NON MEDICAL PRESCRIBING

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1 NON MEDICAL PRESCRIBING AGENDA ITEM 1.14c Executive Lead: Medical Director Author: Service Director Pharmacy Financial impact There is no direct cost following the implementation of this policy. However cost will be attributed to the individual undertaking the associated University led module. Prescribing costs are devolved to relevant Directorate Quality, Safety, Patient Experience impact The policy will ensure that patients receive their medicines in a timely manner and improve patient choice and access to medicines Healthcare Standard Numbers 1, 7, 12 and 15 Equality Impact Assessment Completed: Yes CRAF Reference Number. This can be found here RECOMMENDATION The Quality, Safety and Experience Committee is asked to: APPROVE the Non Medical Prescribing Policy and APPROVE the full publication of the Non Medical Prescribing Policy in accordance with the UHB Publication Scheme. SITUATION This policy ensures that all non-medical prescribing practice within the Cardiff and Vale UHB is governed by robust procedures and processes. It is designed to ensure patient safety, safeguard and support the staff working in these roles and to ensure compliance with legislation. The policy has been updated to reflect the inclusion of Physiotherapists, Podiatrists and Chiropodists as professionals eligible to prescribe. The document is being presented to the group for approval in line with the Written Control Documents Development and Approval Procedure. BACKGROUND The extension of prescribing responsibilities to non medical professions was introduced in Wales to support implementation of Designed for Life - Creating World Class Health and Social Care in Wales in the 21 st Century, May Policy - Non Medical Prescribing Page 1 of 2 Quality Safety and Experience Committee 21 April 2015

2 AGENDA ITEM 1.14c A Trust policy was prepared, approved and implemented in line with Welsh Government guidance on the implementation of non medical prescribing in Wales (July 2007). In the UK the Human Medicines Regulations 2012 set out who is an appropriate practitioner in relation to any prescription only medicine and were amended on August 20 th 2013 by the Human Medicines (Amendment) Regulations 2013 to include physiotherapists, chiropodists and podiatrist independent prescribers as appropriate practitioners. It was then a matter for each devolved administration to decide whether and how it is implemented in each country. Sections 47, 80, 83 and 203 (9) and (10) of the NHS (Wales) Act 2006 give the Welsh Ministers the powers to make regulations which make arrangements for statutory provisions which relate to prescribers to be extended from nurses and pharmacists to include physiotherapists, chiropodists and podiatrists. These amended regulations came into force on 24 th September Introducing non medical prescribing in Wales has enabled: Increased patient choice in accessing medicines. Improved access to advice and services. Appropriate use of a skilled workforce. Contribution to more flexible team working across the NHS Increased capacity to meet demand and new ways of working. Improvement in patient care without compromising patient safety. ASSESSMENT The development of these roles needs to be supported and governed by robust procedures and processes, to ensure patient safety, quality improvement and clear direction for practitioners. Wide consultation has taken place to ensure that the policy/procedure meets the needs of our stakeholder and the Health Board. The consultation undertaken specific to this document was as follows:- The original document was added to the Policy Consultation pages on the intranet between October and November 2013; The updated document was shared with the Medical Director, the UHB s Medicines Management Group, the UHB s Nursing and Midwifery Board, the UHB s Clinical Standards and Innovations Group in November/December Where appropriate comments were taken on board and incorporated within the draft document. - Arrangements for monitoring and review of the document e.g. compliance to be monitored by the UHB Medicines Management Group. - Publication and dissemination The primary source for dissemination of the Non Medical Prescribing Policy within the UHB will be via the intranet and clinical portal. It will also be made available to the wider community and our partners via the UHB internet site which ensures that the UHB fulfils the requirements of its Publication Scheme under the Freedom of Information Act. Policy - Non Medical Prescribing Page 2 of 2 Quality Safety and Experience Committee 21 April 2015

