Standard Operating Procedure s18

STANDARD OPERATING PROCEDURE FOR

NON MEDICAL PRESCRIBERS

Prepared August 2007 Review date August 2008 Reviewed August 2008 Expiry date August 2009 Standard operating procedure Page 1 of 15 STANDARD OPERATING PROCEDURE

NEW PROCESS FOR NON MEDICAL PRESCRIBERS REGISTERING AND ORDERING PRESCRIPTION PADS/COMPUTER SHEETS

Introduction

This procedure details the process that non medical prescribers will follow in order:  To register with Health Solutions Wales  Order and receive prescription pads/computer scripts  Ensure safe handling and security of prescriptions  Report lost or stolen prescriptions

Professionals included in this Standard Operating Procedure:-

Community Practitioner Nurse Prescribers/Practice Nurses Community Practitioner Nurse Prescribers/Practice Nurses are practice nurses who hold the relevant prescribing qualification (V100).

Supplementary Prescribers These are nurses and pharmacists who have undertaken and hold the relevant qualification to become a supplementary prescriber.

Independent Prescribers Currently independent prescribers are supplementary prescribers who have undertaken a ‘top up’ module to become an independent prescriber.

Procedure

1. All non medical prescribers, (these include Practice Nurses, Supplementary and Independent prescribers), on successfully completing the appropriate course, will either access their registration forms via the HSW website (See Appendix 1,2, and 3) http://howis.wales.nhs.uk/sites3/page.cfm?orgid=428&pid=8604, or obtain them from the BSC (Tel: 01495 332072), or via Kath Hier (Tel: 01443 824194) [email protected].

2. Once completed these registration forms need to be returned to Kath Hier in order that  the information may be retained on behalf of the Local Health Boards.  forwarded to HSW for registration.  To provide information to the Local Health Boards, Business Services Centre, Welsh Assembly Government, as appropriate

3. On receipt of the completed form registration with the appropriate body will be checked prior to forwarding details to HSW for registration.

4. Prescribing Professionals need to identify whether they need prescription pads, computer prescription sheets or both.(if there is a choice i.e. SP/IP registrants)

5. Once registered with HSW Kath Hier will place an order for either prescriptions pads or computer scripts (depending on prescribers needs) with the printers.

Standard operating procedure Page 2 of 15 6. Upon receipt the order will be checked and sent to the prescriber with a ‘record of issue/return’ form. (Appendix 4–8) which is to be signed and returned to Kath Hier. (The same form is used and returned to Kath Hier when prescribers leave the practice or are no longer prescribing).

7. Requests for additional supplies of prescription pads or computer sheets following registration should be sent to Kath Hier for processing. It is important that exact requirements are clearly detailed when re-ordering stock.

The relevant Policy and Best Practice guidelines can be accessed via the internet on this site http://www.wales.nhs.uk/sites3/home.cfm?orgid=435

Security and safe handling

8. The prescription pad/form is the property of the Local Health Board/NHS Trust. It is the responsibility of the non medical prescriber to ensure security of the pad/form at all times, therefore: a) Under no circumstances should a blank prescription pad/form be pre signed. b) The prescription pad/form should only be produced when needed, and never left unattended or visible. When not in use the prescription pad/form should be stored in a lockable drawer/filing cabinet/box. c) When travelling between patients the prescription pad/form should not be visible and must be locked in the car boot within a bag d) The bag and prescription pad/form must always be removed from the car when the car is unattended at the end of the working day.

e) Prescribers who: i. Terminate their current employment but continue to work as a prescriber with a different employer. ii. Go on secondment and the issue of prescription pads is therefore, no longer required. iii. Go on maternity leave, long term sick leave or special leave Must return their prescription pad/form to the relevant person, for example, Practice Nurses/Supplementary and Independent prescribers should return the pads/forms to the General Practitioner, Practice Manager or Business Services Centre (BSC).

f) It is the employer’s responsibility to process the appropriate change form and return/destroy the prescription pad/forms (local guidelines) (See appendix 4)

Stolen or lost WP10PN/WP10SP/WP10SPSS/WP10IP/WP10IPSS pad/forms procedure

9. In the event of loss or suspected theft the prescriber must report this immediately to the General Practitioner.

The employers will:  Inform the police and the Contracts Management Department of the Business Services Centre (South East Wales region telephone: 01495 332000). It will be necessary to provide as much detail as possible, for example the numbers on the missing scripts, where and when they were stolen/lost etc. (If the theft or loss occurs on a weekend the GP/ Manager should inform Business Services Centre immediately on Monday morning or as soon as possible.)

