Non Medical Prescribing Policy

Non Medical Prescribing Policy Author: Sponsor/Executive: Responsible committee: Ratified by: Consultation & Approval: (Committee/Groups which signed off the policy, including date) This document replaces: Non Medical Prescribing Lead Non Medical Prescribing Steering Group Director of Nursing and Quality Clinical Governance and Patient Safety Group Quality, Safety and Governance Committee Clinical Governance and Patient Safety Group / June 2016 V3 Date ratified: June 2016 Date issued: July 2016 Review date: June 2019 Version: 4 Policy Number: Purpose of the Policy: If developed in partnership with another agency, ratification details of the relevant agency P19 This policy has been developed to ensure that prescribing by non-medical prescribers is introduced appropriately into the Trust. N/A Policy in-line with national guidelines: Signed on behalf of the Trust:.. Aidan Thomas, Chief Executive Elizabeth House, Fulbourn Hospital, Fulbourn, Cambs, CB21 5EF Phone: 01223 726789

Version Control Page Version Date Author Comments 1.0 Dec 2008 Clare Gaskell Developed from an SHA Framework and Peterborough PCT Policy. Ratified. 2.0 May 2010 Clare Mundell Reviewed to reflect new guidance. Ratified by Quality & Healthcare Governance Committee 3.0 September 2012 Helen Forty Reviewed to reflect inclusion of children s services and new legislation. Ratified by Quality and Performance Sub-Committee 4.0 Julia Ferris Reviewed to reflect inclusion of Integrated Care Services and new legislation Policy Circulation Information Notification of policy release: All recipients; Staff Notice Board; Intranet; Key words to be used in DtGP search. Non Medical Prescribing CQC Standards Regulation 9: Person Centred Care Regulation 12: Safe Care and Treatment Other Quality Standards

Contents 1 Introduction and Scope... 4 2 Purpose and Responsibilities... 4 3 Definitions... 5 4 Non Medical Prescribing in CPFT... 5 5 Supplementary and Independent Prescribing within CPFT... 7 6 Registration within the Trust... 7 7 Application for Organisational Support from the Trust to Undergo Education and Training for Prescribing... 8 8 Accountability and Continuing Professional Development... 9 12 Security and Safe Handling of Prescription Pads... 11 13 Indemnity Insurance and Legal Liability... 12 14 Monitoring of the Policy and Prescription Monitoring... 12 15 Handling ADRs and Medication Incidents... 12 16 Drug Alerts and Recalls... 13 17 Working with the Pharmaceutical Industry... 13 APPENDIX 1... 14 APPENDIX 2... 16

1 Introduction and Scope 1.1 This policy applies to all activity by qualified Non Medical Prescribers employed by the Trust or providing NHS services to the Trust. It also applies to people who wish to undergo training to become a qualified non medical prescriber. 1.2 The aim of this policy is to provide wider and faster access to medicines for service users with more appropriate and flexible use of the workforce skills. NB: This policy does not include Patient Group Directions (PGDs); refer to the Medicines Policy. 1.3 This policy should be read in conjunction with the following policies and procedures that may be referred to throughout this document: Non Medical Prescribing Strategy Medicines Policy including the use of unlicensed and off-label medicines FP10 Procedure (including prescribing and ordering guidelines) Incident and Near Miss Reporting Policy Interaction with Pharmaceutical Industry Policy 1.4 The policy should be read in conjunction with the relevant professional standards from the NMC (Nursing and Midwifery Council), RPS (Royal Pharmaceutical Society) and HCPC (Health and Care Professionals Council). 2 Purpose and Responsibilities 2.1 This policy has been developed to ensure that prescribing by non-medical prescribers is introduced appropriately into the Trust. This is to ensure that: The changes benefit service user care and improve access to medicines. The prescribing practice is compatible with the service development plans of the Trust and is an appropriate extension of a practitioner s role. All non medical prescribers are appropriately qualified for their role and work within the agreed national and local policies. It will also ensure that they are identified in the Trust. All non medical prescribers are supported in their role and access continuing professional development. 2.2 The Chief Executive and the Trust Board have overall responsibility for ensuring that systems and processes for non medical prescribing are robust. 2.3 The Trust Non Medical Prescribing (NMP) Steering group has been established to be responsible for developing this policy and take the lead on the development of non medical prescribing within the Trust. It will also provide a support network for non medical prescribers. 2.4 The NMP lead responsibilities are laid out within this policy. This is particularly in regard to ensuring that the Trust has an up to date database of prescribers and support for non medical prescribers.

