The School Of Nursing And Midwifery.

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1 The School Of Nursing And Midwifery. FUNDING OF NON-MEDICAL PRESCRIBING TRAINING If you are entitled to obtain NHS funding all parts must be completed if you would like funding for your training. If you are self-funding or privately sponsored please complete all sections applicable to you. When completed please return to: CPD Admissions, The University of Sheffield, School of Nursing & Midwifery, Barber House 387 Glossop Road, Sheffield, S10 2HQ Name: SECTION 1 APPLICANT DETAILS (to be completed by the applicant) PIN/Registration Number (As it appears on your professional register NMC, RPSGB, HPC): Year of Qualification: Date of Birth: Organisation/Employer: Work Address: Telephone Number: Unit Code (delete as appropriate): SNM3223 (Degree)/ SNM624 (Masters) Start Applicant Number/Registration Number (if known): What is your job title and how long have you been in post? SECTION 2 DESCRIBING THE SERVICE TO BE PROVIDED (to be completed by the applicant) Is this an extension of service provision within your current role or to provide a new service? Organisation where you anticipate using your prescribing training (if different from above) 1

2 Approximate number of patients who may have access to your prescribing services in one year: Estimated total number of prescriptions likely to be written in one year: How will improvements in patient care be demonstrated? Is this the first time you have applied for this training? If you are unable to attend the course after a place has been allocated it is your responsibility to inform both the university and organisation non-medical prescribing lead as soon as possible. This will allow the place to be freed for someone else. Failure to do this may incur an organisation charge. It is your professional responsibility and an expectation that you will inform the non-medical prescribing lead of your course results on completion. It is an NMC requirement that all applicants have a DBS/CRB check taken within 3 years of the commencement date of this course. You will need to provide the date and number of this DBS/CRB check on the first day of your course. If this has not been produced by the second week of the programme you will be withdrawn. SECTION 3 DESIGNATED MEDICAL PRACTITIONER DETAILS (to be completed by the Designated Medical Practitioner/Mentor) Name: Job Title: Organisation: Address: Telephone: What is your professional status & qualification(s) (please include dates): 2

3 What teaching/mentor qualification do you hold (please include dates): What recent professional development have you undertaken (e.g. conferences/study days/units): Do you have 3 years prescribing experience in a relevant field of practice? If you are a General Practitioner do you hold a Vocational Training Certificate or an equivalent that is recognised by the Joint Committee for Postgraduate Training in General Practice or an equivalent exemption certificate? Are you a Specialist Registrar, Clinical Assistant or Consultant within the NHS Trust or another NHS employer? Do you have the support of your employing organisation to act as a DMP Mentor for the above named applicant who will be required to supervise, support and provide opportunities for development in prescribing practice? Do you have experience of training, teaching or supervising in practice? How many years? Have you been a designated medical supervisor/mentor for a non-medical prescriber on this course before? If yes please give details: Will you have regular contact with the trainee prescriber sufficient to undertake the responsibilities of a Designated Medical Prescriber? Is there an experienced Nurse Prescriber who can support you in the assessment of practice? SECTION 4 SELECTION CRITERIA FOR NON-MEDICAL PRESCRIBING TRAINING (to be completed by the line manager, designated medical practitioner or NMP lead as appropriate in the individual case) Meeting Service or Patient Need A service or patient need has been identified which will benefit from non-medical prescribing. The service or patient need requires non-medical prescribing rather than PGD use for supply and/or administration 3

4 What benefits to patient care and the organisation are anticipated from utilising non-medical prescribing? Is it a new service or an extension of service provision within the current role? Which group(s) of patients will the service be provided for or what speciality? What setting? (E.g. outpatients, GP practice) What disease state(s)? Number of prescription items each year estimated: Applicant Suitability Please note: The individual must have a DBS/CRB undertaken within the last 3 years and must be able to provide evidence of this prior to registration for the programme Is this profession eligible for training as a supplementary and/or independent prescriber? Is this individual registered with the professional body? Has a non-medical prescribing course been started previously and not completed? If so when? The individual has the appropriate post-registration experience in the relevant speciality The individual has sufficient therapeutic knowledge and skills in their chosen area to enable them to prescribe safely (note NMC standards for prescribing in children and young people) The individual has demonstrated an ability to diagnose in their area of specialty The individual is able to study at the required level to fulfil course requirements The individual is able to demonstrate the required level of numeracy to fulfil course requirements Organisation Support-Pre Course The individual is in a role which will enable them to commit to a long-term prescribing role A prescribing budget is agreed and available to initiate a prescribing role on qualification Any cross boundary prescribing and budget issues resolved Service continuity issues utilising non-medical prescribers addressed Support of line manager agreed Relevant clinical lead(s) have agreed to support non-medical prescribing in the defined area(s) Support of the organisation non-medical prescribing lead has been agreed Support of a doctor to act as a designated medical practitioner agreed Doctor meets criteria to act as Designated Medical Practitioner 4

5 Arrangements have been made for release of the individual for training and these are agreed with the employing organisation The individual is able to attend the chosen course Funding for backfill and travel can be identified within the organisation, if necessary The individual has agreed to undertake training and can attend all the university study days Individual can access support from experienced non-medical prescribers as required Organisation Support-Post Course Individual can access peer support as required The organisation can assist the individual to maintain their CPD Mechanisms to monitor the benefits to patient care that the organisation anticipates from utilising non-medical prescribing are in place Audit and evaluation processes for non-medical prescribing are in place Prescribing practice can be built into the individual s appraisal and PDP Job descriptions and contracts can be updated Mechanisms to assess continued competence are in place (note NMC stds for c&yp) SECTION 5 SIGNATURES By signing here I acknowledge that all the statements above are correct, unless otherwise stated. Name of Line Manager: Line Manager Organisation Non-medical Prescribing Lead Name of Non-Medical Prescribing Lead: Name of LBR Lead: Learning Beyond Registration (LBR) Lead 5