Clinical Governing Non-Medical Prescribing in an NHS Trust: Issues for Consideration in Mental Health and Learning Disability

Abstract

The Department of Health (2006a) assert that Non-Medical Prescribing (NMP) has provided patients with faster access to medicines, improved access to health services and made better use of health professionals’ skills since it’s inception over a decade ago. NMP operates from statute, and is required be underpinned by a robust clinical governance framework. This article provides the reader with a summary of the NMP policy and legal context to date, attempting throughout to apply the discussion to the field of mental health and learning disability. It then proceeds to demonstrate the means by which NMP was clinically governed in an acute NHS trust. The aspects of clinical governance to be particularly focused upon comprise the auditing of NMP, implementing independent prescribing, regulating NMP for children and young people as well as producing patient/service user information. To date mental health and learning disability organisations have mostly implemented supplementary prescribing only, and have been slow to implement independent prescribing compared to general or primary care settings (Bradley et al 2008). However given that independent prescribing is now nationally implemented (Department of Health 2006b), it is hoped that the sharing of practice innovations and lessons learned in one acute NHS trust with colleagues in mental health and learning disability, will be timely. The article then concludes by indicating how monitoring and evaluation of the clinical governance established thus far is the necessary next step, as well as signposting some further governance challenges for NMP.