Standard operating procedure Page 3 of 15 Business Service Centre will:  Advise the prescriber to sign all scripts in red for a period of four to six weeks.  Inform all pharmacies in the area, of the name and address of the prescriber concerned, the approximate number of scripts stolen or lost and the period within which the prescriber will sign prescriptions in red.

If an error in a prescription occurs this should be discussed between the prescriber and the General Practitioner.

Clinical incidents should be reported on the appropriate clinical risk incident form (Appendix 9)

Standard operating procedure Page 4 of 15 Appendix 1 Notification of Newly Qualified Nurse Prescriber Change in Circumstances

Use this form to advise details relating to Community Practitioners Practice Nurse Prescribers. Use only one form per nurse.

TO: Registration Department, Health Solutions Wales, 12th Floor, Brunel House, 2 Fitzalan Road, Cardiff, CF24 0HA PLEASE TICK TYPE OF CHANGE NOTES ON COMPLETION

Newly qualified nurse prescriber Please complete sections A and B and Part C1 Nurse working for additional Please complete part A1 and A2, practice Section B and Part C1 Nurse’s employment ends at Please complete, as a minimum, specified practice parts A1, A2, B1, B2 and C2 Nurse details to be removed from Please complete, as a minimum, all current organisations parts A1, A2 and C2

Change of Surname Please complete sections A and B

EFFECTIVE DATE OF THE CHANGE (TO BE COMPLETED IN ALL CASES): SECTION A: Nurse prescriber details Ref Description Details 1 Nurse NMC PIN Number 2 Nurse Name and Initials 3 Title (e.g. Mr/Mrs/Miss/Ms/ Sister, etc) 4 Qualification (i.e. District Nurse or Health Visitor) 5 Nurse prescribing training examination pass date SECTION B: Practice/PMS Pilot details Ref Description Details 1 Practice code or code of Senior GP (state which) 2 Practice/Senior GP name 3 Main surgery address & telephone number SECTION C: Details of the nurse prescriber in the Practice/PMS Pilot Ref Description Details 1 Start date in Practice 2 End date in Practice Signature: ...... employee providing information*

Name: ...... Practice employee providing information*

* please delete as appropriate

Standard operating procedure Page 5 of 15 NOTIFICATION OF SUPPLEMENTARY PRESCRIBER DETAILS Appendix 2

Use this form to advise HSW of details of new supplementary prescribers or changes in circumstances. Note: One form should be completed for each GP practice from which the prescriber will work.

ACTION (please tick as appropriate) New qualification

Working for additional practice

Ceased working for specified practice

No longer working as supplementary prescriber

Change of Surname

SECTION A – Prescriber Details

Professional Registration Number1

Full Name

Title (Mr, Mrs, Miss etc)

Contact telephone number

E-mail address

Supplementary Prescribing Examination Pass Date Prescriber will be using GP system to (Delete as Yes No generate prescriptions applicable)

SECTION B – GP Practice Details

GP Practice Code 2

Senior Partner Name

Address

Start Date in Practice

End Date in Practice

Signature of Supplementary Prescriber: Authorised by (Full name): Signature :

HSW USE ONLY Date Actioned Initials Welsh ID Date Prescriber Notified of Welsh ID.

1 NMC number or Pharmacist registration number 2 HSW practice code – a practice code look up facility can be found at http://howis.wales.nhs.uk/prescribing Standard operating procedure Page 6 of 15 NOTIFICATION OF INDEPENDENT PRESCRIBER DETAILS Appendix 3 completed for each GP practice from which the prescriber will work.

