Guidance for optometrist prescribers

Size: px
Start display at page:

Download "Guidance for optometrist prescribers"

Transcription

1 Guidance for optometrist prescribers Contents Introduction Legislation and terminology Standards for optometrist prescribers Specialist areas of practice Section 1 - Guidance for prescribing practice P1. Licence as a prescriber P2. Accountability P3. Assessment P4. Need P5. Consent P6. Communication P7. Record keeping P8. Clinical management plans (supplementary prescribing) P9. Prescribing and dispensing P10. Prescribing for family and others P11. Computer-generated prescribing by nurses or midwives P12. Evidence-based prescribing P13. Delegation P14 Continuing education and training P15. Continuing professional development P16. Prescribing unlicensed medicines P17. Prescribing medicines for use outside the terms of the licence P18. Repeat prescribing P19. Remote prescribing via telephone, , fax, video link or website P20. Gifts and benefits Section 2 Medicines Management P20 Dispensing P21 Storage and transportation P22 Administration P23 Delegation P24 Disposal P25 Errors Section 3 Additional Information 3.1 Professional indemnity 3.2 Supply and administration via a Patient Group Direction 3.3 Medicines Act exemptions Medicines Act Writing a prescription 3.5 Writing private prescriptions 3.6 Complementary medicinal products 3.7 Dispensing 3.8 Reporting adverse reactions 3.9 Safety of prescription pads 1

2 Section 4 Clinical Governance 4.2 Clinical audit 4.11 Prescribing analysis and evidence based practice 4.13 Risk management 4.14 Continuing Professional Development 4.15 Poor Performance Section 5 Further information Glossary Legal classification of licensed medicines Resources 2

3 Introduction This booklet provides advice on the conduct that is expected of optometrist prescribers who are on one of the GOC specialist registers. Throughout this document the use of the word must indicates a legal or regulatory requirement, and the use of the word should indicates what should follow in all normal circumstances. If an optometrist deviates from the advice in this document the reason for this should be carefully documented. If a complaint is made against you, the General Optical Council s Fitness to Practise Committee will take account of this document and those to which it makes reference. You will be expected to justify any decision to act outside its terms. Legislation and terminology The key legislation that enables optometrists to prescribe is the Medicines for Human Use (Prescribing) (Miscellaneous Amendments) Order 2008, the Medicines (Sale or Supply) (Miscellaneous Amendment) Regulations 2008, and the General Optical Council (Therapeutics and Contact Lens Specialities) Rules Order of Council Further consequential changes to the NHS regulations relating to pharmacy dispensing prescription charges and working with general practice will follow over the next few months. This booklet does not cover: supply and administration of medicines via a Patient Group Direction, or sale, supply or administration of medicines via exemption orders as these are not forms of prescribing. ethical advice on generic issues around the use and supply of drugs and medicines in optometric practice which is covered in the College of Optometrist s Code of Ethics and Guidance for Professional Conduct Throughout this document where the phrase independent prescriber is used, this refers to a doctor or a dentist. The phrase optometrist independent prescriber will be used when an independent prescribing optometrist is meant. Types of optometrist prescribing There are two types of prescribing which you may undertake as an optometrist prescriber: supplementary and independent prescribing. Some optometrists will be qualified as both, others as only a supplementary prescriber. If so annotated on the register, an optometrist independent prescriber can practise as either an optometrist independent prescriber or an optometrist supplementary prescriber. The mode of prescribing practice will depend upon your personal choice and practice circumstances. You may practise solely in one practice mode or move between modes according to patient or practice circumstances. In addition to prescribing there are three other modes of supply and administration of drugs by optometrists: Patient Group Directions (PGD), entry level and Additional Supply. Optometrists should be clear whether they are working as an entry level or additional supply optometrist or under a PGD or as a supplementary or independent prescriber. The advice in this document applies to both NHS and private practice. It is up to individuals to ensure that arrangements for good governance are in place. 3

4 Advice on knowledge and competence for optometrist prescribers The programme of preparation (education and training) for prescribing equips optometrists with the principles of prescribing to enable them to be safe, effective and cost-effective prescribers. Optometrists should ensure that they are able to apply the prescribing principles to their own area of practice bearing in mind that this may be a requirement for continuing registration Prescribers must have sufficient knowledge and competence to: Assess a patient/client s clinical condition Undertake a thorough history, including medical history and medication history, including over-the-counter medicines and complementary therapies, and diagnose where necessary Decide on management of presenting condition including whether or not to prescribe and/or refer Identify appropriate products if medication is required Advise the patient on effects and risks Prescribe if the patient agrees Monitor patient s condition including the response to any medication prescribed Give lifestyle advice as appropriate Refer if necessary This Guidance underpins the principles of prescribing practice within the context of the full scope of optometric practice. The Optometrists Competency Framework published jointly by the National Prescribing Centre and General Optical Council ( provides further information grouped into the following domains: Clinical and pharmaceutical knowledge Establishing options Communicating with patients Prescribing safely Prescribing professionally Improving prescribing practice Information in context The NHS in context The team and individual context 4

5 Section 1 Advice on prescribing practice This section provides advice on prescribing practice. Having achieved the competencies for prescribing, optometrists are expected to follow this advice in their practice. The advice in this document applies to all settings in which an optometrist may prescribe, within the National Health Service, private practice, armed forces or prison service. P 1 Licence as a prescriber 1.1 You must only prescribe once you have successfully completed an approved programme, and been included on the GOC specialist prescribing register 1.2 Optometrists should comply with this and other guidance issued by the College of Optometrists. Failure to do this may put their registration at risk. 1.3 The ability to prescribe is a privilege granted to you by legislation and your employer (if applicable), and should be seen in this light. P 2 Accountability 2.1 You are professionally and legally accountable for your prescribing decisions, including actions and omissions, and cannot delegate this accountability to any other person. 2.2 You must only ever prescribe within your level of experience and competence, acting in accordance with the College of Optometrists Code of Ethics and Guidelines for Professional Conduct. Optometrists must only prescribe for conditions of the eye and surrounding tissues. 2.3 If you move to another area of practice you must consider the requirements of your new role and prepare for it. 2.4 You must inform anyone who needs to know about any restrictions placed on your prescribing practice. In particular, other practitioners with dispensing responsibilities need to know about this. For example you must inform your primary care organisation (PCO) if you had restrictions placed upon your prescribing. An example of a restriction that could be placed on your prescribing practice would be a local NHS policy that limited you to prescribing (or specified that you should not prescribe) certain drugs. This would not prevent you from prescribing these drugs privately. Restrictions as to what you may prescribe may also be placed upon you by your employer (e.g. for hospital optometrists), or you may have restrictions placed upon your prescribing practice by the General Optical Council. 5

6 P 3 Assessment 3.1 In order to prescribe for a patient you must satisfy yourself that you have undertaken a full assessment of the patient, including taking a thorough history and, where possible, accessing a full clinical record. 3.2 You are accountable for your decision to prescribe and must prescribe only where you have relevant knowledge of the patient s health and medical history. 3.3 You must ensure a risk assessment has been undertaken in respect of the patient s current medication and any potential for confusion with other medicines. 3.4 There are scenarios where an optometrist may be expected to assess and prescribe outside their normal field of practice. Optometrists must refer to an appropriate prescriber if they do not fully understand the implications of their prescribing practice in terms of the physiology and pharmaco-therapeutic action of medication prescribed even though they may be able to take a thorough and appropriate history which leads to a diagnosis. P 4 Need 4.1 You must only prescribe where you have assessed the patient and there is a genuine clinical need for treatment. P 5 Consent 5.1 You must explain your role as a non-medical prescriber to the patient or their representative 5.2 You must be aware of cultural and religious differences in so far as they apply to prescribing. 5.3 As an optometrist prescriber you must act in accordance with the College of Optometrists Code of Ethics and Guidelines for Professional Conduct in relation to consent (Chapter 3). 5.4 You must make it clear to the patient that prescribing activity cannot be undertaken in isolation. You should inform anyone else who may be in a position to prescribe for that patient of your actions in order to avoid prescribing errors. This is most likely to be the patient s general medical practitioner, but may also include other medical or non-medical prescribers. If the patient refuses to consent to you sharing such information you must offer an explanation of the risks of not doing so. If the patient continues to refuse to give consent you must consider what course of action is in the best interests of the patient. This must be documented in their records. 6