3 Definitions 3.1 Independent Prescribing (IP) (Formerly Extended Formulary Prescribing (EFP) : Prescribing by a practitioner (e.g. nurse, pharmacist, physiotherapist and podiatrist) responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing. Registered nurses and pharmacists must have completed the necessary education and training in order to be authorised to prescribe independently. Independent Prescribers can prescribe from the British National Formulary (BNF), e-british National Formulary, British National Formulary for Children (BNFc) or e-british National Formulary for Children. Following legislation changes 23/4/12 both Nurse and Pharmacist Independent prescribers can now prescribe any schedule 2-5 controlled drug within their clinical competence. Full details www.legislation.gov.uk/uksi/2012/973/contents/made. Following legislation changes 1/6/2015 physiotherapists and chiropodists can prescribe a restricted list of controlled drugs within their clinical competence. Full details www.legislation.gov.uk/uksi/2015/891/contents/made. 3.2 Supplementary Prescribing (SP): Supplementary prescribing is a voluntary prescribing partnership between an independent prescriber (doctor) and a supplementary prescriber (SP), who has completed the necessary education and training, to implement an agreed patient-specific Clinical Management Plan (CMP) with the patient s agreement. A supplementary prescriber can only prescribe within the parameters set out in the CMP which has been agreed and signed by an independent prescriber (doctor), and agreed with the patient. Supplementary Prescribers can prescribe from the British National Formulary, e-british National Formulary, British National Formulary for Children (BNFc) or e-british National Formulary for Children. Following legislation changes 23/4/12 supplementary prescribers can now prescribe any schedule 2-5 controlled drugs within their clinical competence under a CMP. Full details www.legislation.gov.uk/uksi/2012/973/contents/made. CMPs should follow the national template; CPFT CMP is available from the NMP Lead 3.3 Community Practitioner Nurse Prescribing (V100/V150) V100 - Community practitioner prescribers are nurses who have undertaken a prescribing programme as part of a Specialist Practitioner qualification for example district nurses, health visitors and school nurses. V150 are registered nurses who don t hold a specialist practitioner qualification, but have completed a stand alone prescribing module. Community practitioners with a V100/V150 qualification can only prescribe independently from the Nurse Prescribers Formulary within their clinical competence but not permitted to prescribe off licence. 4 Non Medical Prescribing in CPFT Staff who are eligible to register with the Trust to prescribe are as follows:

4.1 Nurses Nurses will be registered with Nursing & Midwifery Council (NMC) upon successful completion of the independent / supplementary prescribing course or specialist practitioner qualification. The Higher Education institute will notify the NMC and the register will be amended to indicate that nurse has qualified as an Independent/Supplementary Nurse Prescriber V300 or V100 Community Practitioner Prescriber. A qualified nurse registered with the NMC who has successfully completed the Community Practitioner (V100) Prescribing course as part of a specialist practitioner qualification and registered this with the NMC. He/She will prescribe according to competence and from the Nurse Prescribers Formulary. A qualified nurse registered with the NMC who has successfully completed the Independent /Extended Nurse Prescribing Course and registered this with the NMC. A qualified nurse registered with the NMC who has successfully completed the Supplementary Prescribing Course and registered this with the NMC. He/she will prescribe as a Supplementary Prescriber according to a patient specific clinical management plan (CMP). 4.2 Pharmacists A qualified pharmacist registered with the General Pharmaceutical Council (GPhC) who has successfully completed the Independent prescribing course and registered this with the RSPGB. A qualified pharmacist registered with the General Pharmaceutical Council (GPhC) who has successfully completed the supplementary prescribing course and registered this with the (GPhC). He/she will prescribe as a Supplementary Prescriber according to a patient specific clinical management plan (CMP) Pharmacists must register with the (GPhC) upon successful completion of the Independent / Supplementary prescribing course. The Higher Education Institute will notify the. (GPhC). 4.3 Other Professional Groups A qualified physiotherapist, radiographer or podiatrist registered with the Health and Care Professional Council (HCPC) who has successfully completed the Independent prescribing course and registered this with the HCPC. A qualified physiotherapist, radiographer or podiatrist registered with the HCPC who has successfully completed the supplementary prescribing course and registered this with the HCPC. He/she will prescribe as a Supplementary Prescriber according to a patient specific clinical management plan (CMP). Physiotherapist, Chiropodists, Radiographers and Podiatrist must register with the HCPC upon successful completion of the Independent / Supplementary prescribing course. The Higher Education Institute will notify the HCPC. Other professional groups who are granted entitlement to train as independent prescribers and are registered to do so with their professional body

