Prescribers are responsible for all prescriptions they sign, including repeat prescriptions. Here Julie Price, head of risk management and education consultancy at Medical Protection, identifies the risks associated with nurse prescribers.
Nurse prescribers and prescribing pharmacists should only authorise and sign prescriptions that are within their medical competence – with the remainder being authorised by GPs. Prescribers are responsible for any prescription they sign, including repeat prescriptions initiated by colleagues.
If nurse prescribers do wish to sign repeat prescriptions, there should be robust processes in place for the review of each prescription. The nurse prescriber should only sign a prescription for medicines that they have adequate knowledge about.
What the guidance says
Nursing and Midwifery Council, The Code: Professional standards of practice and behaviour for nurses and midwives (2016)
18.1 “Prescribe, advise on, or provide medicines or treatment, including repeat prescriptions (only if you are suitably qualified) if you have enough knowledge of that person’s health and are satisfied that the medicines or treatment serve that person’s health needs.”
Nursing and Midwifery Council, Standards for competence for registered nurses (2014)
“All nurses must: practise independently, recognising the limits of their competence and knowledge. They must reflect on these limits and seek advice from, or refer to, other professionals where necessary.”
Royal Pharmaceutical Society, A Competency Framework for all Prescribers (2016)
7.1 “Prescribes within own scope of practice and recognises the limits of own knowledge and skill.”
7.4 “Minimises risks to patients by using or developing processes that support safe prescribing particularly in areas of high risk (eg, transfer of information about medicines, prescribing of repeat medicines).”
GPs also have professional responsibility when delegating to a member of the healthcare team. The GMC states in Good Medical Practice (2013): “When delegating care you must be satisfied that the person to whom you delegate has the knowledge, skills and experience to provide the relevant care or treatment; or that the person will be adequately supervised. When you delegate care you are still responsible for the overall management of the patient.”
Call Medical Protection FREE on 0800 561 9090 for further medicolegal advice.
Further resources
Practice profile: New repeat prescribing system
MPS highlights prescribing as one of the top risks in general practice
Risk alert: Repeat prescribing
Video - Clinical Risk Self Assessments for General Practitioners
Related workshops
Your Repeat Prescribing Journey
Clinical Risk Assessment for Repeat Prescribing
Medication Errors and Safer Prescribing in Primary Care for Your Team