ACTION (please tick as appropriate) Use this form to advise HSW of details of new independent prescribers or changes in circumstances. Note: One form should be New qualification Working for additional practice Ceased working for specified practice No longer working as independent prescriber Change of Surname

SECTION A – Prescriber Details Professional Registration Number3

Full Name

Title (Mr, Mrs, Miss etc)

Contact telephone number

E-mail address Independent Prescribing Examination Pass Date Prescriber will be using GP system to Yes No (Delete as applicable) generate prescriptions

SECTION B – GP Practice Details GP Practice Code 4

Senior Partner Name

Address

Start Date in Practice

End Date in Practice

Signature of Independent Prescriber: Authorised by (Full name): Signature : HSW USE ONLY Date Actioned Initials Welsh ID Date Prescriber Notified of Welsh ID.

3 NMC number or Pharmacist registration number 4 HSW practice code – a practice code look up facility can be found at http://howis.wales.nhs.uk/prescribing Standard operating procedure Page 7 of 15 Appendix 4 RECORD OF ISSUE/RETURN OF PRESCRIPTION PADS FOR COMMUNITY NURSES/PRACTICE NURSES

I confirm receipt of 3 prescription pads (FP10 PN) for my sole use.

Pad No. 1 serial numbers: to

Please ensure that you are registered with the NMC as a Nurse Prescriber prior to using your prescription pads.

Title: (Mr/Mrs/Miss) Full Name: (Please print)

Practice Address:

Daytime contact No:

I agree to report any stolen/mislaid prescription pads immediately and to return any unused/damaged/unwanted prescription pads to my employer when I cease to work in this Trust/GP practice or cease to prescribe.

Signed: Date:

A copy of this form must be returned to BSC:

This section to be completed when the nurse leaves the GP practice and/or is no longer eligible to prescribe

Record of Return date:______

Serial Numbers:______

Record of destruction:- Line manager /GP signature______

2nd person – signature______

Date:______

Please return to: Kath Hier NHS Business Services Centre NPHS 1 Charnwood Court, Heol Billingsley, Parc Nantgarw, CF15 7QZ

Standard operating procedure Page 8 of 15 Appendix 5 RECORD OF ISSUE/RETURN OF PRESCRIPTION PADS FOR SUPPLEMENTARY PRESCRIBERS

I confirm receipt of 3 prescription pads (WP10SP) for my sole use.

Please ensure that you are registered with the NMC/RPSGB as a Supplementary prescriber prior to using your prescription pads.

Practice Address:

Daytime contact No:

I agree to report any stolen/mislaid prescription pads immediately and to return any unused/damaged/unwanted prescription pads to my employer when I cease to work in this GP practice or cease to prescribe.

Signed: Date:

A copy of this form must be returned to the BSC:

This section to be completed when the prescriber leaves the GP practice and/or is no longer eligible to prescribe

Date:______

Please return to: Kath Hier NHS Business Services Centre NPHS 1 Charnwood Court, Heol Bilingsley, Parc Nantgarw, CF15 7QZ

Standard operating procedure Page 9 of 15 Appendix 6 RECORD OF ISSUE/RETURN OF SINGLE SHEET PRESCRIPTION FOR SUPPLEMENTARY PRESCRIBERS

I confirm receipt of 500 single sheet prescriptions (WP10SPSS) for my sole use. serial numbers

Please ensure that you are registered with the NMC/RPSGB as a Supplementary prescriber prior to using your prescription pads/single sheets.

Practice Address:

Daytime contact No:

Signed: Date:

A copy of this form must be returned to Trust/BSC:

This section to be completed when the Supplementary prescriber leaves the Trust/GP practice and/or is no longer eligible to prescribe

Date:______

Standard operating procedure Page 10 of 15 Appendix 7 RECORD OF ISSUE/RETURN OF PRESCRIPTION PADS FOR INDEPENDENT PRESCRIBERS

I confirm receipt of 3 prescription pads (WP10IP) for my sole use.

