Amendments to the Medicines (Jersey) Law 1995
Introduction
Further amendments to the Medicines (Jersey) Law 1995 are necessary to enable a legal framework for appropriate practitioners other than Doctors and Dentists the opportunity to independently prescribe medicine in the future.
Jersey is not unique in facing similar challenges to other Westernised health care models in terms of the need to deliver safe, cost effective and appropriate health care. Effective medicines management contributes to a significant proportion of the overall healthcare budget. Based on research within other Westernised economies and in particular England, it has been demonstrated that specialist and advanced, appropriately educated non medical prescribers have offered an effective solution to this challenge.
Context
Over the last 15 years a series of changes to United Kingdom Medicines Law have seen appropriate practitioners, which include nurses, pharmacists, midwives, physiotherapists gain full prescribing rights identical to their medical & dental colleagues. This has enabled these appropriate practitioners to safely reconfigure their roles within their professional scopes of practice, to provide comprehensive medicines management.
The amendment to the Medicines (Jersey) Law 1995 will enable a similar legal framework to support future opportunities to develop this area of practice, within a governance framework. All aspects of prescribing practice will similarly be regulated by individual professional regulatory bodies.
The envisaged benefits to the Jersey Island community include improved patient access to treatment, enhanced patient care, maintaining and improving patient experience, enhanced professional satisfaction and application of professional skills, building interprofessional working, enabling effective use of medical staff time and maintaining public health standards.
Future specialist and advanced non medical health professionals will thus be well placed to develop new models of healthcare delivery in line with strategic projected healthcare trends. This amendment will ensure recommendations are met in the Island Plan, The Public Health strategy and the overall organisational development of Health & Social Services. The preliminary data from KPMG, similarly supports Non Medical Prescribing as fundamental in contributing to future health care provision, and within this medicines management, which is fit for purpose and practice.
Other perceived benefits include management of chronic disease, healthcare delivery to an aging population, specialist aspects of care including mental health & substance misuse, sexual & reproductive health, management of minor illness and injury and public health education and promotion. The benefits are envisaged for both primary and secondary care settings where medicines management is integral.
This report has been prepared following consultation with the Medicines Advisory Council, Medicines Governance Committee, Senior Nurse Forum, & Nurse Educational Team. The changes currently being proposed are summarised below and have been subject to detailed legal advice from the Law Officers’ Department and a comprehensive human rights audit.
Effects of the Law amendments
Enabling appropriate practitioners to undertake independent prescribing within their professional scope of professional practice, assuming full prescribing rights as non –medical prescribing practitioners.
Implementation
A further report will follow which will detail the implementation plan.
Financial & Manpower Implications
There are no financial or manpower consequences regarding amending the legislation.
European Convention on Human Rights
The Minister for Health and Social Services has signed a statement to the effect that, in accordance with the provisions of Medicines (Amendment no.3) (Jersey) law 2011, the provisions of the projet de loi to be lodged au Greffe are compatible with the Convention rights.
May 2011
References
Berry, D, Courtenay, M, Bersellini, E. Attitudes towards, and information needs in relation to supplementary nurse prescribing in the UK: an empirical study. Journal of Clinical Nursing 2006; 15, 22-28.
Bradley E. & Nolan P. Impact of nurse prescribing: a qualitative study.
Journal of Advanced Nursing 2007; 59 (2), 120-128
Brooks N, Otway C, Rashid C, Kilty E, Maggs C. The patients’ view; the benefits and
limitations of nurse prescribing. British Journal of Community Nursing 2001; 6: 342-348
Carey, N.J., Stenner, K.L , Courtenay M. Stakeholder views on the implementation of nurse prescribing in dermatology services. Journal of Clinical Nursing 2009; 19, 498-506.
Courtenay, M., Stenner, K., Carey, N (2009). Nurses’ and doctors’ views about the prescribing programme, Nurse Prescribing, 7 (9), 412-417
Courtenay, M & Carey, N. J (2009). Nurse prescribing by children’s nurses: views of doctors and clinical leads in one specialist children’s hospital. Journal of Clinical Nursing, 18, 2668-2675.
Courtenay M, Carey N. (2008). Nurse Independent Prescribing and Nurse Supplementary Prescribing: Findings from a national questionnaire survey. Journal of Advanced Nursing, 61 (4), 403-2 41
Courtenay, M., Gordon, J (2009). A survey of therapy areas in which nurses prescribe and CPD needs. Nurse Prescribing 7 (6) 255-262
DoH (2001). Patients to get quicker access to medicines
(Press Release). London: DoH.
DoH (2002).Supplementary prescribing. London: DoH.
DoH (2005) Written Ministerial Statement on the expansion of independent nurse
prescribing and introduction of pharmacists independent prescribing, DoH, London.
DoH (2009). AHPs and medicine supply mechanisms scoping project. London: DoH
Drennan, J., Naughton, C., Allen, D., Hyde, A., Felle, P., O’Boyle, K., Yreacy, P., Butler, M. National Independent Evaluation of the Nurse and Midwife Prescribing Initiative. Dublin: University College Dublin 2009
Hall, J., Cantrill, J., Noyce, P (2006). Why don’t trained community nurse prescribers prescribe? Journal of Clinical Nursing 15, 403-412
Harrison, A. Mental health service users’ views of nurse prescribing. Nurse Prescribing 2003; 1 (2), 78-85.
HO (200&). Supplementary prescribing of CDs by nurses and pharmacists. London: HO
Jones, M., Bennett, J., Lucas, B., Miller, D., Gray, R (2007). Mental health nurse supplementary prescribing: experiences of mental health nurses, psychiatrists and patients. Journal of Advanced Nursing, 59 (5), 499-496.,
Lomas, C (2009). Nurse prescribing: The next steps. Nursing Standard, 14th July.
MHRA (2009). Revised statement on medical and non-medical prescribing and mixing medicines in clinical practice. London: MHRA
NMC (2006) Standards of Proficinecy for Nursing & Midwife Prescribers
Page, D., Grant, G., Maybury, C. Introducing nurse prescribing in a memory clinic.
Dementia 2008; 7 (1), 139-160