5 Supplementary and Independent Prescribing within CPFT 5.1 All qualified non medical prescribers except community practitioner V100/V150 prescribers can undertake supplementary prescribing within the Trust as defined above (they must be registered with the Trust see Section 2.1). It is expected that supplementary prescribers will have access to clinical supervision from a prescriber: this could be a medical or more experienced non medical prescriber. 5.2 All community practitioner prescribers (V100/V150) should have access to clinical supervision from another prescriber, this could be nursing or medical or a more experienced community practitioner prescriber. 5.3 Independent prescribing must only be undertaken within the Trust with approval by the Non Medical Prescribing Lead and Director of Nursing for nurses and AHP s and for Pharmacists with the approval of the Medical Director and NMP Lead. Where possible this will be done on an individual practitioner basis. It is expected that each practitioner will have access clinical supervision where possible with a prescribing doctor or more experience non medical prescriber either on a 1:1 basis or within a group 5.4 The doctor may be a consultant staff grade, associate specialist or an experienced GP. 5.5 Each individual practitioner, before they can be approved to prescribe independently, must provide the following: An outline of their proposed scope of prescribing practice including the benefits of having an independent prescriber within the role for service users, carers and staff. The specific area of practice in which they will be prescribing and the range of medicines that they may prescribe. Any specific criteria for their prescribing e.g. in what circumstances will they not prescribe or refer to a doctor. Details of their prescribing supervision. 5.6 A template to document this information is available from the Non Medical Prescribing Lead. 6 Registration within the Trust 6.1 The non medical prescriber must advise the Trust NMP Lead of their qualification and intention to prescribe before they start prescribing. 6.2 The qualification and registration must be checked and confirmed by the line manager and shared with the NMP Lead. This includes new staff joining the Trust. No member of staff will prescribe unless they have prior approval from their line manager, the NMP Lead and Director of Nursing or Medical Director. 6.3 The NMP Lead will maintain a database of all non medical prescribers. It will be available on the Trust Intranet site as a read only document for reference.

6.4 A letter of authority to prescribe will be sent to each non medical prescriber. For nurses and AHP s, this will be from the Director of Nursing. For pharmacists, this will be from the Medical Director. 6.5 There must be a statement regarding Non Medical Prescribing within the NMP s job description. If this is not already held within this then an insertion can be added 6.6 Staff joining the Trust who are already qualified as non medical prescribers and non medical prescribers planning to extend their prescribing practice into a new speciality must undertake further practice under supervision of an independent prescriber with whom they will be working. The number of days should be agreed on an individual basis with the independent prescriber. It is considered good practice to complete a reflective diary and revisit the CPFT competency frameworks. The independent prescriber must confirm and document competence. This must then be relayed to the line manager and the NMP Lead. 6.7 When a non-medical prescriber leaves the Trust they and their manager have a responsibility to inform the NMP lead and return any leftover prescriptions according to the Trust or PCT procedures. The NMP Lead must be informed if the NMP has a change of details, job role and change of registration details. 7 Application for Organisational Support from the Trust to Undergo Education and Training for Prescribing 7.1 The training and education required to become a non-medical prescriber is provided externally to the Trust. The non medical prescribing course is accredited and provided by higher education establishments in line with Department of Health and Professional Body standards. 7.2 The NMP Lead can provide advice on the process of course application and available funding. 7.3 Staff and line managers should use the following guidance to determine suitability to undergo the non medical prescribing course. Nurses should have a least three years post registration clinical nursing experience, with one year preceding their application in the clinical area in which they wish to intend to prescribe. Pharmacists should have at least two years experience practicing as a pharmacist in the clinical area in which they intend to practice Physiotherapists, radiographers or podiatrists should have at least three years post registration clinical experience, with one year preceding their application in the clinical area in which they wish to intend to prescribe. Other professionals granted permission to prescribe on a independent/supplementary basis should have at least three years post registration experience with one year preceding their application in the clinical area in which they wish to intend to prescribe unless government legislation or professional body state otherwise Identify the service model within which the non medical prescriber will be operating and discuss with the NMP lead.