Please ensure that you are registered with the NMC/RPSGB as a Independent prescriber prior to using your prescription pads.

Practice Address:

Daytime contact No:

Signed: Date:

A copy of this form must be returned to the BSC:

This section to be completed when the prescriber leaves the GP practice and/or is no longer eligible to prescribe

Date:______

Standard operating procedure Page 11 of 15 Appendix 8 RECORD OF ISSUE/RETURN OF SINGLE SHEET PRESCRIPTION FOR INDEPENDENT PRESCRIBERS

I confirm receipt of ____boxes containing 200 single sheet prescriptions (WP10IPSS) for my sole use.

Serial numbers

Please ensure that you are registered with the NMC/RPSGB as An Independent prescriber prior to using your prescription pads/single sheets.

Practice Address:

Daytime contact No:

Signed: Date:

A copy of this form must be returned to BSC:

This section to be completed when the Independent prescriber leaves the GP practice and/or is no longer eligible to prescribe

Date:______

Standard operating procedure Page 12 of 15 Appendix 9

NOTIFICATION OF A SERIOUS ADVERSE PATIENT INCIDENT

National patient safety Website https://www.eforms.npsa.nhs.uk/staffeform/

Example of SIGNIFICANT INCIDENT & SERIOUS ADVERSE EVENT REPORT FORM Confidential

Practice Name & Address: Date and Time of Incident

Contact Name: Location of Incident Tel:

Is this a Serious Adverse Incident (Please see over for details) YES NO Have you reported the incident to the NPSA? www.npsa.co.uk YES NO Has the incident been discussed with the patient(s) involved? YES NO

Type of Incident: Please Tick (you may tick more than one type) Failure/delay in diagnosis [ ] Documentation (records etc) [ ] Prescribing/medication error [ ] Procedural (Clinical) [ ] Communication within the Practice [ ] Procedural (System/Process) [ ] Cross organisational communication [ ] Medical Device [ ] Staffing/Human Resources [ ] Confidentiality [ ] Facilities/Environment [ ] Organisational/System failure [ ] Other [ ] [ ]

Please provide a detailed description of the incident: (Describe the event, and the designation of who was involved. There is no requirement at this stage to include the names of patient(s), caregiver(s), or individual(s)

What immediate action (operational management) has been taken?

Standard operating procedure Page 13 of 15 What was the severity of the incident? (see over for definitions) Near Miss Minor Moderate Major Catastrophic

What was the outcome for the patient? What was the outcome for the service?

What did the people involve learn from the incident? What improvements/changes have been made to ensure the incident is not repeated?

Should this Incident be shared by an LHB Alert (circulated anonymously with 24 hrs YES NO

Assessing Severity

Near Miss A delayed appointment where the Minor A patient suffered no permanent harm or potential patient may have been inconvenienced for only slight discomfort or injury e.g. a bruise but not harmed Moderate A patient suffered semi permanent Major Severe harm causing disability or health impairment harm requiring remedial action, but no e.g. missed fracture, delayed diagnosis of diabetes permanent sequelae e.g. minor cut or soft tissue infection. Catastrophic Permanent incapacity or death where urgent action is necessary to prevent reoccurrence e.g. Warfarin error resulting in catastrophic haemorrhage

Significant Incidents: please send the reporting form to:

Clinical Governance Facilitator, Tel:.

Serious Adverse Incidents: (These include: Unexpected death whilst under direct care of a health professional, Procedures involving the wrong patient or body part, Retained instruments or other material requiring re operation, Serious medication related error, Any serious act of violence or aggression, Suicide or homicide committed by an NHS patient being treated for a mental health disorder, Known, or suspected cases of health care associated infection which may result in major permanent harm e.g. hepatitis C

Standard operating procedure Page 14 of 15 If the reported incident is a “Serious Adverse Incident” please inform the Local Health Board and the South East Wales Regional Office immediately.

Medical or Nurse Director Regional Director Local Health Board South East Wales Regional Office Brecon House Mamhilad Park Estate Pontypool, NP4 0YP

Tel: 01495 758042

Standard operating procedure Page 15 of 15