3 NON MEDICAL PRESCRIBING POLICY Reference Number: TBA 1 Date of Next Review: To be included when document approved Previous Trust/LHB Reference Number: T322 Policy Statement To ensure the Health Board delivers its aims, objectives, responsibilities and legal requirements transparently and consistently, we will increase the range of health care professionals who can prescribe medicines to patients as part of the National Health Service (NHS) Improvement Plan. This Policy has been updated to reflect the inclusion of Physiotherapists, Podiatrists and Chiropodists as professionals eligible to prescribe. The benefits of Non-medical prescribing include: Increased patient choice in accessing medicines; Improved access to advice and services; Appropriate use of skilled healthcare workforce; Enabling more flexible team working across the NHS allowing doctors to manage more complex patients and develop new skills; Enhance service delivery, enabling further development of services in line with local and national strategy; Improvement in patient care without compromising patient safety. The development of these roles needs to be supported and governed by robust procedures and processes, to ensure patient safety, quality improvement and clear direction for practitioners. The policy outlines the responsibilities of the practitioner, clinical directorates, managers and independent contractors. Policy Commitment This policy ensures that all non-medical prescribing practice within the Cardiff and Vale UHB is governed by robust procedures and processes. It is designed to ensure patient safety, safeguard and support the staff working in these roles and to ensure compliance with legislation. Supporting Procedures and Written Control Documents Nursing and Midwifery Council - Standards for Medicines Management. Nursing and Midwifery Council - The Code. Nursing and Midwifery Council Non Medical Prescribing Standards. All Wales Prescribing Standards. Good prescribing guide. Non Medical Prescribing Wales An Implementation Plan 2007 Other supporting documents are: Welsh Assembly Government (WAG) Guidance Non medical prescribing in Wales A guide for implementation July for full details of the legislation and professional requirements.

4 Non Medical Prescribing Policy 2 of 17 Approval Date: dd mmm yyyy Scope This policy applies to non-medical prescribers in all care settings within the University Health Board. The policy does not encompass non-nhs prescribing by independent contractors (e.g. private prescription in community pharmacy practice). It does not cover other methods of providing medicines to patients such as Patient Group Directions (PGDs) or Patient Specific Directions (PSDs) or prescribing of borderline substances in secondary care by dieticians and speech and language therapists. Full details of the scope of practice of the different categories of prescribers can be found in the Welsh Assembly Government (WAG) Guidance Non medical prescribing in Wales A guide for implementation July Independent Prescribers Definition of Independent Prescribing: Prescribing by a practitioner responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing. 1 Currently nurses, pharmacists physiotherapists and podiatrists may train to be registered as independent prescribers. Independent prescribers must work within their own level of professional competence and expertise and are accountable for their own actions. 1.2 Supplementary Prescribers Definition of supplementary prescribing: A voluntary prescribing partnership between an independent prescriber (doctor or dentist) and a supplementary prescriber, to implement an agreed patient-specific clinical management plan with the patient s agreement. 1 Suitably qualified and registered health professionals may practice as supplementary prescribers: Pharmacists Nurses Midwives Chiropodists Podiatrists Physiotherapists, Radiographers Optometrists. Supplementary prescribers can only prescribe in partnership with a doctor or dentist. 1.3 Community Formulary Nurse Prescribers Definition: Community nurse practitioners who have completed the necessary training to be able to prescribe items appearing on the nurse prescribers formulary for community practitioners (available in the British National Formulary - BNF) Equality Impact Assessment An equality impact assessment has been undertaken to assess the relevance of this policy to equality and potential impact on different groups, specifically in relation to the General Duty of

5 Non Medical Prescribing Policy 3 of 17 Approval Date: dd mmm yyyy the Race Relations (Amendment) Act 2000 and the Disability Discrimination Act 2005 and including other equality legislation. The assessment identified that the policy presented a low risk to the University Health Board. Health Impact Assessment Policy Approved by A Health Impact Assessment is not required for this policy. Quality Safety & Experience Committee Group with authority to approve procedures written to explain how this policy will be implemented Accountable Executive or Clinical Board Director Nursing and Midwifery Board Corporate Medicines Management Group Health and Care Professionals Committee Executive Medical Director Disclaimer If the review date of this document has passed please ensure that the version you are using is the most up to date either by contacting the document author or the Governance Directorate. Summary of reviews/amendments Version Number Date Review Approved Date Published Summary of Amendments 1 Date approved by Board/Committee/Sub Committee dd/mm/yyyy 2 TBA [To be inserted by the Gov. Dept] State if either a new document, revised document (please list main amendments). List title and reference number of any documents that may be superseded