Assess whether the prescribing option chosen is best option for medicine access for patient group, e.g. IP / SP or PGD. Assess if there is a budget for prescribing they will have authority to use. 7.4 The application should be discussed with the NMP Lead before submission and it will be approved on behalf of the Trust by the NMP Steering Group for approval either at the next NMP Steering Group or by email to NMP Steering Group depending upon timescale. 7.5 Once qualified as a non medical prescriber, the Trust does expects a non medical prescriber to undertake continuing professional development (as detailed in the next section). There is no requirement for further formal training unless the non medical prescriber does not have any prescribing episodes for a period of a year. If this occurs then some refresher training is required, the exact requirements for this will be decided between the individual, their line manager and the NMP Lead. 8 Accountability and Continuing Professional Development 8.1 Accountability is a key element in relation to non-medical prescribing. All registered non medical prescribers are personally and professionally accountable for their practice, actions and omissions and when prescribing medicines, must work to the same standard or competence that applies to all other prescribers. See Medicines Policy for further details 8.2 Non-medical prescribers must only prescribe within their own level of experience and competence, acting in accordance with Clause 6 of the NMCs Code of Professional Conduct or Medicines, Ethics and Practice A guide for Pharmacists RPS or Standards for Prescribing - HCPC. 8.3 Non medical prescribers will only prescribe medicines that are commonly used within their own service areas and role and are mostly on Trust formulary for mental health and other prescribed medications would generally be on the CCG formulary. 8.4 Non medical prescribers have a responsibility to keep up to date in their field of practice and any changes in national and local policy. 8.5 If there are concerns about a Non Medical Prescribers prescribing competence then the prescriber s Line manager and NMP Lead will be contacted. If required then an NMP may be required to suspend prescribing while any investigations take place 8.6 The NMC states that prescribers are not expected to undertake additional hours of practice to meet practice hours requirements i.e. over and above the 450 hours already expected The NMC has specific guidance about CPD for non medical prescribing nurses. This details the types of activity that constitute CPD as well as principles for CPD. It is available on their website. It also states that CPD must meet individual need. Identification of CPD needs should be undertaken annually (as part of the Trust Appraisal process) and will determine