7 P 6 Communication 6.1 You have a responsibility to communicate effectively with other practitioners involved in the care of the patient. You must refer the patient to another prescriber when it is necessary to do so. 6.2 When prescribing, you must take the views of the patient into account in order to create an environment where shared-decision making is the norm. This will include taking into account the patient s personal views and beliefs and discussing treatments in relation to these. P 7 Record keeping 7.1 The College of Optometrists Code of Ethics and Guidelines for Professional Conduct provide the underlying principles. 7.2 You should ensure records are accurate, comprehensive, contemporaneous and accessible by all members of a prescribing team (effective policies must be in place locally to enable this to happen). 7.3 In supplementary prescribing, the independent and supplementary prescribers must share access to, consult and, wherever possible, use the same common patient record. 7.4 Records should include the prescription details, together with relevant details of the consultation with the patient. The maximum time allowed between writing the prescription and entering the details into the patient record is for local negotiation. Only in exceptional circumstances, e.g. the intervention of a weekend or public holiday, should this exceed 48 hours. P 8 Clinical management plans (supplementary prescribing) 8.1 If you are prescribing as a supplementary prescriber you must prescribe in accordance with a patient s individual clinical management plan (CMP). 8.2 The independent prescriber must have made the initial diagnosis of the patient. 8.3 Where standard CMPs are in place as a starting point, you must tailor them to reflect the individual patient s personal, medical and medicines history. The CMP must be agreed by an independent prescriber and yourself with the consent of the patient before supplementary prescribing begins. This could be in the form of a signature, or for an electronic record, a recordable indication of agreement. 8.4 Within supplementary prescribing you must refer the patient back to the independent prescriber should the patient s circumstances change so that they cannot be managed within the CMP. 8.5 Within supplementary prescribing you must never prescribe medication in the absence of a CMP which has been agreed with the independent prescriber and with the consent of the patient. The independent prescriber may agree 7

8 verbally to a CMP providing that it is confirmed by fax or secure before prescribing occurs, and formally agreed within two working days. 8.6 The prescribing of a Prescription Only Medicine (POM) by a supplementary prescriber outside a clinical management plan constitutes a criminal offence under the terms of the Prescription Only Medicines Order. Such action could be subject to sanctions under the Medicines Act 1968, although it is more likely that action will be taken by the General Optical Council under its Fitness to Practise procedure. 8.7 If an optometrist who is both an independent and a supplementary prescriber sees a patient as a supplementary prescriber they must adhere to the terms of the CMP when managing the patient s condition for which the CMP has been agreed. This does not however prohibit the optometrist from prescribing medication for the patient for an unrelated condition, where the optometrist is acting as an independent prescriber and is competent to treat the condition concerned. The patient should be told of the different authority the optometrist has to prescribe such medication, and that the optometrist is acting as an independent prescriber in that instance. P 9 Prescribing and dispensing of drugs 9.1 Dispensing is the preparation and supply of a medicinal product by a practitioner in accordance with a prescription 9.2 You must ensure separation of prescribing and dispensing of drugs whenever possible. 9.3 Optometrists must ensure they have indemnity insurance to cover the prescribing and dispensing of drugs. P 10 Prescribing for family and others 10.1 You must not prescribe for yourself You should never prescribe for anyone with whom you have a close personal or emotional relationship, other than in an exceptional circumstance If a prescription is necessary you should refer this to be undertaken by another registered prescriber wherever possible You must be able to justify what is considered an exceptional circumstance and why, at the time, a prescription could not be issued by another independent prescriber At all times you must maintain an objective view of your patient s interests. See in particular chapter 40 of the College of Optometrists Code of Ethics and Guidelines for Professional Conduct. 8

9 P 11 Computer-generated prescribing by optometrists 11.1 You may prescribe via computer-generated prescriptions providing the necessary software is available A visible audit trail of your prescribing actions must be maintained You must never tamper with existing prescriber s details on a prescription or add your own prescribing details, whether that be handwritten or by stamp Prescriptions should always be signed immediately Prescriptions must never be written or printed-off and signed in advance, and then stored for future use. P 12 Evidence-based prescribing 12.1 Optometrists should prescribe according to the available evidence base. Evidence-based prescribing involves the application of best available evidence when making prescribing decisions. Reference to the evidence base can minimise the risk of adverse drug reactions, and ensure effectiveness. An evidence-based approach has been used in the development of the College of Optometrists Clinical Management Guidelines. In the first instance, guidelines have been developed for 60 conditions that present with varying frequency in ophthalmic primary care. Whenever possible evidence-based interventions (pharmacological and non-pharmacological) are recommended. However, where the evidence base is minimal, recommendations are included where there is clinical consensus for their effectiveness Clinical management guidelines can be used in conjunction with the e- formulary contained within emedinfo: a medicines information resource for optometrists produced by the College of Optometrists in conjunction with Thomson Software Solutions. The first clinical management guidelines will be made available from late November 2008 and will be added to from time to time. P 13 Delegation 13.1 You may delegate the administration of a medication that you have prescribed. You remain accountable for your actions and you must be sure the person to whom you have delegated is competent and has received sufficient training to administer the prescribed medication You may not delegate administration of a medication that you supply or administer via a Patient Group Direction (see Glossary for the definition of a Patient Group Direction) You may delegate the administration of a medication that you are supplying or administering via a Patient Specific Direction (PSD). 9

10 P14 Continuing education and training 14.1 Optometrists are reminded that CET is a requirement for registration. Optometrist prescribers should check the additional CET requirements for them to maintain their specialist registration It is a requirement for optometrist independent prescribers to maintain their practical experience in order for them to maintain their specialist registration (see GOC registration rules 13(1)(aa)) It is your responsibility to remain up-to-date with knowledge and skills to enable you to prescribe competently and safely You must act in accordance with the College of Optometrists Code of Ethics and Guidelines for Professional Conduct. P 15 Continuing professional development 15.1 As an optometrist whose name is included on the GOC s specialist prescribing register, you should ensure that your continuing professional development is in line with your role as a prescriber. P 16 Prescribing unlicensed medicines 16.1 You must not prescribe an unlicensed medication as an optometrist independent prescriber You may prescribe an unlicensed medication as a supplementary prescriber as part of a CMP providing: a) the independent prescriber and yourself acting as a supplementary prescriber have agreed the plan with the patient s consent; b) you are satisfied that an alternative, licensed medication would not meet the patient s needs; c) you are satisfied there is a sufficient evidence base and/or experience to demonstrate the medication s safety and efficacy for that particular patient; d) you and the independent prescriber are prepared to take the responsibility for prescribing the unlicensed medicine and have agreed the patient s CMP to that effect; e) the patient agrees to a prescription in the knowledge that the drug is unlicensed and understands the implications of this; f) the medication chosen and the reason for choosing it is documented in the CMP. P 17 Prescribing medicines for use outside the terms of their licence (offlicence) 17.1 Off licence prescribing is where licensed medications are prescribed outside the terms of their licence. There may be circumstances in which optometrists may prescribe licensed medicines for the purposes for which they are not 10

11 licensed and this is most likely to be the case when prescribing for children (see the Guidance below). However, optometrists without an additional qualification may also come across this, for example the use of fusidic acid gel for blepharitis is strictly using it off licence. Optometrist independent prescribers should not normally prescribe off-licence. However, when working within the limits of their own experience and competence optometrists may occasionally encounter situations in which it would be desirable to prescribe a drug for an unlicensed indication. If you do so you must ensure the following conditions are met: a) you are satisfied that it would better serve the patient s needs than an appropriately licensed alternative; b) you are satisfied that there is a sufficient evidence base and/or experience of using the medicine to demonstrate its safety and efficacy. Where the manufacturer s information is of limited help, the necessary information must be sought from another source; c) you should explain to the patient or parent/carer, in broad terms, the reasons why medicines are not licensed for their proposed use. If optometrists intend to prescribe off licence they are advised to obtain the written consent of the patient. The College has produced a pro-forma for this purpose; d) you make a clear, accurate, and legible record of all medicines prescribed and the reasons for prescribing an off-licence medicine You may also, as a supplementary prescriber, prescribe a medicine for use outside the terms of its licence providing: a) there is a CMP in place, written in conjunction with the independent prescriber and with the consent of the patient or parent/carer; b) the use of the medicine outside the terms of its licence is documented; and c) the independent prescriber and the optometrist supplementary prescriber take responsibility for prescribing the medicine and you jointly oversee and monitor the patient s care, and arrange for appropriate follow-up Pharmaceutical companies do not usually test their medicines on children and consequently cannot apply to license their medicines for use in the treatment of children. It is often necessary in paediatric practice to use medicines that are licensed only for adults. See the British National Formulary for Children It is good practice to give as much information as patients, or those authorising treatment on their behalf, require or which they may see as significant. This would include the proposed course of treatment, and any known serious or common side effects or adverse reactions. Information must be given that is appropriate to the target audience, e.g. children or those with learning difficulties Any information provided may be supported by written information, e.g. the leaflet on unlicensed medicines produced by the Royal College of Paediatrics and Child Health/Neonatal and Paediatric Pharmacists Group Standing Committee on Medicines. P 18 Repeat prescribing and repeatable prescriptions 11