6 Non Medical Prescribing Policy 4 of 17 Approval Date: dd mmm yyyy 2. Implementation of Non Medical Prescribing 2.1 Planning, selection and approval of new prescriber posts Identifying appropriate new prescriber roles is fundamental to the success of non medical prescribing (Appendix 1). Health care professionals selected for non-medical prescribing roles require the support of their line manager and directorate / Clinical Board to ensure that: The post is one in which there is a service need and therefore the opportunity to act as a prescriber upon qualifying; The practitioner is undertaking (or has completed) a programme of advanced practice to include history taking, physical assessment and diagnosis (as appropriate) A Designated Supervising Medical Practitioner (DSMP) can be identified; Financial arrangements are in place to meet the cost of prescriptions (as appropriate); Access to continuing professional development opportunities on completion of the course. The line manager will complete The Cardiff and Vale University Health Board Selection Criteria for non-medical prescribers, (appendix 2) and forward to Clinical Board Nurse / Clinical Board Pharmacist as appropriate, for approval. 2.2 Procedure for Registration and Accreditation of New Non-medical Prescribers within Cardiff and Vale University Health Board. When qualified as a non-medical prescriber the following process must be completed BEFORE commencing prescribing practice: Practitioner registers as a prescriber with the appropriate professional body. For example Registered Nurses the prescribing qualification must be Registered with the NMC within 12 months of attainment; For practitioners in hospital settings, a completed Cardiff and Vale University Health Board s Non-medical Prescribers Scope of Practice form (appendix 3,) must be signed by the Clinical Board Nurse/Clinical Board Pharmacist/ Professional Head for Quality and Safety (CD&T) as appropriate and sent to Pharmacy University Hospital of Wales Prescriber s Job description must be annotated to reflect the prescribing role. Induction Period The first three months of prescribing practice is an opportunity for the practitioner, line manager and Clinical Board Nurse/ Clinical Board Pharmacist to assess the role and provide any further support required.

7 Non Medical Prescribing Policy 5 of 17 Approval Date: dd mmm yyyy During this period the Non Medical Prescriber should maintain a portfolio of practice for discussion with their line manager and Clinical Board Nurse/ Clinical Board Pharmacist The portfolio should include: o National Prescribing Centre s (NPC) competency self assessment (this may have been done as part of prescribing course); Medicines and Prescribing Support from NICE. o Prescribing activity log for a minimum of one month (or fifty prescriptions) - (appendix 4); Prescribing activity is a term used to describe the process from Patient Assessment, Diagnostic Reasoning, Shared Decision Making and the use of Therapeutics. o Record any critical incident logs. o Annual audit data and results Any change in the role or scope of practice must be notified to Clinical Board Nurse/ Pharmacist by completing a new Cardiff and Vale University Health Board Non-medical Prescribers Scope of Practice Form. (appendix 3) 3. Training Implications Currently in Wales the following courses are available and accredited by the nursing and pharmaceutical professional bodies 1 : Independent Prescribing Conversion Course an interim arrangement to enable qualified nurse / pharmacist supplementary prescribers to qualify as independent prescribers; Integrated Independent/Supplementary Prescribing Course multidisciplinary course for nurses, midwives, pharmacists and allied health professionals meeting the entry criteria (appendix 5) Courses are part time over approximately six months and involve a combination of face to face teaching and learning in practice. Community Nurse Formulary Prescribing Course- It is mandatory for all non-medical prescribers to have successfully demonstrated their numeracy skills. This is integral to courses delivered in Wales, but for prescribers joining the organisation with a qualification from outside Wales, numeracy skills need to be established, either by providing evidence of numeracy assessed as part of their NMP course or by completing a University Health Board assessment prior to registration as a prescriber within the Cardiff and Vale University Health Board. (Contact the Director of Pharmacy and Medicines Management, Ext for further advice). In addition to fulfilling the entry criteria for the course, the individual must have identified a doctor as Designated Supervising Medical

