Drug prescribing by nurses in the UK - Editor of the Lancet urges caution

May 30, 2002

The contentious issue of drug prescribing by nurses is assessed by Richard Horton, Editor of THE LANCET, in a Commentary in this week's issue of the journal. He concludes that UK government plans to introduce unrestricted prescribing rights to nurses over the next few years could have serious consequences in the provision of health care.

Richard Horton comments: "Nurse prescribing offers enormous benefits to patients. But the evidence indicates that the rate at which nurse prescribing is being implemented holds grave dangers if the policy set out by Milburn [Minister for Health], Jones [Royal College of Nursing], and others is acted upon - and the first supplementary nurse prescribers are supposed to be qualified by the end of this year - the UK will be embarking on a dangerous uncontrolled experiment."

The Commentary is critical of the motives which underlie current UK government thinking on drug prescribing. Horton adds: "Nurses are being manipulated, under the guise of providing quicker and more efficient access to health care to fill the gaps left by too few doctors. Prescribing is not a major advance in professional status for nurses. It is merely redrawing the boundaries of a profession to serve an acute political problem, with little regard for the impact it will have either on nursing or patient care. Moreover, when doctors prescribe, they make mistakes. Only very recently have we begun to understand why [see Lancet 2002; 359: 1373-78]. Surely we must learn more about why errors take place before further widening prescribing responsibilities. To extend the burden of risk so quickly is reckless."

The additional training of nurses required for drug prescribing is highlighted as a crucial issue, yet there exist major inconsistencies within current nursing curricula, Horton observes: "If prescribing rights are extended to all drugs, nurses will need to know basic and clinical pharmacology - including the mechanism of action of drugs, pharmacokinetics, pharmacodynamics, and how to appraise evidence from clinical trials. In other words, we will be training nurses to be more like doctors. Is that really the future of nursing. This issue is not a question of retraining interprofessional barriers. It is about respecting distinctive professional expertise at a time when there is a serious nursing shortage."

Richard Horton concludes: "Taken together, this evidence, and the uncertainties and arguments that flow from it, send a clear message to government: slow down the process of widening prescribing rights. Nurse prescribing has too much to offer patient care to let it founder through hasty and politically expedient implementation."
Contact: Dr Richard Horton, c/o Richard Lane, The Lancet Press Office, 32 Jamestown Road, London NW1 7BY, UK; T) +44 (0)20 7424 4949; F) +44 (0)20 7424 4912; E) richard.lane@lancet.com


Related Health Care Articles from Brightsurf:

Study evaluates new World Health Organization Labor Care Guide for maternity care providers
The World Health Organization developed the new Labor Care Guide to support clinicians in providing good quality, women-centered care during labor and childbirth.

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

MU Health Care neurologist publishes guidance related to COVID-19 and stroke care
A University of Missouri Health Care neurologist has published more than 40 new recommendations for evaluating and treating stroke patients based on international research examining the link between stroke and novel coronavirus (COVID-19).

Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.

International medical graduates care for Medicare patients with greater health care needs
A study by a Massachusetts General Hospital research team indicates that internal medicine physicians who are graduates of medical schools outside the US care for Medicare patients with more complex medical needs than those cared for by graduates of American medical schools.

The Lancet Global Health: Improved access to care not sufficient to improve health, as epidemic of poor quality care revealed
Of the 8.6 million deaths from conditions treatable by health care, poor-quality care is responsible for an estimated 5 million deaths per year -- more than deaths due to insufficient access to care (3.6 million) .

Under Affordable Care Act, Americans have had more preventive care for heart health
By reducing out-of-pocket costs for preventive treatment, the Affordable Care Act appears to have encouraged more people to have health screenings related to their cardiovascular health.

High-deductible health care plans curb both cost and usage, including preventive care
A team of researchers based at IUPUI has conducted the first systematic review of studies examining the relationship between high-deductible health care plans and the use of health care services.

Read More: Health Care News and Health Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.