Nurse and midwife prescribing continues to develop at a considerable rate and it is well established within many areas of practice across the UK. Clearly the development of prescribing within nursing and midwifery practice will continue to evolve as a direct response the changing health needs of the population and the supporting government policy across the four UK countries. The recommendation for nurses to prescribe originated in the Cumberlege report (DHSS 1986) which recommended that community nurses should be able to prescribe from a Nurse Prescribing Formulary. The legislation to enable nurses to prescribe received the Royal Assent on 16th March 1992 and since then it has evolved with resulting changes in legislation and accompanying educational programmes approved by the UK’s Nursing and Midwifery Council (NMC).
The NMC in 2006 set out Standards of Proficiency for Nurse and Midwife Prescribers (SPNMP). These standards consist of two sections: the educational requirements and the standards for prescribing practice. These standards ensure the educational preparation for nurse and midwife independent prescribing is delivered within approved education institutions. These standards apply to community practitioner nurse prescribers (V100) nurse and midwife independent prescribers (V200) and supplementary and independent prescribers (V300). In 2009 the NMC set additional standards for educational preparation for nurses who do not hold a specialist practice qualification to enable nurses to prescribe from the Nurse Prescribers Formulary for Community Practitioners (NMC 2009). This prescribing is labelled as V150.
The NMC’s current SPNMP are dated and the evidence base for some of the educational requirements is unclear. Additionally since their publication ten related circulars have been established to clarify points and add additional information. The NMC (2015) revised Code also contains a section on prescribing and medicines management.
Moving forward the NMC has proposed that educational requirements are removed from Standards of Proficiency of all their documents containing standards and are contained within a new education framework that is currently under development. Considering this a review of the current SPNMP is also being undertaken.
The core competencies for prescribing are the same no matter what formulary a professional prescribes from or whether it be as a supplementary prescribing (NMC 2006 2009; Royal Pharmaceutical Society 2016). Additionally it is the responsibility of the professional to contextualise their scope of prescribing to reflect different areas of practice and work within the Code (NMC 2015). Therefore it is proposed that the learning outcomes of a prescribing programme should reflect national competency frameworks for all prescribers for example The Royal Pharmaceutical Society's Single Competency Framework for all Prescribers (2016).