8 Non Medical Prescribing Policy 6 of 17 Approval Date: dd mmm yyyy Practitioner (DSMP) who is willing and able to contribute to and supervise the days learning in practice element of the training. The education institutions provide training programmes for DSMPs (approximately half a day). 4. Annual Appraisal and Revalidation Prescribers should have access to relevant education and training to meet Continuing Professional Development (CPD) and competency requirements. In addition, it is expected that individual prescribers will undertake CPD in relation to their prescribing role and to include a review of their prescribing activity as part of their annual appraisals (PADR) 5. Review, Monitoring and Audit Arrangements. The Cardiff and Vale University Health Board will provide reports of nonmedical prescribing activity in the organisation through the corporate Medicines Management Group. Prescribers should submit their annual audits to the Clinical Boards who in turn will include non-medical prescribing audits in their annual audit plans and report results through the Clinical Board Medicines Management Group and the Quality and Safety Group of the appropriate Clinical Board. 6. Managerial Responsibilities 6.1 Liability and Responsibilities of the Prescriber Non Medical Prescribers must: Ensure that they have appropriate professional indemnity insurance. They should follow the most up to date advice given by their professional registering body; Be accountable for all aspects of their prescribing decisions. They must be able to recognise and deal with the consequences that might result in inappropriate prescribing; Maintain security of prescription stationery (including not pre-signing blank forms) and report any loss or suspected theft of prescriptions to their line manager immediately, complete an incident form and inform Pharmacy; Return unused prescriptions (WP10s) to pharmacy if post is vacated or circumstances change. 6.2 Liability and Responsibilities of the Clinical Boards Each Clinical Board should have a framework and guidelines for non medical prescribing within their Board. This should include responsibility delegated to the relevant line manager to:- Ensure that the employee is qualified and competent to prescribe in the area of practice identified; Provide non-medical prescribers with a designated point of contact within the directorate / Clinical Board to discuss problems (eg DSMP, Nurse practitioner, Clinical Board Nurse / Pharmacist)

9 Non Medical Prescribing Policy 7 of 17 Approval Date: dd mmm yyyy Ensure that the employee s job description includes a clear statement that prescribing is required as part of the duties of that post or service; Ensure that the employee undertakes regular annual appraisal and review with their manager; Ensure that a criminal records bureau (CRB) check has been undertaken according to Cardiff and Vale University Health Board procedure; In the case of supplementary prescribers, ensure that the DSMP fulfils their obligations as specified in the guidance Pharmacy will maintain a register of the non-medical prescribers working in the organisation and health care community together with a copy of the prescribers signatures. The individual Clinical Board may choose to maintain a register of their non medical prescribers, but it will be the responsibility of the Clinical Board to update their register. To inform pharmacy when there is a change in scope of practice of an individual prescriber, or when an individual leaves post; In the case of loss or suspected theft of WP10 prescriptions, to inform Pharmacy Duty Manager (UHW) and if appropriate the Police. 6.3 Responsibilities of Cardiff and Vale University Health Board To issue WP10 prescription forms as appropriate and to maintain records and an audit trail of all issues, in CARDIFF AND VALE UNIVERSITY HEALTH BOARD WP10 will be issued through Pharmacy, who will then be responsible for maintaining records and a robust audit trail; 7. Retention or Archiving 7.1Record keeping All health professionals are required to keep accurate, legible, unambiguous and contemporaneous records of a patient s care. Prescribers are required to comply with professional good practice guidelines and employers record keeping policies where appropriate. Supplementary and independent prescribers must write SP or IP respectively after their signature on prescriptions (unless prescribing status is pre-printed on the prescription form). All Wales Prescription Writing Standards must be followed and the details entered into the shared patient record during or immediately after the consultation. 7.2 Prescription stationery Only approved prescription stationery must be used. This includes in-patient medication charts, discharge prescriptions, outpatient prescriptions (including GP communication forms) and WP10 or WP10HP prescriptions (as appropriate to the area of practice).

10 Non Medical Prescribing Policy 8 of 17 Approval Date: dd mmm yyyy 8. Non Conformance All staff are reminded of their responsibilities of being aware of and complying with the organisation s policies, procedures and protocols on Non Medical Prescribing. All staff should be aware that failure to comply with the guidance given in this policy could compromise patient safety and put patients and staff at risk and leave the UHB vulnerable to patient complaints and litigation. 9. References 1. Non medical prescribing in Wales A guide for implementation, Welsh Assembly Government July Maintaining Competency in Prescribing An Outline Framework to help Pharmacist Prescribers, second edition, October 2006, National Prescribing Centre 3. Maintaining Competency in Prescribing An Outline Framework to help Nurse Prescribers, first edition, November 2001, National Prescribing Centre 4. The National Health Service (Physiotherapist, Podiatrist or Chiropodist Independent Prescribers) (Miscellaneous Amendments) (Wales) Regulations 2014 No 2291 (W.226).