the required level of input to demonstrate competency. The Trust agrees with this statement but also expects that each non medical prescribing nurse will undertake 15 hours per year of non medical prescribing CPD activity, some of which will be able to be used towards NMC revalidation requirements. Each prescriber must keep a portfolio of CPD and their ongoing needs, through reflection and be able to submit their portfolio once a year to the NMP lead when requested. 8.7 Non medical prescribing pharmacists are also expected to undergo 15 hours per year of NMP CPD activity and to keep a portfolio of CPD and their ongoing needs through reflection. This portfolio should be submitted to the Chief Pharmacist annually. 8.8 The HCPC has no specific guidance around CPD for NMP however the Trust will expect Non medical prescribing physiotherapists, radiographers and podiatrists to follow trust good practice and undertake 15 hours of NMP CPD per year and to keep a portfolio of CPD and their ongoing needs through reflection. This portfolio should be submitted to the NMP Lead who will liaise with the Trust AHP Lead and relevant directorate AHP Lead as required. 8.9 If the NMP Lead, Chief Pharmacist or Trust AHP Lead are concerned that the CPD portfolio and evidence of prescribing decisions are not sufficient to demonstrate competency then a meeting should be called with the non medical prescriber and their line manager to discuss supporting how this can be achieved. 8.10 If the practitioner cannot demonstrate competency through the CPD portfolio and evidence of prescribing decisions then the NMP lead may decide (in consultation with their line manager) that they are no longer approved to prescribe within the Trust. 8.11 The Trust has a responsibility to support non medical prescribers in meeting their CPD needs. This may be through advice or signposting to types of CPD. It is also expected that the NMP lead will arrange 8 hours of CPD or education sessions a year within the Trust. 9 Good Practice and Ethics 9.1 Prescribing should be evidence based 9.2 Non medical prescriber can only prescribe for a patient for whom they have personally assessed. They must not be requested to sign prescriptions for people that they have not assessed. 9.3 Non medical prescribers must ensure that patients are aware they are being treated by a Non Medical Prescriber and the scope of their prescribing practice may mean referral onto another Health Care Professional if necessary. 9.4 Non medical prescribers must not prescribe for themselves or for family members or friends.

10 Documentation and Record Keeping 10.1 All prescribing must be carried out on either Trust approved prescription form or prescription pads (FP10 s) issued to each individual practitioner or named team. The type of form that will be used will depend upon the area of practice; advice can be sought from the Chief Pharmacist and NMP lead. 10.2 On FP10 prescriptions the signature must be accompanied by the IP/SPs details including their registration number. On In-patient ward prescription charts the NMP role must be noted. 10.3 All health professionals are required to keep accurate, legible, unambiguous and contemporaneous records of patient care. All records will be maintained and stored as per Trust Policy and in line with Professional Regulations. 10.4 If prescribing is being undertaken within primary care then the GP record will be either directly updated by the non medical prescriber or a fax will be sent to the GP within 48 hours of writing the prescription so that their records can be updated. 10.5 BNFs for Independent Prescribers will be obtained by the NMP Lead on a yearly review of the Trust database for adult BNFs BNFc. All CPFT NMP s will be informed of how to access the on-line versions of the BNF and BNFc. 11 Ordering Prescription Forms 11.1 FP10 prescriptions CPFT FP10 (green) and nurse prescribers FP10 (Lilac) prescription forms must be ordered according to the FP10 procedure. Each non medical prescriber must order their own prescription pad in order for a specimen signature to be obtained. In some areas, arrangements have been made with a CCG for their prescriptions to be used by Trust staff, in these cases the procedures for obtaining prescriptions should be followed, advice can be sought from the NMP Lead. 11.2 Outpatient prescriptions Outpatient (white) prescriptions can be ordered from your local pharmacy department. 11.3 Trust inpatient prescriptions Should be available for use on the inpatient area or within the team base. 12 Security and Safe Handling of Prescription Pads The FP10 procedure details the requirements for the safe and secure handling of prescription pads including ordering procedures, storage requirements and returning prescriptions pads to Fulbourn pharmacy or follow procedure for returning CCG pads when leaving employment with the Trust.

