies.’

Individuals have been advised they can reduce their risk by avoiding having unprotected sex, not injecting drugs, or sharing needles when injecting, avoiding having tattoos, piercings or acupuncture when overseas, and avoiding accessing medical or dental care in high-prevalence countries.

Boost in training places ‘will do little’ to solve recruitment crisis

The ‘biggest ever expansion’ of the NHS medical workforce will be brought on by an increase in the number of training positions, according to the government’s latest announcement.

As part of its bid to train 1,500 extra doctors a year, the Department of Health will continue its drive next year by will offer 500 new places and mark out another 1,000 for organisations who will ‘bid’ to target candidates from disadvantaged backgrounds.

Working with Health Education England, the government is also aiming to offer clinical placement funding for the training of 10,000 extra nurses and midwives, with some positions available as soon as this year.

Extra places for nurses, midwives, doctors and allied health professionals will see approximately 100,000 training places available between now and 2020 in a 11% increase on current figures, according to the government.

‘We’re committed to giving more talented students the chance to be part of our world-class NHS workforce,’ said health minister Philip Dunne. ‘Not only is this the biggest ever expansion to the number of doctor training places, but it’s also one of the most inclusive.

‘For too long, a cap on training places has meant thousands of talented students are rejected from university courses each year despite meeting requirements for medicine or nursing. These students will now be able to fulfill their potential as our future NHS nurses, midwives and allied health professionals.’

New homeless healthcare initiative as figures soar

The number of people sleeping rough in London doubled from 2009-2015, as the Queen’s Nursing Institute (QNI) begins a new initiative to improve healthcare for the homeless.

Transition to Homeless Health Nursing is a new self-guided online resource to help nurses who have recently or are considering transferring into caring for homeless patients. It includes safe working practices, risk assessment and details common patient conditions.

QNI chief executive Dr Crystal Oldman launched the resource at an event attended by nurses and allied health professionals who work with homeless people.

It can be used as a refresher guide for more experienced community nurses, as teaching materials for educators, or learning materials for student nurses looking for a placement or a career move into homeless health nursing.

Homeless health programme manager for the QNI David Parker-Radford said: ‘Excellent nursing care for people who are homeless can only come by learning on the job over time.

Scottish NHS ‘must not get complacent’ over positive report

Scottish authorities ‘should not be complacent’, according to the Royal College of Nursing (RCN), despite a report from the Nuffield Trust comparing the country’s NHS favourably over the rest of the UK.

Learning from Scotland’s NHS is a report put together by the trust to analyse what advantages Scotland holds over the other countries’ healthcare systems. Particular praise was given to the country’s methods of seeking improvement to quality and safety.

The Scottish Patient Safety Programme (SPSP), introduced in 2008, was highlighted as ‘exemplary and the keystone of quality improvement’ for the way it directly involves clinicians and managers. It has recently expanded into mental health, primary care and maternity, bringing with it ‘highly specific’ interventions and targets for improvement.

Lead author Mark Dayan said: ‘Scotland’s well thought-through system of improving patient safety and quality of care works by engaging frontline staff in the process, and importantly the country has stuck with that approach rather than chopping and changing every couple of years.

‘The dark cloud on the horizon threatening these strengths is potentially serious financial problems. Scotland’s NHS has the same resource constraints as England and Wales, but doesn’t yet have a medium-term plan for dealing with them – and in a harsh political environment, open debate and difficult decisions can seem impossible.’

Northern Irish women will have abortions in England funded by government

Abortions will now be free for women in Northern Ireland when they travel to England to have them, the government has announced following a vote on the Queen’s speech.

In Northern Ireland, abortion is illegal with very few exceptional circumstances and the DUP – who currently have a deal with the Conservative government – are staunchly against the practice. However, in a first test of their agreement, MPs voted in favour of the government funding Northern Irish women who want to come to England to have an abortion.

The decision was welcomed by the Royal College of Midwives (RCM), who see abortion as a healthcare matter which should be decriminalised everywhere and made available to all women who need it.

RCM director for Northern Ireland Breedagh Hughes said: ‘The RCM is very pleased with this announcement and looks forward to seeing the details of this crucial agreement. This is a significant step forward for women in Northern Ireland.

‘We already know that women in Northern Ireland are purchasing abortion pills illegally online as many cannot afford to travel to the UK to receive the medical treatment they need.

Vulnerable children ‘heading for explosive situation’ if health visitors not funded

Health visitors need to ‘collaborate with the community’ to help out a number of children equivalent to the population of Manchester that a Children’s Commissioner report has found to be living in vulnerable situations.

According to Anne Longfield, the children’s commissioner for England, there are 800,000 children aged 5-17 suffering from mental health disorders, 700,000 live with families that have ‘vulnerabilities’ and 1,200 have been identified as victims of modern slavery.

The figures were described by Ms Longfield as the ‘tip of the iceberg’ as many children remain undiscovered due to the unavailability of data. Ms Longfield will be requesting data from local authorities and government departments over the next year in an attempt to fill in the gaps of her report.

She said: ‘It is shocking that half a million children – a number equivalent to the entire population of Manchester – need direct intervention or care from the state because they are living vulnerable lives.

‘Yet even more shocking is that this is only the tip of the iceberg. The actual numbers are likely to be much higher. The truth is nobody knows the exact number of vulnerable children.

‘What we do know is that even these numbers are unacceptably high. Our ambition as a nation should be for all our children to live happy and healthy lives. This report shows that millions are not doing so – and that has to change.’

Demands to ‘scrap the pay cap’ as inflation at four-year high

The Royal College of Midwives (RCM) has called for the pay cap on nurses’ wages to be lifted after it was revealed inflation has hit a four-year high and continues to outpace pay growth.Data from the Office for National Statistics (ONS) showed inflation running at 2.9% in May this year, as pay growth slowed to 1.7%.

Nurses’ pay rises have been capped at 1% for the past seven years, leading to several nursing groups considering or announcing protest action.

A years-long policy of capping pay rises for nursing staff at 1% annually was expected to continue until 2020, but the Conservative minister appeared to make concessions while speaking at NHS Confed17 in Liverpool on 15 June.

Mr Hunt told his audience of NHS senior managers he had a ‘great deal of sympathy’ with nurses, who he believed do ‘an absolutely brilliant job’. Following announcements from the NHS across the UK that the cap would continue, the Royal College of Nursing (RCN) decided in a ballot among its members to engage in a ‘summer of protest action’ in opposition.

‘I have had a very constructive letter from [RCN chief executive] Janet Davies. I will be meeting with her and will make sure the conversation is reflected back to the chancellor before we make that decision.

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.