11 Non Medical Prescribing Policy 9 of 17 Approval Date: dd mmm yyyy Appendix 1 Procedure for Selection & Accreditation of Non- medical Supplementary & Independent Prescribers within CARDIFF AND VALE UNIVERSITY HEALTH BOARD Practitioner/Line Manager Completes Selection Criteria Form Clinical Board Nurse/Pharmacist/Head of service approval & registration on appropriate course Organisational Lead for Non Medical Prescribing (Deputy Director of Nursing or Service Director for Pharmacy) Individual successfully completes prescribing course Register with professional body Complete Cardiff and Vale UHB Prescribers Scope of Practice form signed by Line Manager, Clinical Board Nurse/Pharmacist or Head of Service and send to Pharmacy Manager updates job description to reflect prescribing role Commence prescribing whilst maintaining portfolio of evidence Inform Clinical Board Nurse/ Pharmacist of any changes in scope of practice Re-submit Scope of Practice form to Pharmacy. Portfolio to include: Complete NPC competency self assessment Prescribing activity log for minimum of 1 month or 50 records Critical incident logs where appropriate Annual audit data and results Continue CPD & Annual appraisals

12 Non Medical Prescribing Policy 10 of 17 Approval Date: dd mmm yyyy Appendix 2 Clinical Board Selection criteria for Non-Medical Prescribers Section 1 Name of practitioner Practitioner / Line Manager to complete Professional group Professional body and registration number Proposed prescribing role (Consider: Type of service, patient activity, type of prescribing role (SP/IP) Is this a new development? Previous application to undertake IP? If yes, why was this not undertaken / supported? What are the anticipated benefits of this role? Does the individual meet the minimum criteria for non-medical prescribing? (appendix 5) Is the individual aware of the time commitments of the training course and has work / home commitment been discussed? Is there a suitably qualified Designated Supervisory Medical Practitioner (DSMP)? Who is this (Give name and job title)? Is the DSMP aware of the time commitment involved and of their responsibilities as a trainer and assessor? Who will be responsible for clinical supervision once the post holder is qualified? (give name and job title) What arrangements will be in place to cover annual leave and other absences? Name of line manager: Designation: Signature of line manager:

13 Non Medical Prescribing Policy 11 of 17 Approval Date: dd mmm yyyy Date: Name of practitioner: Signature of practitioner: Date: Copy form to personal file and send to CB Nurse and Pharmacist)

14 Non Medical Prescribing Policy 12 of 17 Approval Date: dd mmm yyyy Appendix 2 Clinical Board Selection criteria for Non-Medical Prescribers Section 2 to be completed by Clinical Board Nurse/ Clinical Board Pharmacist (as appropriate) Is funding available for the training course? Is this development part of the directorate s overall business plan? What are the funding implications for prescribing when the individual is qualified? Signature of Clinical Board Nurse/Clinical Board Pharmacist approving application Date: Section 3 Signature of Organisational Lead for Non Medical Prescribing (Nursing or Pharmacy as appropriate). Signature Date

15 Non Medical Prescribing Policy 13 of 17 Approval Date: dd mmm yyyy Appendix 3 Cardiff and Vale Scope of Practice for Non Medical Prescribers. Newly qualified non-medical prescribers (or those changing scope of practice) to complete and forward to Pharmacy for inclusion on Cardiff and Vale UHB Register of Non-Medical Prescribers.. Name of post-holder: Professional regulatory body: Membership number: Registered as prescriber? Yes/No Independent or Supplementary prescriber? Job Title Directorate address: Education institute attended for prescribing course (if course attended outside Wales, evidence of numeracy skills assessment will be required before prescribing in the Cardiff and Vale UHB) Date of qualification Designated Supervising Medical Practitioner Name Description of clinical area / scope of practice: Please state clinical condition; independent or supplementary prescribing (or both); area of practice (outpatient, inpatient, primary care) Does the post-holder require WP10 prescription forms? Does the post-holder have unlimited access to patient notes in area of practice? Yes / No Yes / No