12 18.1 The plurality of provision within health services in both the NHS and in private practice will mean that repeat prescribing and the issue of repeatable prescriptions may be a significant aspect of the role of optometrist prescribers (see glossary). The National Prescribing Centre in England has published good practice guidelines: Saving time, helping patients: a good practice guide to quality repeat prescribing, available at You may issue a repeat or repeatable prescription, but you do so in the knowledge that you are responsible as the signatory of the prescription and are accountable for your practice Before signing a repeat or repeatable prescription you must be satisfied that it is safe and appropriate to do so and that secure procedures are in place to ensure that: a) the patient is issued with the correct prescription; b) each prescription is regularly reviewed and is only re-issued to meet clinical need; c) a case review takes place after six months; d) suitable provision is in place to ensure that patients who need a further examination or assessment do not receive repeat prescriptions without first being seen by an appropriate prescriber; e) a record is made of the repeat prescription on the patient s record. P 19 Gifts and benefits 19.1 You must make your choice of medicinal product for the patient, based solely on clinical suitability and cost effectiveness You must maintain a register of interests within your own personal portfolio, which may be produced on request if required for audit purposes You should adhere to local corporate policy when maintaining a register of interests The advertising and promotion of medicines is strictly regulated under the Medicines (Advertising) Regulations Personal gifts are prohibited and it is an offence to solicit or accept a gift or inducement. Companies may offer hospitality for a professional/scientific meeting, but such hospitality must be reasonable in level, and subordinate to, the main purpose of the meeting. This legislation is enforced by the Medicines and Healthcare Products Regulatory Agency The NHS may have a local policy on sponsorship and gifts from pharmaceutical companies. Such a policy is useful guidance as to whether such benefits offered by a pharmaceutical company to an optometrist would or would not be acceptable. 12

13 Section 2 Medicines Management P.20 Dispensing P.20.1 Optometrists may in exceptional circumstances label from stock and supply a clinically appropriate medicine to a patient, against a written prescription, for self-administration or administration by another professional, and to advise on its safe and effective use. P. 21 Storage and transportation P 21.1 Optometrists must ensure that all medicinal products are stored in accordance with the patient information leaflet, summary of product characteristics document found in dispensed UK-licensed medication, and in accordance with any instruction on the label. Storage instructions for common ophthalmic medicines are included in emedinfo. P Optometrists may transport medication to patients where patients or their carers/representatives are unable to collect them, provided the optometrist is conveying the medication to a patient for whom the medicinal product has been prescribed (e.g. from a pharmacy to the patient s home). P. 22 Administration P If you administer medicines to a patient you must: be certain that you are administering the medicine to the correct patient; check that the patient is not allergic to the medicine before administering it know the therapeutic uses of the medicine to be administered, its normal dosage, side effects, precautions and contra-indications; be aware of the patient s diagnosis and management; check that the prescription or the label on the medicine dispensed is clearly written and unambiguous; check the expiry date (where it exists) of the medicine to be administered have considered the dosage, method of administration, route and timing; have considered co-existing therapies contact the prescriber or another authorised prescriber without delay where contra-indications to the prescribed medicine are discovered, where the patient develops a reaction to the medicine, or where assessment of the patient indicates that the medicine is no longer suitable make a clear accurate and immediate record of all medicine administered, intentionally withheld or refused by the patient, ensuring that the signature is clear and legible; it is also your responsibility to ensure that a record is made when delegating the task of administering medicine. P22.2 Where medication is not given the reason for not doing so should be recorded. P22.3 You are responsible for the initial and continued assessment of patients who are self-administering and have continuing responsibility for recognising and acting upon changes in a patient s condition. P.22.4 In exceptional circumstances, where medication has been previously prescribed and the prescriber is unable to issue a new prescription, but where changes to the dose are considered necessary, the use of information 13

14 technology (such as fax, text message or ) may be used to confirm such changes. P.22.5 You must ensure that there are protocols in place to ensure patient confidentiality and documentation of any fax, text message or sent or received. P.22.6 Optometrists should never administer any prescription only medication that has not been prescribed for that patient, or that has been acquired over the internet without a valid prescription. P Optometrists must assess the patient s suitability and understanding of how to use an appropriate compliance aid safely. P. 23 Delegation P.23.1 The optometrist is responsible for the delegation of any aspect of the administration of medicinal products. P.23.2 Students must never administer or supply medicinal products without direct supervision. P. 24 Disposal P.24.1 Optometrists must dispose of medicinal products in accordance with current legislation and local arrangements. P. 25 Errors P.25.1 If you discover that you have made an error you must take immediate action to prevent potential harm to the patient and report the error as soon as possible according to local protocols. 14

15 Section 3 Additional information 3.1 Professional indemnity Every optometrist prescriber must ensure that he or she has professional indemnity insurance. Optometrists must contact their insurer to ensure that their indemnity insurance covers them for the scope of their prescribing practice. 3.2 Supply and administration via a Patient Group Direction This is not a form of prescribing. Guidelines are provided on the website of the National Prescribing Centre at Supply and administration via Medicines Act exemptions Medicines Act 1968 This is not a form of prescribing. There are two levels of exemptions for optometrists: entry level and Additional Supply. 3.4 Writing a prescription Prescriptions must be written legibly and in ink. They should be dated, state the full name and address of the patient and be signed in ink by the prescriber. It is a legal requirement to state the age of a child under 12 years for a prescription of a prescription only medicine (POM). The names of drugs and preparations must be written clearly using approved titles only and not abbreviations. For further guidance on writing a prescription, see Prescription writing in the British National Formulary. Computer-generated prescriptions may be used provided they are signed in ink. Even if you are using a computer to write prescriptions you must be competent to complete a prescription by hand should it be necessary. 3.5 Writing private prescriptions Optometrist independent prescribers may issue private prescriptions for any licensed medicines for conditions affecting the eye and the tissues surrounding the eye, within the recognised area of expertise and competence of the optometrist, except for any controlled drug. Supplementary prescribing may also operate in private practice where, of course, any prescription must be in accordance with what has been agreed with the doctor and the patient in the CMP 3.6 Complementary medicinal products Optometrists need to be familiar with a range of complementary medicinal products that their patients or clients may be using, or may wish to be used, in their treatment. These may affect the prescribing decision of the optometrist and may include 15

16 homeopathic remedies, herbal remedies, aromatherapy oils, flower essences and the broad area of vitamin and mineral supplements. 3.7 Dispensing Dispensing is part of the remit of the pharmacy profession, who undertake a clinical screen of prescriptions prior to dispensing by trained technicians, and a final accuracy check by a pharmacist or higher level pharmacy technician. Optometrists should not dispense medicines unless there is a local policy in place, agreed by clinical governance directorates to endorse the optometrist s actions. An optometrist should not normally dispense against a prescription that they have issued. The recipient of the medication will expect the same level of practice from an optometrist as they would from a pharmacist. As an optometrist you are accountable for your actions and should understand the medication that you are dispensing, its therapeutic effect, correct dosage, side effects and contra-indications. You should be able to inform the patient about what they should expect when taking the medication, and to whom any adverse reaction should be reported. You should only dispense medication if you feel competent to do so, and in the knowledge that you are accountable for your actions. A record should be kept of your dispensing practice. Following clinical governance policy you should ensure that an audit trail is present and visible. The same principles apply for all drugs, whether they are Prescription Only Medicines or pharmacy-level medicines. It is recommended that optometrists ensure that they are covered for vicarious liability (if appropriate) and seek appropriate indemnity insurance for this practice. See Glossary for definition of dispensing. 3.8 Reporting adverse reactions If a patient experiences an adverse reaction to a medication they have been prescribed, you should record this in the patient notes, notify the prescriber (if you did not prescribe the drug) and notify the MHRA via the Yellow Card Scheme immediately. Yellow cards are found in the back of the British National Formulary and also online at In addition you have a duty to inform the patient that they may also report adverse reactions independently to the Yellow Card Scheme. You can also report adverse reactions via the Medicines and Healthcare Products Regulatory Agency (MHRA) website at and any untoward incidents should be reported to the National Patient Safety Agency (NPSA). 16

17 3.9 Safety of prescription pads You are responsible for the safety of your prescription pad. You should take all reasonable precautions to prevent loss or inappropriate use. You should only use one prescription pad at a time. You should keep a record of the first and last serial number of prescriptions in pads issued to you. It is considered good practice to record the serial number of the first remaining prescription form of an in-use pad at the end of each working day. This would help to identify any lost or stolen overnight. If a prescription pad is lost, mislaid or stolen this should be reported immediately according to local protocols. 17

18 Section 4 Clinical Governance 4.1 Patient safety is of paramount importance within all aspects of prescribing and medicines management. Optometrists must practise within the law, to a high professional standard, and ensure that they strive continuously to improve the quality of care that they offer to patients. Poor professional performance needs to be identified and rectified at an early stage. Optometrists who are working within the NHS are likely to be covered by appropriate Clinical Governance protocols and procedures. This will include prescribing analysis and clinical audit. Optometrists who are not prescribing within the NHS should ensure that they have appropriate clinical governance. Arrangements should be made for: (a) clear lines of responsibility and accountability for overall quality of clinical care; (b) development of quality improvement programmes such as clinical audit, supporting evidence-based practice, implementation of clinical standards, monitoring of clinical care, access to appropriate CPD programmes; (c) management of risk; (d) procedures to identify and remedy poor performance. Clinical audit 4.2 Clinical audit is an important part of clinical governance, as it helps optometrists to monitor their prescribing activities. Examples of audits that could be undertaken could include: the number of patients presenting with an eye condition who were managed with over the counter medication, and those who were managed with prescription only medication. If the optometrist is both an independent and supplementary prescriber, it is useful to audit both independent and supplementary prescribing activities. An audit could also be done of patients who were managed by the optometrist within their practice who would otherwise have been referred to a medical practitioner. See also the College of Optometrists Clinical Audit Framework. 4.3 Optometrists who are supplementary prescribers should ensure that they participate in regular (normally at least annually) meetings with their independent prescriber. 4.4 Optometrists should audit how many of the patients for whom they have prescribed medication have required medical follow-up, and how many have been successfully managed within the optometric practice. 4.5 Optometrists should monitor how patients respond to their treatment and how many follow-up visits are taking place. Systems should be put in place to ensure that patients who do not attend ( DNA ) for their appointments are followed up (e.g. by telephone, letter, text message or ). 4.6 Optometrists who are working as supplementary prescribers should audit their practice to ensure that the patient s CMP is being followed. 4.7 Optometrists should ensure that the prescriptions they write are clear and legible. Optometrists should audit how many times a pharmacist contacts the optometrist to query what was written. 18

