Supplementary Prescribing by Nurses within NHSScotland: A Guide for Implementation

Supplementary Prescribing by Nurses within NHS Scotland


Supplementary Prescribing by Nurses within NHSScotland: A Guide for Implementation

ANNEX D
SUPPLEMENTARY PRESCRIBERS
PART 1: REGISTRATION

Registration with the Primary Care Information Group (PCIG) of the Common Services Agency Information & Statistics Division (ISD)

1. Supplementary prescribers employed in the NHS Primary Care sector must be registered 2 with the Primary Care Information Group (PCIG). Employers are asked to use form ISD (P) 1 "Primary Care Nurse Prescribers: Registration or Change of Circumstances" for this purpose. (Form ISD (P) 1 is reproduced at Appendix 1.)

2. Form ISD (P) 1 should also be used to notify PCIG of any new or changed circumstances (e.g. change of name) for all nurse prescribers (HV/DN, Extended Formulary or Supplementary). Stocks of ISD (P) 1 will be distributed to all appropriate NHS offices as soon as possible. When they are received any remaining stocks of the previous notification form should be destroyed. (That form was included as an annex to "Extending Independent Nurse Prescribing within NHSScotland") and known as Annex A.

3. The information requested on form ISD (P) 1 includes:

  • Supplementary prescriber's profession and name;

  • Supplementary prescriber's "personal identification number" provided by the NMC;

  • Details of the GP practice(s) where the supplementary prescriber's patients are registered;

  • Organisation for which prescriber works (where relevant).

NB. Employers must notify PCIG of each GP practice whose patients are served by the supplementary prescriber and identify the "principal prescribing practice" i.e. the GP practice for whose patients the supplementary prescriber will write the most prescriptions.

4. On receipt of the correctly completed ISD (P) 1 a prescriber code will be allocated and ISD (P) 1 form will be returned to the lead nurse.

Changes to Prescriber Details

5. (i) It is the responsibility of employers to notify PCIG without delay of all relevant changes to prescriber details, e.g. change of name on marriage, etc. Form
ISD (P) 1 should also be used for this purpose. No change can be made to prescription stationery until formal notification is received.

(ii) Any changes of prescriber details should be passed to the relevant NHS Board or Trust administrator within 48 hours (excluding weekends or Bank Holidays). This information should be passed to PCIG as specified in (i) above.

6. When completed, ISD (P) 1 should be sent by post to Primary Care Information Group, Information & Statistics Division, Trinity Park House, South Trinity Road, Edinburgh EH5 3SQ. This address is also printed on the form.

Prescriber Ceases Employment / Prescribing

7. PCIG must be advised immediately if a registered supplementary prescriber stops prescribing together with an appropriate reason e.g. because s/he has changed employer, retired, resigned, been suspended from the register or had her/his approval as a prescriber withdrawn.

8. In this situation, prescription stationery should be retrieved from the prescriber as a matter of urgency, and disposed of in accordance with the procedure outlined in Part 2 paragraph 11.

9. Notification is also required where the prescriber's employer is contracted to provide services for other commissioning organisations, e.g. nursing services through a Community Nurse Prescribing Contract. See also Part 2 paragraph 8 - "Non-NHS Employees".

10. Employers should annotate their lists of supplementary prescribers with the reasons for any changes to ensure that an up-to-date record exists.

PART 2: PRESCRIPTION STATIONERY

GP10N: Nurse Prescribers - Primary Care

1. Nurses working in primary care settings will prescribe using a GP10N form annotated, "EFNP/SUPPLEMENTARY PRESCRIBER" ( copy attached at Appendix 4). The GP10N will be pre-printed with the prescriber's name, nurse prescriber code, Nursing and Midwifery Council (NMC) number, practice address and contact telephone number.

2. EFNP/Supplementary prescribers who prescribe across more than one GP practice will be supplied with 2 different types of GP10N prescription pads. Pads issued in respect of the "principal prescribing practice" i.e. the practice for whose patients the greatest number of prescriptions will be written, will be pre-printed with all the details described above. See ( Appendix 4). Prescription pads used for patients registered with any other GP practice will be printed with the prescriber's name, NHS Organisation address, NMC number and contact telephone number. Prescribers will need to write the appropriate nurse prescriber code on each prescription form. See ( Appendix 5.)

Ordering GP10N Stationery

3. On receipt of form "Primary Care Nurse Prescribing: Registration or Change of Circumstances" (ISD) (P) 1 ( Appendix 1) from PCIG the lead nurse will order a supply of stationery for the EFNP/Supplementary prescriber using form PSD 1, ( Appendix 2), which should be sent to: Practitioner Services, Room D090, Trinity Park House, South Trinity Road, Edinburgh EH5 3SG.

Nurse Prescribers - Secondary Care

4. Prescriptions can be written for hospital inpatients or outpatients using:

  • Hospital inpatient prescription forms or sheets - used for inpatients and discharge supplies only.

  • Internal hospital prescription forms - used for outpatients in cases where the hospital pharmacy dispenses the prescription.

  • HBPN prescription forms, used for prescriptions written by a hospital prescriber for dispensing by a community pharmacist.

NB. Prescriptions written on internal hospital forms cannot be accepted for dispensing at community pharmacies.

