Cumberlege Report 1986

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The Cumberlege Report (1986) or Neighbourhood nursing: a focus for care was the report of a Department of Health and Social Security (DHSS) committee advocating that community nurses in the United Kingdom be permitted to prescribe from a restricted list of treatments.

Contents

Context

A committee was created in 1985 by the DHSS to review the care provided by nurses and health visitors outside hospitals and report on how resources could be used more effectively. [1] The committee focussed on primary care nursing. [1] Welsh and Scottish reviews also took place, on different timelines. [2]

Julia Cumberlege was appointed chair. [3]

Report

The Cumberlege Report was published in 1986. The Report stated that patient care would be improved and resources used more effectively if nurses were able to prescribe items from a limited list. [3]

The Report also recommended that a neighbourhood nursing service be established, with eventual removal of differences between distruct nurses, health visitors and school nurses. [2] It suggested a "nurse practitioner" role be created to designate more highly skilled nurses with prescribing powers and also that general practices should not be subsidised to employ practice nurses. [1]

Impact

The Cumberlege Report recommendations were included in Promoting Better Health, a 1987 white paper. [1] A Whitley Council was told to review nurse pay. [1]

In 1989, the Department of Health created a committee with Dr June Crown as chair, to examine nurse prescribing. [4] It issued the Report of the advisory group on nurse prescribing (Crown Report), which recommended which items nurses might prescribe and the circumstances in which they might prescribe them. The report stated that doctors often merely signed-off nurse prescribing decisions and that 'There is wide agreement that action is now needed to align prescribing powers with professional responsibility.' [4] The Crown Report noted that patients particularly likely to benefit from changes were those with a catheter or stoma, those with postoperative wounds, and homeless people not registered with a general practitioner. [4]

In 1992, the Medicinal Products; Prescriptions by Nurses etc Act was enacted. [5] [6] A trial of community nurse prescribing took place and then the Secretary of State gave district nurses and health visitors prescribing powers from a Nuse Prescriber's Formulary in 1998. [7] By the 2010s, there were approximately 54,000 nurse and midwife prescribers in the UK. [3] [7]

In 1997, Crown again headed a review into prescribing and in 1999 recommended an extension to prescribing. The Review of Prescribing, Supply and Administration of Medicines (Crown II Report) led to nurses being able to prescribe from the Formulary, plus licensed pharmacy and general sales list medicines, and some prescription-only medicines, under a "dependent prescribing" or "supplementary prescribing" framework. [7] [6] [8] In 2001, supplementary prescribing was extended to pharmacists and some other health professionals. [7] [8] From 2006, the Extended Formulary was eliminated and those who had permission to prescribe from it were able to independently prescribe any licensed medicine except controlled drugs. [7] [8]

See also

Related Research Articles

<i>British National Formulary</i> Pharmaceutical reference book for the UK

The British National Formulary (BNF) is a United Kingdom (UK) pharmaceutical reference book that contains a wide spectrum of information and advice on prescribing and pharmacology, along with specific facts and details about many medicines available on the UK National Health Service (NHS). Information within the BNF includes indication(s), contraindications, side effects, doses, legal classification, names and prices of available proprietary and generic formulations, and any other notable points. Though it is a national formulary, it nevertheless also includes entries for some medicines which are not available under the NHS, and must be prescribed and/or purchased privately. A symbol clearly denotes such drugs in their entry.

<span class="mw-page-title-main">Medical prescription</span> Health-care communication from a physician to a pharmacist

A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered healthcare professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historically, it was a physician's instruction to an apothecary listing the materials to be compounded into a treatment—the symbol ℞ comes from the first word of a medieval prescription, Latin recipere, that gave the list of the materials to be compounded.

<span class="mw-page-title-main">Prescription drug</span> Medication legally requiring a medical prescription before it can be dispensed

A prescription drug is a pharmaceutical drug that is permitted to be dispensed only to those with a medical prescription. In contrast, over-the-counter drugs can be obtained without a prescription. The reason for this difference in substance control is the potential scope of misuse, from drug abuse to practicing medicine without a license and without sufficient education. Different jurisdictions have different definitions of what constitutes a prescription drug.

The Pharmaceutical Benefits Scheme (PBS) is a program of the Australian Government that subsidises prescription medication for Australian citizens and permanent residents, as well as international visitors covered by a reciprocal health care agreement. The PBS is separate to the Medicare Benefits Schedule, a list of health care services that can be claimed under Medicare, Australia's universal health care insurance scheme.

<span class="mw-page-title-main">Nurse practitioner</span> Mid-level medical provider

A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion.

<i>British National Formulary for Children</i>

BNF for Children (BNFC) is the standard UK paediatric reference for prescribing and pharmacology.

An advanced practice nurse (APN) is a nurse with post-graduate education and training in nursing. Nurses practicing at this level may work in either a specialist or generalist capacity. APNs are prepared with advanced didactic and clinical education, knowledge, skills, and scope of practice in nursing.

District Nurses work manage care within the community and lead teams of community nurses and support workers. The role requires registered nurses to take a NMC approved specialist practitioner course. Duties generally include visiting house-bound patients and providing advice and care such as palliative care, wound management, catheter and continence care and medication support. Their work involves both follow-up care for recently discharged hospital inpatients and longer-term care for chronically ill patients who may be referred by many other services, as well as working collaboratively with general practitioners in preventing unnecessary or avoidable hospital admissions.