19 4.8 Optometrists should audit how often they supply a prescription only medicine to a patient, rather than writing a signed order or prescription for the pharmacist to supply the drug. 4.9 Optometrists should audit their record keeping to ensure that all the pertinent details are included contemporaneously Patients experiences of optometrist prescribing are an important part of clinical care, and should be regularly sought. Prescribing analysis and evidence based practice 4.11 Optometrist prescribers should ensure that they have information about national guidelines (e.g. NICE guidelines, NSFs), local guidelines, local agreements and formularies If optometrist prescribing is within the NHS it should be included in the reports on the quality of clinical care to local Clinical Governance Committees or their equivalent. Risk Management 4.13 Optometrists should ensure that they have an appropriate Risk Management programme in place. This would include clinical risk management and patient safety (including the NPSA National Reporting and Learning Scheme), confidentiality, safety of prescription pads and a system for handling complaints. Continuing Professional Development 4.14 Optometrists should ensure that they set aside sufficient time to access programmes and resources to meet their CPD needs. This may include Peer Review sessions. Optometrists should include reflective learning in their CPD portfolio. Poor Performance 4.15 Procedures should be put in place for identifying poor professional performance, including that of optometrist prescribers. This could be via peer review processes or pharmacist/medical practitioner feedback. The National Clinical Assessment Service (NCAS) publishes several documents relating to performance issues. Although currently the NCAS service is only available for doctors and dentists, the principles are applicable to other healthcare professionals including optometrists. Further information is available at under Key Publications and Toolkit. 19

20 Section 5 Further information Glossary Clinical governance Clinical Management Guidelines (CMGs) Clinical Management Plan (CMP) Commissioners Competence Competencies Compliance aids Dispensing (of drugs) Quality assurance activities which ensure that pre-determined clinical standards that have been set, are seen to be maintained by practitioners, and are evident within health care settings. CMGs are produced by the College of Optometrists and represent a reliable source of evidence-based information about the conditions commonly managed in ophthalmic primary care. Each guideline includes information on aetiology, clinical presentation, differential diagnosis and management of the condition by the optometrist (including guidance on referral). The CMP is the foundation stone of supplementary prescribing. Before supplementary prescribing can take place, it is obligatory for an agreed CMP to be in place (written or electronic) relating to a named patient and to that patient s specific condition(s) to be managed by the supplementary prescriber. The CMP is required to include details of the illness or conditions that may be treated, the class or description of medical products that can be prescribed or administered, and the circumstances in which the supplementary prescriber should refer to, or seek advice from, the independent prescriber. The CMP is an agreement between the independent and the supplementary prescriber and is made with the consent of the patient or a person responsible for the patient. Supplementary prescribers must have access to the same patient health records as the independent prescriber. Those funding the programme, such as: Primary Care Trust or Practice Based Commissioning Groups (England); Local Health Board (Wales); Scottish Executive Health Department; and Department of Health and Social Services and Public Safety (DHSSPS Northern Ireland). Relates to the need for the student to demonstrate their capability in certain skill areas to a required standard at a point in time. Component skills which contribute to being competent and achieving the standards of proficiency for registration. Competencies might include skills arising from learning outcomes or other requirements. Medication compliance aids include devices such as multicomponent containers for tablets that are designed to act as a reminder for daily dosing. Various devices are also available to help patients with the administration of eye drops. To label from stock and supply a clinically appropriate medicine to a patient/carer, usually against a written prescription, for selfadministration or administration by another professional, and to advise on safe and effective use. 20

21 emedinfo Independent prescriber Licensed medication Marketing authorisation Medicines Act exemptions Medicines and Healthcare Products Regulatory Authority (MHRA) Off licence Patient Group Direction (PGD) emedinfo is an electronic resource produced by the College of Optometrists in conjunction with Thomson Software Solutions to support the safe and effective use of diagnostic and therapeutic drugs. It comprises an e-formulary of those agents available to optometrists, a database of ocular adverse reactions to medicines and access to sources of prescribing information. A practitioner (e.g. doctor, dentist, nurse, pharmacist or optometrist) who is responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing. Within medicines legislation the term used for these practitioners is appropriate practitioner. The Medicines and Healthcare products Regulatory Agency (MHRA) operates a system of licensing before medicines are marketed (see marketing authorisation). However, the Medicines Act allows certain exemptions from licensing which include: The manufacture and supply of unlicensed relevant medicinal products for individual patient/clients (commonly known as specials ) The importation and supply of unlicensed relevant medicinal products for individual patient/clients Herbal remedies exemption Previously known as a product licence. This normally has to be granted by the MHRA before a medicine can be prescribed or sold. This authorisation, which confirms that medicines have met standards for safety, quality and efficacy, considers all of the activities associated with marketing medicinal products. Allow certain groups of healthcare professionals including optometrists to sell or supply particular medicines directly to patients. Provided the requirements of any conditions attached to those exemptions are met, a Patient Group Direction is not required. The MHRA is a government body, set up in 2003, which brings together the functions of the Medicines Control Agency and the Medical Devices Agency. It is the government agency which is responsible for ensuring that medicines and medical devices work, and are acceptably safe. The use of a medicine outside the terms of its licence (also called Off label ). This should not be confused with unlicensed medicines. A written instruction for the supply or administration of named medicines to specific groups of patients who may not be individually identified before presenting for treatment. Guidance on the use of PGDs is contained within Health Service Circular 21

22 (HSC) 2000/026. The circular also identifies the legal standing of PGDs plus additional guidance on drawing them up and operating within them. It is vital that anyone involved in the delivery of care within a Patient Group Direction is aware of the legal requirements. It is not a form of prescribing. See also guidance at Patient Specific Direction A Patient Specific Direction is the traditional written instruction, from a doctor, dentist, nurse, pharmacist or optometrist independent prescriber, for medicines to be supplied or administered to a named patient. Most medicines are still supplied or administered using this process. In primary care, this might be a simple instruction in the patient s notes. Examples in secondary care include instructions on a patient s ward drug chart. Register of interests Repeat prescribing Repeatable prescription Specialist practitioner qualification Supplementary prescribing Unlicensed medicines Yellow Card Scheme Prescribers are required to keep a register of interests that they may have that could impact on their prescribing practice e.g. links with pharmaceutical companies, pharmaceutical company sponsorship of events, gifts received etc. A partnership between patient and prescriber that allows the prescriber to issue duplicate prescriptions at agreed intervals, without the patient having to consult the prescriber at each issue. A prescription which authorises a pharmacist to fill it more than once (e.g. supply X medication every month for 6 months ). The qualification awarded to optometrists on successful completion of a programme of preparation leading to specialist practice. Specialist practice is the exercising of higher levels of judgement, discretion and decision-making in clinical care. A voluntary partnership between an independent prescriber and a supplementary prescriber, to implement an agreed patientspecific clinical management plan with the patient s agreement. This term refers to medicines that are not licensed for any indication or age group. Reasons why a drug may not be licensed include: (a) the drug is undergoing a clinical trial, has been imported, has been prepared extemporaneously or prepared under a special manufacturing licence; (b) the product is not a medicine but is being used to treat a rare condition. If a patient experiences an adverse drug reaction to a medication the optometrist should record this in the patient notes, notify the prescriber (if they did not prescribe the drug) and notify the MHRA via the Yellow Card Scheme immediately. Yellow cards are found in the back of the British National Formulary and online on For further information consult the BNF or access the MHRA website 22

23 Legal classification of licensed medicines Prescription only medicines (POM) POMs require a prescription to be written, usually by a doctor, dentist, nurse, pharmacist, optometrist or other approved prescriber. POMs are subject to the additional requirement that they are sold or supplied in accordance with an appropriate practitioner s prescription. An appropriate practitioner is a doctor, dentist, nurse independent prescriber, pharmacist independent prescriber, optometrist independent prescriber or supplementary prescriber. Pharmacy medicine (P) P medicines can only be sold through a registered pharmacy under the personal supervision of a pharmacist, i.e. the pharmacist needs to be present before a P medicine can be sold. General sales list medicine (GSL) GSL medicines can be sold in general shops as well as through pharmacies, albeit often in small quantities. All of the products are sold in manufacturer s original packs. Over the counter medicine (OTC) Not a legal classification but a generic term that covers both GSL and P medicines. Note Where the same drug is available in more than one legal classification, for example both POM and P, the licensed indications for its use may differ. Resources Clinical Knowledge Summaries are a reliable source of evidence-based information and practical know how about the common conditions managed in primary care, providing quick answers to real life questions that arise in the consultation. For further information see Department of Health website at Emed info Medicines and Healthcare Products Regulatory Agency website contains information about the legal framework governing the prescribing, supply and administration of medicines at Medicines Partnership Programme at The National Clinical Assessment Service The National Prescribing Centre produces useful information including competency frameworks, guides to practice and resources to help healthcare professionals understand prescribing matters. The NPC also organises study days and conferences to update practitioners. The web address is: The National Electronic Library for Medicines includes a web page on Patient Group Directions on which a centrally maintained archive of approved PGDs can be found. Visit 23

