title: Non medical prescribing leads views on their role and the implementation of non medical prescribing from a multi-organisational perspective.
abstract: BACKGROUND
  In the United Kingdom, non-medical prescribing (NMP) has been identified as one way to improve healthcare quality and efficiency. Healthcare organisations are charged with overseeing the clinical governance of NMP and guidance recommends the identification of a lead director to be responsible for its implementation. While over twelve million items are prescribed each year by the 50,000 qualified NMPs its uptake is inconsistent. Several studies have explored the barriers to NMP at a practice level, however little is known about the role the NMP lead and the implementation of NMP from an organisational perspective. The aim of this research was to explore the role of the organisational NMP lead across a range of practice settings within one Strategic Health Authority (SHA) and consider the development of NMP from a multi-organisational perspective.
  
  
  METHODS
  Semi-structured telephone interviews with 28 NMP leads across one SHA were undertaken by a trained qualitative researcher. Interviews addressed the purpose of the role and difficulties encountered; audiotapes were transcribed, coded and themes were identified.
  
  
  RESULTS
  The NMP lead role comprised of four main functions; communication, coordinating, clinical governance and support. Factors hampering progress in overseeing the safe development of NMP included lack of clarity about the NMP lead role and responsibilities, strategic support and a lack of protected time. The extent to which clinical governance systems were in place across organisations was inconsistent. Where a strategic approach to its development was adopted, fewer barriers were encountered and NMP was more likely to become embedded within organisations.
  
  
  CONCLUSIONS
  The significant contribution that NMP leads play in embedding NMP within organisations should be acknowledged by clearer national guidance for this role and its responsibilities. Greater standardisation and consistency is required of clinical governance systems if quality and safety is to be ensured given the expanding development of NMP. The extent to which NMP is in place worldwide differs. However, our findings will be of interest to policymakers in other countries involved in the development and implementation of this role.
authors.affiliation: Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK. m.courtenay@surrey.ac.uk
authors.forename: Molly
authors.initials: M
authors.lastname: Courtenay
authors.forename: Nicola
authors.initials: N
authors.lastname: Carey
authors.forename: Karen
authors.initials: K
authors.lastname: Stenner
mesh_terms: D000488:Allied Health Personnel / Q000592:standards / Q000706:statistics & numerical data; D054976:Clinical Governance; D017598:Efficiency, Organizational; D006801:Humans; D017146:Models, Organizational; D009726:Nurses / Q000592:standards / Q000706:statistics & numerical data; D010820:Physicians / Q000592:standards / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D024382:Professional Role; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D006113:United Kingdom