13 Indemnity Insurance and Legal Liability 13.1 The Trust will hold vicarious liability for non medical prescribers where the following criteria are met: The non medical prescriber is registered with their professional body as a prescriber. The role of the non medical prescriber is approved by the manager and included within the individual s job description. The non medical prescriber must be registered on the Trust data base. The non medical prescriber must work within the legal framework of the role, within their CMP if appropriate and within Trust Policies. 13.2 Additional indemnity insurance can be provided by trade unions or professional organisations for their members. It is recommended that all non medical prescribers are members of an affiliated trade union or professional organisation. 14 Monitoring of the Policy and Prescription Monitoring 14.1 The pharmacy will provide feedback on prescribing on all prescribing codes registered to CPFT and where arrangements for the supply of prescription pads have been sent up with CCG, the CCG will send the Chief Pharmacist any data relating to our prescribers on a three monthly basis. 14.2 It is responsibility of line managers and individual NMPs to ensure that staff operating as non medical prescribers have read this policy and are operating within it. 14.3 The Trust, through the NMP lead, will audit adherence to the policy once every three years. 14.4 The Trust has a non medical prescribing clinical governance framework that will be reviewed by the NMP lead annually. It is attached at Appendix 1. 15 Handling ADRs and Medication Incidents 15.1 The non medical prescriber must report any medication incidents in accordance with Trust incident, medicines policy and near miss reporting policy. 15.2 If a non medical prescriber suspects that a patient is experiencing/has experienced a drug reaction (ADR) to a medicine or combination of medicines the non medical prescriber will inform the clinician responsible for the patients continuing care. 15.3 The non medical prescriber will evaluate the suspected ADR in accordance with the guidance issued by the Committee on Safety of Medicines and decide if a yellow card needs completing to notify the CSM of a suspected drug reaction. Advice can be sought from pharmacy and the Trust medicine policy. 15.4 Where appropriate the patient specific CMP should be updated to list the suspected /observed allergy ADR and details documented in the patients record.

16 Drug Alerts and Recalls 16.1 Drug alerts and recalls are cascaded via the Medical Directorate to the Director of Nursing, Non Medical Prescribing Lead and Chief Pharmacist as appropriate. They will cascade further to non medical prescribers if necessary. 16.2 Any SABS (Safety Alert Broadcasts) that relate to medication will be cascaded by Medical Devices Lead to the Non Medical Prescribing Lead and nurse prescribers. The Chief Pharmacist will cascade to any pharmacist prescribers. 17 Working with the Pharmaceutical Industry All non medical prescribers will adhere to the Trust policy on working with the Pharmaceutical Industry. Acknowledgements This policy contains some content taken directly from Improving Patients Access to Medicines: A Guide to Implementing Nurse and Pharmacist Independent Prescribing within the NHS in England (April 2006) which means that this policy is applicable to independent prescribing. Further background information and detail can be obtained from the guide.

APPENDIX 1 Non-medical Prescribing Clinical Governance Framework Patient Experience and involvement The Trust should demonstrate: Patient information is available outlining non medical prescribing. Patient forums have been informed about the development of Non-medical Prescribing. Increased patient choice and access to appropriate health professionals. Use of information The Trust should demonstrate: For non-medical prescribers that: Co-ordinated systems are in place to ensure all non-medical prescribers are kept informed of all the relevant clinical information, i.e. changes with immediate effect, Drug alerts, Hazard warnings Prescribers are aware of the importance of using the yellow card system to report Adverse Drug Reactions. (ADRs) Prescribers are aware of the importance of reporting untoward incidents. Information is disseminated on the Trust policy regarding involvement with the representatives of the Pharmaceutical Industry. For the Trust: A co-ordinated system/ database is kept listing all prescribers and their status. Systems are in place to inform Non-Medical Prescribing lead in the Trust when new prescribers are employed and prescribers leave. A system is in place for the ordering and safe distribution of prescription pads to prescribers. A system is in place to retrieve prescription pads when staff leave the Trust A contact point within the Trust for any queries on the prescribing status of staff. i.e. from dispensing pharmacists System for receipt of information from the Head of Learning and Development and the University to the NMP Lead about the status of Trusts applicants to the course and results. Processes for Quality Improvement: The Trust should demonstrate: A Trust Non-medical Prescribing Policy exists and is available to all Non medical prescribers. The policy needs to include: Record keeping, Accountability and liability, Security and safe handling of prescription pads