40 Use and Supply of Drugs or Medicines in Optometric Practice

40 Use and Supply of Drugs or Medicines in Optometric Practice 40 Use and Supply of Drugs or Medicines in Optometric Practice Guideline 40.01 The optometrist has a duty to take due care in the use of drugs in optometric practice and to only supply drugs when it is

More information

Case scenarios: Patient Group Directions

Case scenarios: Patient Group Directions Putting NICE guidance into practice Case scenarios: Patient Group Directions Implementing the NICE guidance on Patient Group Directions (MPG2) Published: March 2014 [updated March 2017] These case scenarios

More information

Policy and Procedure for the Development, Approval and Implementation of Patient Group Directions in NHS Haringey Clinical Commissioning Group

Policy and Procedure for the Development, Approval and Implementation of Patient Group Directions in NHS Haringey Clinical Commissioning Group BEFORE USING THIS POLICY ALWAYS ENSURE YOU ARE USING THE MOST UP TO DATE VERSION Policy and Procedure for the Development, Approval and Implementation of Patient Group Directions in NHS Haringey Clinical

More information

PATIENT GROUP DIRECTION PROCEDURE

PATIENT GROUP DIRECTION PROCEDURE PATIENT GROUP DIRECTION PROCEDURE Date approved 2 October 2015 Version 3 Approved by Yvette Oade, Chief Medical Officer Procedure Lead Clinical Governance Lead - Medicines Management Procedure Author Karen

More information

Dear Colleague GENERAL OPHTHALMIC SERVICES OPTOMETRY INDEPENDENT PRESCRIBING. Summary

Dear Colleague GENERAL OPHTHALMIC SERVICES OPTOMETRY INDEPENDENT PRESCRIBING. Summary NHS: PCA(O)(2013)4 Health and Social Care Integration Directorate Primary Care Division Dear Colleague GENERAL OPHTHALMIC SERVICES OPTOMETRY INDEPENDENT PRESCRIBING Summary 1. This letter advises NHS Boards

More information

Template Standard Operating Procedure For: Handling of Midazolam and other controlled drugs in Dental Practices

Template Standard Operating Procedure For: Handling of Midazolam and other controlled drugs in Dental Practices Name of Dental Practice : Objectives To ensure implementation of the regulations and guidance on safe and secure handling of midazolam and other controlled drugs (CDs) Scope To cover all aspects of obtaining

More information

THE RESPONSIBLE PHARMACIST REGULATIONS

THE RESPONSIBLE PHARMACIST REGULATIONS THE RESPONSIBLE PHARMACIST REGULATIONS A SUMMARY OF THE RESPONSES TO PUBLIC CONSULTATION ON PROPOSALS FOR THE CONTENT OF THE REGULATIONS DH INFORMATION READER BOX Policy HR / Workforce Management Planning

More information

MEDICINES, MEDICAL DEVICES, TREATMENTS AND HEALTH

MEDICINES, MEDICAL DEVICES, TREATMENTS AND HEALTH 11 MEDICINES, MEDICAL DEVICES, TREATMENTS AND HEALTH Background The rules in this section are designed to ensure that advertisements that include health claims (please see Section 13 for health claims

More information

DIRECT ACCESS - Guidance to BSDHT Members

DIRECT ACCESS - Guidance to BSDHT Members DIRECT CCESS - Guidance to BSDHT Members Direct ccess came into effect from 1 May 2013. But what does it mean for dental hygienists and dental therapists? The GDC have published guidance notes on the subject

More information

Issue: March 2016 PROFESSIONAL STANDARDS AND GUIDANCE FOR ADVERTISING MEDICINES AND PROFESSIONAL SERVICES

Issue: March 2016 PROFESSIONAL STANDARDS AND GUIDANCE FOR ADVERTISING MEDICINES AND PROFESSIONAL SERVICES Issue: March 2016 PROFESSIONAL STANDARDS AND GUIDANCE FOR ADVERTISING MEDICINES AND PROFESSIONAL SERVICES PROFESSIONAL STANDARDS AND GUIDANCE FOR ADVERTISING MEDICINES AND PROFESSIONAL SERVICES CONTENTS

More information

Prescription only medicines (POMs)

Prescription only medicines (POMs) Prescription only medicines (POMs) 2017 Learning objectives Explain the legal framework with which registered health care professionals can administer prescription only medicines Define the role and limitations

More information

An overview of Patient Group Directions (PGDs)

An overview of Patient Group Directions (PGDs) An overview of Patient Group Directions (PGDs) The first stop for professional medicines advice Jo Jenkins Specialist Pharmacist Patient Group Directions SPS February 2018 Scope of SPS PGD service where

More information

Patient Group Directions (PGDs)

Patient Group Directions (PGDs) Patient Group Directions (PGDs) Document level: Trustwide (TW) Code: MP2 Issue number: 4 Lead executive Authors details Type of document Target audience Document purpose Medical Director Senior Clinical

More information

DIRECT ACCESS Guidance to BSDHT Members

DIRECT ACCESS Guidance to BSDHT Members DIRECT CCESS Guidance to BSDHT Members Direct ccess comes into effect from 1 May 2013. But what does it mean for dental hygienists and dental therapists? The GDC have published guidance notes on the subject

More information

North of England Cancer Network. Policies and Procedures. Standards for the Safe Use of Oral Anticancer Medicines

North of England Cancer Network. Policies and Procedures. Standards for the Safe Use of Oral Anticancer Medicines \ North of England Cancer Network Policies and Procedures Standards for the Safe Use of Oral Anticancer Medicines NECN Oral Anticancer medicine Policy version 1.6 Page 1 of 17 Issue Date: Feb 2017 Contents

More information

Patient Group Directions Policy

Patient Group Directions Policy Patient Group Directions Policy Category: Summary: Equality Analysis undertaken: Valid From: Date of Next Review: Approval Date/ Via: Distribution: Related Documents: Author(s): Further Information: This

More information

Information about cases being considered by the Case Examiners

Information about cases being considered by the Case Examiners Information about cases being considered by the Case Examiners 13 October 2016 1 Contents Purpose... 3 What should I do next?... 3 Background... 4 Criteria that Case Examiners will consider... 5 Closing

More information

Guide to Professional Conduct and Ethics for Registered Medical Practitioners. Relationships between doctors and industry Frequently Asked Questions

Guide to Professional Conduct and Ethics for Registered Medical Practitioners. Relationships between doctors and industry Frequently Asked Questions Guide to Professional Conduct and Ethics for Registered Medical Practitioners Relationships between doctors and industry Frequently Asked Questions Partnership Practice Performance Relationships between

More information

Developed By Name Signature Date

Developed By Name Signature Date Patient Group Direction 2155 version 2.0 Administration / Supply of Inhaled Salbutamol in Asthma by Registered Practitioners employed by Torbay and South Devon NHS Foundation Trust Date of Introduction:

More information

Response to Scottish Government A Consultation on Electronic Cigarettes and Strengthening Tobacco Control in Scotland December 2014

Response to Scottish Government A Consultation on Electronic Cigarettes and Strengthening Tobacco Control in Scotland December 2014 Responseto ScottishGovernment AConsultationonElectronicCigarettesand StrengtheningTobaccoControlinScotland December2014 Contact Janice Oman Scotland Representation Manager National Pharmacy Association

More information

PATIENT GROUP DIRECTIONS POLICY

PATIENT GROUP DIRECTIONS POLICY PATIENT GROUP DIRECTIONS POLICY To be read in conjunction with the Medicines Policy and the Controlled Drugs Policy Version: 5 Ratified by: Senior Managers Operations Group Date ratified: August 2015 October

More information

COPYRIGHTED MATERIAL. Introduction

COPYRIGHTED MATERIAL. Introduction 1 Introduction Pharmacology is the science of drugs and their effects on biological systems. A drug can be defined as a chemical that can cause a change in a biological system; the important biological

More information

Review of Medicines Act 1968: informal consultation on issues relating to the PLR regime and homeopathy

Review of Medicines Act 1968: informal consultation on issues relating to the PLR regime and homeopathy Review of Medicines Act 1968: informal consultation on issues relating to the PLR regime and homeopathy Introduction 1. The consolidation and review of the UK medicines legislation (including the Medicines

More information

Day care and childminding: Guidance to the National Standards

Day care and childminding: Guidance to the National Standards raising standards improving lives Day care and childminding: Guidance to the National Standards Revisions to certain criteria October 2005 Reference no: 070116 Crown copyright 2005 Reference no: 070116