Ordering HBPN Stationery

5. There is currently no requirement to notify PCIG of changes to the details of hospital-based supplementary prescribers. This is because no prescriber details are pre-printed on HBPN forms. ( Copy attached at Appendix 6.)

6. (i) Once registered with the NMC as a supplementary prescriber, a nurse should inform her/his lead nurse who will arrange for the Chief Pharmacist to order a stamp containing the following information:

  • EFNP/SUPPLEMENTARY PRESCRIBER

  • NMC number

  • Contact address and telephone number

  • Hospital/Department prescriber code.

(ii) The Chief Pharmacist will also order HBPN forms by completing PSD 2 and forwarding it to: Practitioner Services, Room D090, Trinity Park House, South Trinity Road, Edinburgh EH5 3SG. Each prescription form will have to be stamped with the above information before use. ( PSD 2 is reproduced at Appendix 3.)

General Administrative Arrangements

7. Stationery supplies for NHS prescribers are normally distributed in bulk twice per year. Prior to each distribution a review of current prescribers is conducted by PSD with the help of NHS Boards/Trusts. In order to avoid errors each NHS Trust/Board is asked to complete the PSD Master List electronically.

Non-NHS Employees

8. A non-NHS supplementary prescriber cannot issue a GP10 type prescription, ie one which will be dispensed in a NHS community pharmacy, unless the organisation they work for has an arrangement/contract with an NHS provider which allows the non-NHS organisation to use NHS community pharmacy dispensing services. The NHS provider should organise the supply of GP10-type prescription forms (and obtain the prescribing code(s) to be used) for the non-NHS organisation, if this is appropriate.

Prescription Forms Ordered but not Delivered

9. Practitioner Services Division (PSD) should be informed about prescription stationery which is ordered, but not delivered. Contact:

Moira Gardner
Practitioner Services, Room D090
Trinity Park House
South Trinity Road
Edinburgh EH5 3SE

e-mail: moira.gardner@psd.csa.scot.nhs.uk
Tel: 0131 551 8175
Fax: 0131 625 6236

Security and Safe Handling of Prescription Forms: Good Practice

10. The security of prescription forms is the responsibility of both the employing organisation and the prescriber. Local policy should be established on monitoring the use of prescription forms to deter theft and fraudulent use. Employers should record the serial numbers of prescriptions issued to each prescriber, and to surgeries, clinics etc. It is also advisable to hold minimal stocks of prescription stationery. This reduces the number of forms vulnerable to theft, and helps to keep stocks up-to-date. (Prescription forms are normally revised annually.)

11. It is the responsibility of the employer to:

  • Recover and record all unused prescription forms relating to supplementary prescribers who leave their employment for whatever reason.

  • Send retrieved pads to stores with list of serial numbers.

  • Securely destroy retrieved pads by, e.g. shredding and placing in confidential waste.

  • Ensure that no further prescription pads are ordered for a prescriber who has left their employment or who has been suspended from prescribing duties.

  • Record the first and last serial numbers of the pads destroyed.

12. Each prescriber should keep a record of the serial numbers of prescriptions issued to him or her. The first and last serial numbers on each pad should be recorded. It is also good practice to record the number of the next unused prescription form on an in-use pad at the end of the working day. Such steps help to identify any forms that are lost or stolen.

13. Blank prescription forms must never be pre-signed and prescription pads should never be left unattended. In addition, prescription forms should not be left on a desk but placed in a locked drawer and produced when needed. Best practice is to return all unused forms to stock at the end of the session or day. Prescriptions are less likely to be stolen from (locked) secure stationery cupboards than from desks, bags or cars.

14. All prescribers working in primary care should report the loss or theft of prescription stationery to their Primary Care Manager as soon as the theft/loss is discovered. The approximate number of prescription forms lost/stolen, their identification numbers, and where and when they were lost or stolen must be reported.

15. (a) The Primary Care Manager will immediately notify the Fraud Liaison Officer (FLO) who is responsible for informing local pharmacists and deciding on the action to be taken.

(b) The FLO should notify

Counter Fraud Services
Stevenson House
555 Gorgie Road
Edinburgh
EH11 3LG
Tel: 0131 536 5252
Fax: 0131 536 5255
Email: gail.tait@psd.csa.scot.nhs.uk

who will maintain a database of lost/stolen prescription forms.

16. Following a loss of prescription stationery the prescriber concerned will be asked to write and sign all prescription forms in a particular colour (usually red) for a period of two months. The employer will inform all pharmacies in their area and adjacent NHS areas of the name and address of the prescriber concerned, the approximate number of prescription forms lost/stolen and the period for which the prescriber will write in a specific colour. This advice will normally be put in writing within 24 hours, excepting weekends.

17. In the event of a loss or suspected theft, an Acute sector-employed prescriber should report this immediately to whoever issued the prescription forms (normally the hospital pharmacy) and the local fraud specialist. The prescriber should give details of the number of scripts stolen, their serial numbers, and where and when they were stolen. Thereafter hospital-based prescribers should follow local instructions following the loss or theft of prescription forms - this may include writing and signing all scripts in a particular colour (usually red) for a period of two months.

18. NB. All of the above requirements highlight the need for clear channels of communication, particularly between GP practices/PMS pilots and primary care systems.

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