16 Non Medical Prescribing Policy 14 of 17 Approval Date: dd mmm yyyy Has the post-holders job description been annotated to reflect Yes / No the prescribing role State evidence of competence in this clinical area (e.g. experience in practice; qualifications): Details of clinical supervision provided to post holder Name of line manager: Designation: Signature of line manager: Date: Name of practitioner: Signature of practitioner: Date: Clinical Board Nurse / Clinical Board Pharmacist (as appropriate) Name Signature Date Assistant Director of Nursing name Signature Date Pharmacy Use Only Date of entry on to Cardiff and Vale UHB Non- Medical Prescribers Register Entered by (Print name) Signature

17 Non Medical Prescribing Policy 15 of 17 Approval Date: dd mmm yyyy Date Appendix 4 Suggested Template for Prescribing Activity Log, for Portfolio. Date Location Patient initials Item(s) prescribed Comments

18 Non Medical Prescribing Policy 16 of 17 Approval Date: dd mmm yyyy Appendix 5 Criteria for Entry onto Integrated Independent Supplementary Prescribing Course Nurses must: Be registered with relevant professional regulatory body Nursing & Midwifery Council (NMC) as a first level nurse, midwife and/or specialist community public health nurse. Pharmacists must: Be registered with relevant professional body Royal Pharmaceutical Society of Great Britain (RPSGB). Be a practising pharmacist. Have at least three years experience as a practising nurse, midwife and/or specialist community public health nurse and be deemed competent by employer to undertake the programme. One year (immediately preceding application to the programme), must have been in the clinical field in which there is an intention to prescribe. Have at least two years patient orientated experience practising in a hospital, community or primary care setting following pre-registration year. Have an up-to-date clinical, pharmacological and pharmaceutical knowledge relevant to their intended area of prescribing practice. Demonstrate how they reflect on their own performance and take responsibility for their own CPD. Demonstrate how they will develop their own networks for support, reflection and learning, including prescribers from other professions. Provide evidence via the Accreditation of Prior and Experiential Learning (APEL) of ability to study at minimum academic level three (degree). Identify a Designated Supervising Medical Practitioner willing and able to contribute to and supervise the days learning in practice element of training. Have practised for a sufficient period to be deemed competent by their employer (particularly if part-time worker). Demonstrate competence in consultation and diagnostic skills.

19 Non Medical Prescribing Policy 17 of 17 Approval Date: dd mmm yyyy Appendix 6 safe handling of prescription pads. The prescription pad/form is the property of the CARDIFF AND VALE UNIVERSITY HEALTH BOARD It is the responsibility of the non medical prescriber to ensure security of the pad/form at all times, therefore: a) Under no circumstances should a blank prescription pad/form be pre signed; b) The prescription pad/form should only be produced when needed, and never left unattended or visible. When not in use the prescription pad/form should be stored in a lockable drawer/filing cabinet/box; c) When travelling between patients the prescription pad/form should not be visible and must be locked in the car boot within a bag; d) The bag and prescription pad/form must always be removed from the car when the car is unattended at the end of the working day. e) Prescribers who: i. Terminate their current employment but continue to work as a prescriber with a different employer. ii. Go on secondment and the issue of prescription pads is therefore, no longer required. iii. leave Go on maternity leave, long term sick leave or special Must return their prescription pad/form to Pharmacy Stolen or lost WP10PN /WP10SP /WP10SPSS/ WP10IP/ WP10IPSS pad /forms procedure In the event of loss or suspected theft the prescriber must report this immediately to Pharmacy and Clinical Board Nurse.