More information

PRESCRIBING BY RADIOGRAPHERS: A VISION PAPER

PRESCRIBING BY RADIOGRAPHERS: A VISION PAPER PRESCRIBING BY RADIOGRAPHERS: A VISION PAPER 1 INTRODUCTION 1.1 The Review of Prescribing, Supply & Administration of Medicines (Crown II) Final Report was submitted to The Secretary of State for Health

More information

Consent to research. A draft for consultation

Consent to research. A draft for consultation Consent to research A draft for consultation 1 Consent to research About the guidance Our guidance Consent: patients and doctors making decisions together (2008) 1 sets out the principles of good practice

More information

COMPETENT AUTHORITY (UK) MEDICAL DEVICES DIRECTIVES GUIDANCE NOTES FOR MANUFACTURERS OF DENTAL APPLIANCES

COMPETENT AUTHORITY (UK) MEDICAL DEVICES DIRECTIVES GUIDANCE NOTES FOR MANUFACTURERS OF DENTAL APPLIANCES COMPETENT AUTHORITY (UK) 10 EC MEDICAL DEVICES DIRECTIVES GUIDANCE NOTES FOR MANUFACTURERS OF DENTAL APPLIANCES (CUSTOM MADE DEVICES) Updated March 2008 CONTENTS PAGE Introduction 3 Definition of dental

More information

USE OF UNLICENSED MEDICINES AND OFF-LABEL MEDICINES WHERE A LICENSED MEDICINE IS AVAILABLE

USE OF UNLICENSED MEDICINES AND OFF-LABEL MEDICINES WHERE A LICENSED MEDICINE IS AVAILABLE NHS Scotland Directors of Pharmacy and Scottish Association of Medical Directors USE OF UNLICENSED MEDICINES AND OFF-LABEL MEDICINES WHERE A LICENSED MEDICINE IS AVAILABLE CONSENSUS STATEMENT This consensus

More information

Changing practice to support service delivery

Changing practice to support service delivery Nurse and Midwife Medicinal Product Prescribing Toolkit Authorised Medicinal Products, Off-label Prescription and Exempt Medicinal Products Toolkit Changing practice to support service delivery Introduction

More information

Guidelines on the Sourcing of Medicinal Products for Sale or Supply by a Retail Pharmacy Business

Guidelines on the Sourcing of Medicinal Products for Sale or Supply by a Retail Pharmacy Business Guidelines on the Sourcing of Medicinal Products for Sale or Supply by a Retail Pharmacy Business to Facilitate Compliance with Regulations 5(1)(g), 6, 8 and 11 of the Regulation of Retail Pharmacy Businesses

More information

Consultation Group: Dr Amalia Mayo, Paediatric Consultant. Review Date: March Uncontrolled when printed. Version 2. Executive Sign-Off

Consultation Group: Dr Amalia Mayo, Paediatric Consultant. Review Date: March Uncontrolled when printed. Version 2. Executive Sign-Off Policy For The Adjustment Of Insulin Injections By Paediatric Diabetes Specialist Nurses/Community Paediatric Nurses Diabetes Working With Children Within NHS Grampian Co-ordinators: Lead Paediatric Diabetes

More information

The Professional Relationships Associated with the Practice of Dental Therapy Practice Standard

The Professional Relationships Associated with the Practice of Dental Therapy Practice Standard The Professional Relationships Associated with the Practice of Dental Therapy Practice Standard December 2006 I:\Communications\C7 - Website\Practice standards rebranded Aug15\Dental therapy working relationship

More information

Chief Dental Officer England: Advice on commercial practice of online registered dental practitioners selling patient group directions for NHS

Chief Dental Officer England: Advice on commercial practice of online registered dental practitioners selling patient group directions for NHS Chief Dental Officer England: Advice on commercial practice of online registered dental practitioners selling patient group directions for NHS England commissioned services. Chief Dental Officer England:

More information

Guidance for Pharmacists on Extemporaneous Dispensing

Guidance for Pharmacists on Extemporaneous Dispensing Guidance for Pharmacists on Extemporaneous Dispensing Pharmaceutical Society of Ireland Version 1 June 2015 Contents 1. Introduction 2 2. Legislative Basis and Implications 3 3. Guidance 4 3.1 Key Responsibilities

More information

Memorandum of Understanding between the Care Quality Commission and the General Dental Council

Memorandum of Understanding between the Care Quality Commission and the General Dental Council Memorandum of Understanding between the Care Quality Commission and the General Dental Council 1. The purpose of this Memorandum of Understanding (MoU) is to promote patient safety and high quality health

More information

Draft Guidance for Pharmacists on Extemporaneous Dispensing. Version 1

Draft Guidance for Pharmacists on Extemporaneous Dispensing. Version 1 1. Introduction Draft Guidance for Pharmacists on Extemporaneous Dispensing Version 1 The purpose of this guidance is to assist pharmacists in discharging their legal and professional obligations to patients

More information

Guidelines for the employment of Assistant Psychologists

Guidelines for the employment of Assistant Psychologists Guidelines for the employment of Assistant Psychologists 1. INTRODUCTION This document has been written for the benefit of assistant psychologists, their employers and managers, to provide guidance on

More information

Draft Guidelines on the Sale and Supply of Non- Prescription Medicinal Products from a Retail Pharmacy Business

Draft Guidelines on the Sale and Supply of Non- Prescription Medicinal Products from a Retail Pharmacy Business Draft Guidelines on the Sale and Supply of Non- Prescription Medicinal Products from a Retail Pharmacy Business To facilitate compliance with Regulations 5(1)(d), 5(1)(h) and 10 of the Regulation of Retail

More information

Guidance on Bulk Prescribing for Care Home Patients

Guidance on Bulk Prescribing for Care Home Patients Guidance on Bulk Prescribing for Care Home Patients Introduction Many patients in care homes taking medicines when required (PRN) can inevitably present problems for the prescriber in determining the quantity

More information

Policy and process for development and management of PGDs for general practice that require SCCG authorisation

Policy and process for development and management of PGDs for general practice that require SCCG authorisation Policy and process for development and management of PGDs for general practice that require SCCG authorisation C027 CO27 PGD Policy (2) Page 1 of 30 Contents 1. Introduction... 3 1.1 Status... 3 1.2. Purpose

More information

DRUG PRODUCT INTERCHANGEABILITY AND PRICING ACT

DRUG PRODUCT INTERCHANGEABILITY AND PRICING ACT c t DRUG PRODUCT INTERCHANGEABILITY AND PRICING ACT PLEASE NOTE This document, prepared by the Legislative Counsel Office, is an office consolidation of this Act, current to September 22, 2014. It is intended

More information

Management of AIDS/HIV Infected Healthcare Workers Policy

Management of AIDS/HIV Infected Healthcare Workers Policy Management of AIDS/HIV Infected Healthcare Workers Policy DOCUMENT CONTROL: Version: 4 Ratified by: Corporate Policy Panel Date ratified: 20 July 2017 Name of originator/author: HR Manager Name of responsible

More information

On successful completion of the Unit the learner will be able to:

On successful completion of the Unit the learner will be able to: Higher National Unit specification General information Unit code: H9R8 34 Superclass: PF Publication date: September 2015 Source: Scottish Qualifications Authority Version: 03 Unit purpose This Unit is

More information

Proposed Radiation Safety Regulations: Submission form

Proposed Radiation Safety Regulations: Submission form Proposed Radiation Safety Regulations: Submission form Making a submission This form is designed to assist submitters responding to the discussion points in Proposed Radiation Safety Regulations: A consultation

More information

Developed By Name Signature Date

Developed By Name Signature Date Patient Group Direction 2156 version 2.0 Administration of Ipratropium 250mcg/ml Nebuliser Solution in Acute Asthma by Registered Practitioners employed by Torbay and South Devon NHS Foundation Date of

More information

Care and Social Services Inspectorate Wales

Care and Social Services Inspectorate Wales Care and Social Services Inspectorate Wales Service Regulation and Inspection Guidance on inspecting welfare provision in boarding schools, residential special schools and accommodation of students under

More information

CNHC Guidance on The Cancer Act (Please note this does not constitute legal advice)

CNHC Guidance on The Cancer Act (Please note this does not constitute legal advice) CNHC Guidance on The Cancer Act 1939 (Please note this does not constitute legal advice) 1. Introduction 1.1. In November 2012 CNHC produced Advertising Guidance to support CNHC registered practitioners

More information

Appendix C. Aneurin Bevan Health Board. Smoke Free Environment Policy

Appendix C. Aneurin Bevan Health Board. Smoke Free Environment Policy Appendix C Aneurin Bevan Health Board Smoke Free Environment Policy Content 1. Policy statement 2. Introduction 3. Smoking restrictions within the Health Board 4. Responsibilities 5. Staff working in patients

More information

Medical gap arrangements - practitioner application

Medical gap arrangements - practitioner application Medical gap arrangements - practitioner application For services provided in a licensed private hospital or day hospital facility (Private Hospital) only. Please complete this form to apply for participation

