Stakeholders' views of UK nurse and pharmacist supplementary prescribing.
OBJECTIVE
Supplementary prescribing (SP) by pharmacists and nurses in the UK represents a unique approach to improving patients' access to medicines and better utilizing health care professionals' skills. Study aims were to explore the views of stakeholders involved in SP policy, training and practice, focusing upon issues such as SP benefits, facilitators, challenges, safety and costs, thereby informing future practice and policy.


METHODS
Qualitative, semi-structured interviews were conducted with 43 purposively sampled UK stakeholders, including pharmacist and nurse supplementary prescribers, doctors, patient groups representatives, academics and policy developers. Analysis of transcribed interviews was undertaken using a process of constant comparison and framework analysis, with coding of emergent themes.


RESULTS
Stakeholders generally viewed SP positively and perceived benefits in terms of improved access to medicines and fewer delays, along with a range of facilitators and barriers to the implementation of this form of non-medical prescribing. Stakeholders' views on the economic impact of SP varied, but safety concerns were not considered significant. Future challenges and implications for policy included SP being potentially superseded by independent nurse and pharmacist prescribing, and the need to improve awareness of SP. Several potential tensions emerged including nurses' versus pharmacists' existing skills and training needs, supplementary versus independent prescribing, SP theory versus practice and prescribers versus non-prescribing peers.


CONCLUSIONS
SP appeared to be broadly welcomed by stakeholders and was perceived to offer patient benefits. Several years after its introduction in the UK, stakeholders still perceived several implementation barriers and challenges and these, together with various tensions identified, might affect the success of supplementary and other forms of non-medical prescribing.
Cooper
Richard
R
Centre for Pharmacy, Health and Society, University of Nottingham, Nottingham, UK. Richard.cooper@nottingham.ac.uk
Anderson
Claire
C
Avery
Tony
T
Bissell
Paul
P
Guillaume
Louise
L
Hutchinson
Allen
A
Lymn
Joanne
J
Murphy
Elizabeth
E
Ratcliffe
Julie
J
Ward
Paul
P
D011307:Drug Prescriptions; D006297:Health Services Accessibility; D007407:Interviews as Topic; D009726:Nurses; D010595:Pharmacists; D013222:State Medicine; D006113:United Kingdom