20 EQIA Non Medical Prescribing Policy 2015 Equality Impact Assessment Section A: Assessment Name of Policy - Non Medical Prescribing Policy. Person/persons conducting this assessment with Contact Details Louise Williams Nurse Advisor Medicines Management, Louise.Williams7@wales.nhs.uk Date February 6 th The Policy Is this a new or existing policy Review of existing policy. What is the purpose of the policy? To ensure the Health Board delivers its aims, objectives, responsibilities and legal requirements transparently and consistently, we will increase the range of health care professionals who can prescribe medicines to patients as part of the National Health Service (NHS) Improvement Plan. How do the aims of the policy fit in with corporate priorities? i.e. Corporate Plan This policy ensures that all non-medical prescribing practice within the Cardiff and Vale UHB is governed by robust procedures and processes. It is designed to ensure patient safety, safeguard and support the staff working in these roles and to ensure compliance with legislation. Who will benefit from the policy? Patients and the Multi Disciplinary team. What outcomes are wanted from this policy? Increased patient choice in accessing medicines; Improved access to advice and services; Appropriate use of skilled healthcare workforce; Enabling more flexible team working across the NHS allowing doctors to manage more complex patients and develop new skills; Enhance service delivery, enabling further development of services in line with local and national strategy; Improvement in patient care without compromising patient safety. Are there any factors that might prevent outcomes being achieved? (e.g. Training/practice/culture/human or financial resources) In order to become a non medical prescriber the identified professional must successfully complete the appropriate module. There is a cost applied to the training process, in both financial and work time terms.

21 EQIA Non Medical Prescribing Policy Data Collection Nursing and Midwifery Council - Standards for Medicines Management. Nursing and Midwifery Council - The Code. Nursing and Midwifery Council Non Medical Prescribing Standards. All Wales Prescribing Standards. Good prescribing guide. Non Medical Prescribing Wales An Implementation Plan 2007 Welsh Assembly Government (WAG) Guidance Non medical prescribing in Wales A guide for implementation July for full details of the legislation and professional requirements. 3. Impact Please answer the following Do you think that the policy impacts on people because of their age? (This includes children and young people up to 18 and older people) No adverse impacts have been identified Do you think that the policy impacts on people because of their caring responsibilities? No adverse impacts have been identified Do you think that the policy impacts on people because of their disability? (This includes Visual impairment, hearing impairment, physically disabled, Learning disability, some mental health issues, HIV positive, multiple sclerosis, cancer, diabetes and epilepsy.) No adverse impacts have been identified Do you think that the policy impacts on people because of Gender reassignment? (This includes Trans transgender and transvestites) No adverse impacts have been identified Do you think that the policy impacts on people because of their being married or in a civil partnership? No adverse impacts have been identified Do you think that the policy impacts on people because of their being pregnant or just having had a baby? No adverse impacts have been identified Do you think that the policy impacts on people because of their race? (This includes colour, nationality and citizenship or ethnic or national origin such as Gypsy and Traveller Communities.) No adverse impacts have been identified

22 EQIA Non Medical Prescribing Policy 2015 Do you think that the policy impacts on people because of their religion, belief or non-belief? (Religious groups cover a wide range of groupings the most of which are Buddhist, Christians, Hindus, Jews, Muslims, and Sikhs. Consider these categories individually and collectively when considering impacts) No adverse impacts have been identified Do you think that the policy impacts on men and woman in different ways? No adverse impacts have been identified Do you think that the policy impacts on people because of their sexual orientation? (This includes Gay men, heterosexuals, lesbians and bi-sexuals) No adverse impacts have been identified Do you think that the policy impacts on people because of their Welsh language? No adverse impacts have been identified 4. Summary. It is anticipated that the policy will have positive impacts for all equality groups as they will benefit from increased patient choice in accessing medicines and improved access to advice and services; The Policy does not present any negative impacts for any equality group. The policy is not directly or indirectly discriminatory under the equalities legislation.

23 EQIA Non Medical Prescribing Policy 2015 Appendix 3 Cardiff and Vale University Health Board Action Plan As no negative impact has been identified on any equality group in reference to this policy there are no actions identified. 6. Report, publication and Review Please record details of the report or file note which records the outcome of the EQIA together with any actions / recommendations being pursued (date, type of report etc) Policy Approval Cover Report - Non Medical Prescribing Policy. Quality and Safety Executive April 2015 Please record details of where and when EQIA results will be published Cardiff and Vale Intranet Site (CAVWEB) Policies and Procedures page. Please record when the EQIA will be subject to review. April Name of person completing Louise Williams Nurse Advisor Medicines Management C&VUHB Signed Louise Williams Date: 6 th February 2015 Name of Senior Manager Authorising Assessment and Action Plan for publication Darrell Baker Service Director Pharmacy. Signed: Date:

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