The Nursing and Midwifery Council (NMC) has now issued a circular (04/2010) that permits nurse and midwife independent prescribers to prescribe unlicensed medicines, following legislative changes in December.
The circular updates the “Standards of proficiency for nurse and midwife prescribers“, setting out the requirements for this type of prescribing. The prescriber must be satisfied that an alternative, licensed medication would not meet the patient’s needs and that there is sufficient evidence and/or experience to demonstrate efficacy and safety for that individual; the prescriber must take responsibility for prescribing the unlicensed medicine and for overseeing care; the patient must understand the implications of being prescribed an unlicensed medicine and agree to this; the reasons for choosing this medication must be documented in the patient’s notes; professional advice must be obtained as necessary; and adverse drug reactions must be reported via the Yellow Card scheme. The guidance stresses that nurse and midwife prescribers should pay particular attention to the risks associated with unlicensed medicines, and says that the NMC will consider it best practice to have policies and systems in place to monitor and manage the clinical risks.
A second circular (03/2010) requires approved educational institutions to amend the content and learning outcomes of V300 programmes to reflect the legislative changes. Programmes must conform by 1 February 2011.