Nursing in the United Kingdom has a long history. The current form of nursing is often considered as beginning with Florence Nightingale who pioneered modern nursing. Nightingale initiated formal schools of nursing in the United Kingdom in the late 19th and early 20th centuries. The role and perception of nursing has dramatically changed from that of a handmaiden to the doctor to professionals in their own right. There are over 700,000 nurses in the United Kingdom and they work in a variety of settings, such as hospitals, health centres, nursing homes, hospices, communities, military, prisons, and academia, with most working for the National Health Service (NHS). Nurses work across all demographics and requirements of the public: adults, children, mental health, and learning disability. Nurses work in a range of specialties from the broad areas of medicine, surgery, theatres, and investigative sciences such as imaging. Nurses also work in large areas of sub-specialities such as respiratory, diabetes, cancer, neurology, infectious diseases, liver, research, cardiac, women's health, sexual health, emergency and acute care, gastrointestinal, infection prevention and control, neuroscience, ophthalmic, pain and palliative, and rheumatology. Nurses often work in multi-disciplinary teams but increasingly are found working independently.

In the United States, a psychiatric-mental health nurse practitioner (PMHNP) is an advanced practice registered nurse trained to provide a wide range of mental health services to patients and families in a variety of settings. PMHNPs diagnose, conduct therapy, and prescribe medications for patients who have psychiatric disorders, medical organic brain disorders or substance abuse problems. They are licensed to provide emergency psychiatric services, psychosocial and physical assessment of their patients, treatment plans, and manage patient care. They may also serve as consultants or as educators for families and staff. The PMHNP has a focus on psychiatric diagnosis, including the differential diagnosis of medical disorders with psychiatric symptoms, and on medication treatment for psychiatric disorders.

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<span class="mw-page-title-main">Nursing</span> Health care profession

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A formulary is a list of pharmaceutical drugs, often decided upon by a group of people, for various reasons such as insurance coverage or use at a medical facility. Traditionally, a formulary contained a collection of formulas for the compounding and testing of medication. Today, the main function of a prescription formulary is to specify particular medications that are approved to be prescribed at a particular hospital, in a particular health system, or under a particular health insurance policy. The development of prescription formularies is based on evaluations of efficacy, safety, and cost-effectiveness of drugs.

Electronic prescription is the computer-based electronic generation, transmission, and filling of a medical prescription, taking the place of paper and faxed prescriptions. E-prescribing allows a physician, physician assistant, pharmacist, or nurse practitioner to use digital prescription software to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy. It outlines the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of the major reasons for the push for electronic medical records. By sharing medical prescription information, e-prescribing seeks to connect the patient's team of healthcare providers to facilitate knowledgeable decision making.

<span class="mw-page-title-main">Julia Cumberlege, Baroness Cumberlege</span>

Julia Frances Cumberlege, Baroness Cumberlege, is a British Conservative Party politician and businesswoman. She was created a life peer on 18 May 1990 as Baroness Cumberlege, of Newick in the County of East Sussex.

<i>Irish Medicines Formulary</i>

Irish Medicines Formulary (IMF) is a medicines reference for doctors, nurses, pharmacists and dentists, providing medicines information which is medico-legally relevant in Ireland. It is published in online and print formats, and lists original brands, branded generics and pure generic prescription medicines.

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<span class="mw-page-title-main">Healthcare in the Isle of Man</span>

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References

  1. 1 2 3 4 5 Bramwell, Donna; Checkland, Kath; Shields, Jolanta; Allen, Pauline (2023), Bramwell, Donna; Checkland, Kath; Shields, Jolanta; Allen, Pauline (eds.), "1983–1990: The Era of General Management", Community Nursing Services in England: An Historical Policy Analysis, Cham: Springer International Publishing, pp. 33–42, doi: 10.1007/978-3-031-17084-3_4 , ISBN   978-3-031-17084-3 , retrieved 2024-01-08
  2. 1 2 Buckley, E.G. (July 1986). "The future of community nursing". The Journal of the Royal College of General Practitioners. 36 (288): 299–300. ISSN   0035-8797. PMC   1960697 .
  3. 1 2 3 "Factsheet on nurse prescribing in the UK". The Royal College of Nursing. 2012-07-09. Retrieved 2024-01-08.
  4. 1 2 3 Courtenay, Molly; Griffiths, Matt, eds. (2010). Independent and supplementary prescribing: an essential guide (2 ed.). Cambridge: Cambridge University Press. ISBN   978-0-521-12520-8.
  5. "Medicinal Products: Prescription by Nurses etc. Act 1992". of 16 March 1992.
  6. 1 2 "Nurse prescribing". HSC Public Health Agency. Retrieved 2024-01-08.
  7. 1 2 3 4 5 Cope, Louise C.; Abuzour, Aseel S.; Tully, Mary P. (August 2016). "Nonmedical prescribing: where are we now?". Therapeutic Advances in Drug Safety. 7 (4): 165–172. doi:10.1177/2042098616646726. ISSN   2042-0986. PMC   4959632 . PMID   27493720.
  8. 1 2 3 Dunn, Joanne; Pryor, Claire (2023). "Non-medical prescribing in nursing: the history and evolution of independent and supplementary prescribing". British Journal of Nursing. 32 (20).