More information

Guidance for Pharmacists on the Safe Supply of Non-Prescription Levonorgestrel 1500mcg for Emergency Hormonal Contraception

Guidance for Pharmacists on the Safe Supply of Non-Prescription Levonorgestrel 1500mcg for Emergency Hormonal Contraception Guidance for Pharmacists on the Safe Supply of Non-Prescription Levonorgestrel 1500mcg for Emergency Hormonal Contraception Pharmaceutical Society of Ireland Version 4 December 2016 Updates made following

More information

Workplace Drug and Alcohol Policy

Workplace Drug and Alcohol Policy Workplace Drug and Alcohol Policy January 2017 This Drug and Alcohol Policy is intended for and includes but is not limited to all Students, Contractors and all others either directly or indirectly engaged

More information

Drug Misuse and Dependence Guidelines on Clinical Management

Drug Misuse and Dependence Guidelines on Clinical Management Department of Health Scottish Office Department of Health Welsh Office Department of Health and Social Services, Northern Ireland Drug Misuse and Dependence Guidelines on Clinical Management An Executive

More information

Care homes - Homely remedies

Care homes - Homely remedies Bulletin 72 August 2014 Care homes - Homely remedies Care home staff have a recognised duty of care to be able to respond to minor symptoms experienced by residents. A homely remedy is a medicinal product

More information

All Saints First School Administering of Medicines Policy

All Saints First School Administering of Medicines Policy All Saints First School Administering of Medicines Policy Success Indicators The following indicators will demonstrate the level of compliance with this policy and its procedures: a) Employees who are

More information

Professional Development: proposals for assuring the continuing fitness to practise of osteopaths. draft Peer Discussion Review Guidelines

Professional Development: proposals for assuring the continuing fitness to practise of osteopaths. draft Peer Discussion Review Guidelines 5 Continuing Professional Development: proposals for assuring the continuing fitness to practise of osteopaths draft Peer Discussion Review Guidelines February January 2015 2 draft Peer Discussion Review

More information

Education and Training Committee 15 November 2012

Education and Training Committee 15 November 2012 Education and Training Committee 15 November 2012 Review of the process of approval of hearing aid dispenser pre-registration education and training programmes. Executive summary and recommendations Introduction

More information

Non-Prescription Medicinal Products Containing Codeine: Guidance for Pharmacists on Safe Supply to Patients

Non-Prescription Medicinal Products Containing Codeine: Guidance for Pharmacists on Safe Supply to Patients Non-Prescription Medicinal Products Containing Codeine: Guidance for Pharmacists on Safe Supply to Patients Pharmaceutical Society of Ireland Version 3 October 2017 Updates made following the enactment

More information

I M REGISTERED. Promoting your status as a registered health professional. A guide for osteopaths

I M REGISTERED. Promoting your status as a registered health professional. A guide for osteopaths I M REGISTERED Promoting your status as a registered health professional A guide for osteopaths 2 Why is it important for me to raise awareness of my registration? Patients want to be assured that you

More information

Unit 204 Assist with the assembly of prescribed items

Unit 204 Assist with the assembly of prescribed items Element 1 Assemble prescribed 171 172 Element 1 Assemble prescribed Background Assembling prescribed is a complex process. The two main components of this process are labelling and dispensing. It is essential

More information

Care homes - Homely remedies

Care homes - Homely remedies Bulletin 72 August 2014 Community Interest Company Care homes - Homely remedies Care home staff have a recognised duty of care to be able to respond to minor symptoms experienced by residents. A homely

More information

Drug and Alcohol Policy

Drug and Alcohol Policy Drug and Alcohol Policy Purpose Skillset Pty Ltd ( Skillset ) is committed to providing a safe and healthy work environment, so far as is reasonably practicable in which all workers are treated fairly,

More information

Code of Conduct for Communication Professionals

Code of Conduct for Communication Professionals Code of Conduct for Communication Professionals Effective from 1 January 2010 The purpose of this Code of Conduct is to ensure that NRCPD regulated communication professionals carry out their work with

More information

Service Specification & Contract Intermediate Stop Smoking Service & Voucher fulfilment - Pharmacy Newcastle

Service Specification & Contract Intermediate Stop Smoking Service & Voucher fulfilment - Pharmacy Newcastle Service Specification & Contract Intermediate Stop Smoking Service & Voucher fulfilment - Pharmacy Newcastle Contents 1. Agreement period 2. Scope 3. Targets 4. Service outline 5. Support for clients using

More information

IT and Information Acceptable Use Policy

IT and Information Acceptable Use Policy BMI IMpol04 Information Management IT and Information Acceptable Use Policy This is a controlled document and whilst this document may be printed, the electronic version posted on the intranet/shared drive

More information

Consultation Group: See relevant page in the PGD. Review Date: October 2017

Consultation Group: See relevant page in the PGD. Review Date: October 2017 Patient Group Direction For Supply Of Paracetamol Oral Suspension 120mg/5mL For Prevention Of Post Immunisation Fever Following Administration Of Meningococcal Group B Vaccine (Bexsero ) By Community Pharmacists

More information

Borders. Patient Group Direction (PGD) Development Policy For NHS Borders

Borders. Patient Group Direction (PGD) Development Policy For NHS Borders Borders Title Document Type Patient Group Direction (PGD) Development Policy For NHS Borders Policy Issue no. 2 Issue date November 2014 Review date November 2016 Distribution Prepared by Developed by

More information

Document Details. Ibuprofen 200mg tablets and Ibuprofen oral liquid 100mg in 5ml

Document Details. Ibuprofen 200mg tablets and Ibuprofen oral liquid 100mg in 5ml Title Document Details Patient Group Direction (PGD) Ibuprofen 200mg tablets and Ibuprofen oral liquid 100mg in 5ml Trust Ref No 1445-36348 Local Ref (optional) Main points the document The treatment of

More information

Enhanced Service Specification. Childhood seasonal influenza vaccination programme 2018/19

Enhanced Service Specification. Childhood seasonal influenza vaccination programme 2018/19 Enhanced Service Specification Childhood seasonal influenza vaccination programme 2018/19 Contents Childhood seasonal influenza vaccination programme... 1 Contents... 4 1 Introduction... 5 2 Background...

More information

Guidance For The Development And Implementation Of Patient Group Directions (PGDs) For Staff Working Within NHS Grampian. Consultation Group:

Guidance For The Development And Implementation Of Patient Group Directions (PGDs) For Staff Working Within NHS Grampian. Consultation Group: NHS...... Grampian Guidance For The Development And Implementation Of Patient Group Directions (PGDs) For Staff Working Within NHS Grampian Co-ordinators: Medicines Management Specialist Nurse Consultation

More information

Guideline for the Rational Use of Controlled Drugs

Guideline for the Rational Use of Controlled Drugs Guideline for the Rational Use of Controlled Drugs Ministry of Health Male' Republic of Maldives April 2000 Table of Contents Page Introduction.. 2 1. Procurement and Supply of Controlled Drugs 3 1.1 Import

More information

Enhanced Service Specification. Childhood seasonal influenza vaccination programme 2017/18

Enhanced Service Specification. Childhood seasonal influenza vaccination programme 2017/18 Enhanced Service Specification Childhood seasonal influenza vaccination programme 2017/18 2 Enhanced Service Specification Childhood seasonal influenza vaccination programme Version number: 1 First published:

More information

making a referral for breast imaging Standard Operating Procedure

making a referral for breast imaging Standard Operating Procedure Document Control Title Reporting Radiographer Author Directorate Surgery Date Version Issued 0.1 May 2016 Status Draft Author s job title Reporting Radiographer Department Breast Imaging Comment / Changes

More information

PATIENT GROUP DIRECTION. Oral (live attenuated) Typhoid Vaccine (Ty21a) (Vivotif )

PATIENT GROUP DIRECTION. Oral (live attenuated) Typhoid Vaccine (Ty21a) (Vivotif ) PATIENT GROUP DIRECTION Administration of: Oral (live attenuated) Typhoid Vaccine (Ty21a) (Vivotif ) By: Practice Nurses In: General Practice It is the responsibility of the professional working under

More information

Information provided to Duchenne muscular dystrophy patient organisations regarding Raxone

Information provided to Duchenne muscular dystrophy patient organisations regarding Raxone Information provided to Duchenne muscular dystrophy patient organisations regarding Raxone (idebenone) and the Early Access to Medicines Scheme in the UK (EAMS 46555/0001) April 26 th 2018 Raxone tablets

More information

CALDERDALE PRIMARY CARE TRUST

CALDERDALE PRIMARY CARE TRUST CALDERDALE PRIMARY CARE TRUST PATIENT GROUP DIRECTION FOR THE SUPPLY AND ADMINISTRATION OF MEDICINES BY NON- MEDICAL PERSONNEL Progestogen-only emergency contraception for use in Community Pharmacies APPROVED

More information

- The development of a training, qualifications and registration system for BSL / English Interpreters.