The organisation has considered the impact of non-medical Prescribing on other policies such as incident reporting, drug errors and near miss major incidents. Non-medical prescribing/ Clinical Negligence Scheme for Trusts Procedures are in place for ordering and distributing the latest available copy of the BNF/NPF and for accessing the e-bnf to Non-Medical prescribers Raise awareness of Non-medical prescribing within the organisation to Doctors, Nurses, Pharmacists, AHP s and Managers. Review the need for Trust Prescribing guidelines/protocols with regard to Clinical Management Plans for supplementary prescribing, i.e. Chronic Disease Management. Provide evidence of monitoring the implementation of Clinical Management Plan development. Assessment of the potential need for Non-medical prescribing within the Trust. Reduction of semi-legal or illegal practices involving prescribing medications, i.e. pre-signed prescriptions, issuing stock supplies. Evidence of how the organisation will address competency issues. Clinical Audit of Non-medical Prescribing. Staff Management: The Trust should demonstrate: Effective infrastructures to develop implement and monitor non-medical prescribing. Job descriptions are amended to account for prescribing responsibilities. All non-medical prescribing staff receives an annual appraisal with reference to prescribing. Effective systems are in place to provide Continuous Professional Development Multi-professional might be an option in the future. Leadership Strategy and Planning: The Trust should demonstrate that: A clear organisational structure exists with the Trust Non-Medical Prescribing lead reporting directly to the Medicines Management Group and the Clinical Governance and Patient Safety Group chaired by Director of Nursing to the Trust Board. An assessment of the suitability of those wishing to access the course takes place, i.e. are they working in a position that requires them to be a prescriber? Are they willing to prescribe once qualified?

APPENDIX 2 CPFT NMP Competencies principle areas, knowledge, skills and competencies required to underpin prescribing practice and monitor CPD NMP COMPETENCIES Building on knowledge gained on NMP course The following need to be met: Competency 1 - Knowledge Has completed appropriate NMP course at degree or masters level or appropriate module Has up-to-date clinical, pharmacological and pharmaceutical knowledge relevant to their area of work Medicines Management mandatory training completed Safe Prescribing e-learning completed (for mental health staff) Aware of national and local policies and procedures related to NMP Competency 2 - Options Evidence Evidence Able to make or review a diagnosis, generate management choices with the patient and follows up management Requests and interprets relevant investigations as per NICE guidelines Aware of trust Formulary or CCG formulary Competency 3 Shared Decision Making Aware of trust Shared Decision Making Policy- ratified January 2015 Competency 4 - Safe Knows the limit of own knowledge and skills and works and prescribes within them Has a, supervisor or supervision group organised Keeps up to date with advances in practice and emerging safety concerns related to prescribing Able to write legible, clear and complete prescriptions that meet legal requirements Evidence Evidence Signature Signature Signature Signature

Competency 5 - Professional NMP qualification registered with NMC, HCPC or GPhC Ensures prescribing practice is consistent with scope of practice, organisational, professional and regulatory standards Accepts personal responsibility for prescribing and understands the legal and ethical implications of doing so Knows and applies legal and ethical framework affecting prescribing practice Takes responsibility for own learning and CPD. CPFT current requirement of 15 hours per year of NMP CPD Competency 6 Always Improving Learns and changes from reflecting on practice to enhance service user outcomes Makes use of networks for support, refection and learning To be part of CPFT Non Medical prescribing group email Competency 7 The Healthcare System Understands and works within local and national policies, processes and systems that impact on prescribing practice. (e.g. NICE, NMC, HCPC, RPSGB and CPFT NMP policy) Competency 8 Information Knows how to access relevant information and can use and apply this information in practice. See Appendix for current books and journals in CPFT library Has an Athens account Competency 9 Self and Others Works as part of a multidisciplinary team to ensure continuity of care Negotiates the appropriate level of support and supervision for role as a prescriber Provides support and advice to other prescribers where appropriate Evidence Evidence Evidence Evidence Evidence Signature Signature Signature Signature Signature

Acceptable evidence to meet competencies Certificates relevant to practice from Courses/ training sessions Copies of written prescriptions to show you are meeting the standards or verbal or written discussion on safe prescription writing Copy of prescribing audits carried out Evidence of reading relevant journals and articles in relation to the competency Verbal evidence through discussion with your mentor/ manager Written evidence of supervision/ mentor notes etc. Verbal knowledge/ awareness of guidelines/ standards/ policies/ procedures etc. relevant to prescribing and area of practice Minutes of meetings with manager/ colleagues/ other prescribers Reflective practice evidence in relation to change/ improvement in practice Evidence of incident forms (if relevant) Discussion using patients notes