- The development of a training, qualifications and registration system for BSL / English Interpreters. SUBJECT: INTERPRETING CONFERENCE SUPPORTING DEAF PEOPLE AN INTERNATIONAL ONLINE CONFERENCE FOR INTERPRETING PROFESSIONALS. THEMES: TRAINING, ETHICS AND PROFESSIONALISM AND EDUCATIONAL INTERPRETING. CACDP

More information

Hearing aid dispenser approval process review Introduction Hearing aid dispenser data transfer... 6

Hearing aid dispenser approval process review Introduction Hearing aid dispenser data transfer... 6 Hearing aid dispenser approval process review 2010 11 Content 1.0 Introduction... 4 1.1 About this document... 4 1.2 Overview of the approval process... 4 2.0 Hearing aid dispenser data transfer... 6 2.1

More information

pat hways Key therapeutic topic Published: 26 February 2016 nice.org.uk/guidance/ktt16

pat hways Key therapeutic topic Published: 26 February 2016 nice.org.uk/guidance/ktt16 pat hways Anticoagulants, including non-vitamin K antagonist oral anticoagulants (NOACs) Key therapeutic topic Published: 26 February 2016 nice.org.uk/guidance/ktt16 Options for local implementation NICE

More information

AUDIT TOOL FOR SELF INSPECTION OF COMPLIANCE WITH QUALITY MANAGEMENT SYSTEM FOR PATIENT GROUP DIRECTIONS

AUDIT TOOL FOR SELF INSPECTION OF COMPLIANCE WITH QUALITY MANAGEMENT SYSTEM FOR PATIENT GROUP DIRECTIONS AUDIT TOOL FOR DISPENSING SERVICES COMPILED BY: Lynn Morrison ISSUE 1 CHECKED BY: Colette Byrne NUMBER: ISSUE DATE: 01.12.07 SUPERSEDES: NEW REVIEW DATE: 01.12.09 AUDIT TOOL FOR SELF INSPECTION OF COMPLIANCE

More information

Controlled Drugs Accountable Officers Network Scotland Executive Group. Gabapentin and Pregabalin - Frequently Asked Questions

Controlled Drugs Accountable Officers Network Scotland Executive Group. Gabapentin and Pregabalin - Frequently Asked Questions Gabapentin and Pregabalin - Frequently Asked Questions Gabapentin and pregabalin will become Schedule 3 Controlled Drugs in April 2019 NHS Contractor Services Prescribers are legally permitted to be in

More information

Guideline on the Regulation of Therapeutic Products in New Zealand

Guideline on the Regulation of Therapeutic Products in New Zealand Guideline on the Regulation of Therapeutic Products in New Zealand Part 10: Requirements for information for prescribers and consumers Edition 7.0 January 2016 Section 1: Legislation Section summary This

More information

Name of Event: Date of Event: Details of Event Organiser: [Name, Address, Contact number, ]

Name of Event: Date of Event: Details of Event Organiser: [Name, Address, Contact number,  ] FOOD SAFETY PLAN [Template] - Please complete the missing details and change or add to this plan as required so that it is specific to your event and covers all the food safety issues at your event. -

More information

New regulatory requirements DPCS Regulations 2017

New regulatory requirements DPCS Regulations 2017 New regulatory requirements DPCS Regulations 2017 Prescribers and pharmacists May 2017 Table of Contents Explanatory notes... 1 Clarifying the meaning of key terms... 1 Chart instructions and prescriptions...

More information

Document Details Patient Group Direction Hepatitis A vaccine (Havrix Monodose ) Trust Ref No Local Ref (optional) Main points the

Document Details Patient Group Direction Hepatitis A vaccine (Havrix Monodose ) Trust Ref No Local Ref (optional) Main points the Document Details Title Patient Group Direction Hepatitis A vaccine (Havrix Monodose ) Trust Ref No 1506-41174 Local Ref (optional) Main points the Active immunisation against infection caused by Hepatitis

More information

PATIENT GROUP DIRECTION (PGD) Supply of potassium iodide 65mg tablets to adults and children exposed to, or at risk of exposure to radioactive iodine

PATIENT GROUP DIRECTION (PGD) Supply of potassium iodide 65mg tablets to adults and children exposed to, or at risk of exposure to radioactive iodine PHE publications gateway number: PATIENT GROUP DIRECTION (PGD) Supply of potassium iodide 65mg tablets to adults and children exposed to, or at risk of exposure to radioactive iodine For the supply of

More information

Guide to Interchangeable Medicines

Guide to Interchangeable Medicines Guide to Interchangeable Medicines AUT-G0115-6 01 JUNE 2018 This guide does not purport to be an interpretation of law and/or regulations and is for guidance purposes only. CONTENTS 1 BACKGROUND 3 1.1

More information

Safe Prescribing and Dispensing of Controlled Drugs. Joint Guidance Medical Council and Pharmaceutical Society of Ireland

Safe Prescribing and Dispensing of Controlled Drugs. Joint Guidance Medical Council and Pharmaceutical Society of Ireland Safe Prescribing and Dispensing of Controlled Drugs Joint Guidance Medical Council and Pharmaceutical Society of Ireland Purpose of this Guidance Purpose of this Guidance This resource aims to facilitate

More information

Psychotherapists and Counsellors Professional Liaison Group (PLG) 30 September 2010

Psychotherapists and Counsellors Professional Liaison Group (PLG) 30 September 2010 Psychotherapists and Counsellors Professional Liaison Group (PLG) 30 September 2010 Information for organisations invited to present to meetings of the Psychotherapists and Counsellors Professional Liaison

More information

MS Society Safeguarding Adults Policy and Procedure (Scotland)

MS Society Safeguarding Adults Policy and Procedure (Scotland) MS Society Safeguarding Adults Policy and Procedure (Scotland) Safeguarding Adults Policy The phrase adult support and protection is used instead of safeguarding in Scotland. However for consistency across

More information

Care Homes - Homely Remedies Protocol

Care Homes - Homely Remedies Protocol Care Homes - Homely Remedies Protocol A homely remedy is a medicine for the short-term treatment of a minor ailment, such as indigestion, a cough, mild to moderate pain or constipation, and can be obtained

More information

Response to. GPhC Consultation. Guidance to ensure a safe and effective pharmacy team.

Response to. GPhC Consultation. Guidance to ensure a safe and effective pharmacy team. Response to GPhC Consultation on Guidance to ensure a safe and effective pharmacy team. Contact Helga Mangion National Pharmacy Association Mallinson House 38-42 St Peter s Street St Albans Herts AL1 3NP

More information

APPENDIX 2. Appendix 2 MoU

APPENDIX 2. Appendix 2 MoU APPENDIX 2 THIS APPENDIX CONTAINS BOTH THE TEXT OF THE CURRENT MEMORANDUM OF UNDERSTANDING BETWEEN JCSTD, THE GDC AND COPDEND ABOUT THEIR JOINT WORKING ARRANGEMENTS AND THE WORKING NOTES DRAFTED BY PROF

More information

PHYSIOTHERAPY ACT AUTHORIZATION REGULATIONS

PHYSIOTHERAPY ACT AUTHORIZATION REGULATIONS c t PHYSIOTHERAPY ACT AUTHORIZATION REGULATIONS PLEASE NOTE This document, prepared by the Legislative Counsel Office, is an office consolidation of this regulation, current to July 11, 2009. It is intended

More information

Document Details. Patient Group Direction

Document Details. Patient Group Direction Document Details Title Patient Group Direction (PGD) Salbutamol Aerosol Inhaler and salbutamol Nebulised Solution Trust Ref No 1569-34313 Local Ref (optional) Main points the document Treatment of acute

More information

GDC Disclosure and Publication Policy

GDC Disclosure and Publication Policy GDC Disclosure and Publication Policy 1 DISCLOSURE AND PUBLICATION POLICY TABLE OF CONTENTS PURPOSE... 4 THE LAW... 4 PUBLICATION OF FITNESS TO PRACTISE INFORMATION... 5 Publication of Conduct and Performance

More information

Medicines Optimisation Strategy

Medicines Optimisation Strategy Clinical Reducing Dosing Errors with Opioid Medicines (Controlled Drug SOP): Document Control Summary Status: Version: Author/Owner/Title: Approved by: Ratified: Related Trust Strategy and/or Strategic

More information

Core Competencies Clinical Psychology A Guide

Core Competencies Clinical Psychology A Guide Committee for Scrutiny of Individual Clinical Qualifications Core Competencies Clinical Psychology A Guide Please read this booklet in conjunction with other booklets and forms in the application package

More information

SWINDON PCT CATARACT DIRECT REFERRAL SCHEME SERVICE LEVEL AGREEMENT

SWINDON PCT CATARACT DIRECT REFERRAL SCHEME SERVICE LEVEL AGREEMENT SWINDON PCT CATARACT DIRECT REFERRAL SCHEME SERVICE LEVEL AGREEMENT PROTOCOL This document sets out the details of the administrative protocol for the direct referral by Optometrists/OMPs of cataract patients.

More information

Trust Policy 218 Ionising Radiation Safety Policy

Trust Policy 218 Ionising Radiation Safety Policy Trust Policy 218 Ionising Radiation Safety Policy Purpose Date Version August 2016 7 To ensure that Plymouth Hospitals NHS Trust complies with all relevant legislation with regard to the use of ionising

More information