When to use supplementary prescribing
and
How to write a clinical management plan
Kimberley Tordoff
Introduction
• On completion of this course you will gain
a qualification of being an IP & SP
• Therefore you must demonstrate the
ability to complete a clinical management
plan required for supplementary
prescribing
• Errors on your clinical management plan
(CMP) may lead you to fail your portfolio
Uses of CMP
• Long term conditions
• Useful if working in a new area
• Useful for prescribing Controlled Drugs
(CDs)
• Widely used before the whole BNF
opened
CMPs
• Blank templates on Department of Health
website
• You may use your own version as long as
ALL the legally required information is there
• Choose the one appropriate to your practice
(do you have access to the notes or not?)
• Only put one condition to be treated or one
symptom
• For CMPs to work they need to be quick and
simple (NPC 2003)
CMPs
• You are the SP and the doctor is the IP
• If more than one SP all must be listed by name and
all must sign in the relevant section to enable more
than one SP in a team to use the plan.
• Use the patient details & address in your module
guide
• Fill in the patient details including an NHS number
(false)
• Condition to be treated
• Aim of the treatment; be specific e.g. BP between x
& x or Hba1c @ x, peak flow over x.
CMPs
• Preparation can be the name of 1 drug if it is that
specific, but a plan works better if it is over a
range of drugs or the whole class of drugs
• Include the section of the BNF e.g. Section
3.2.1of BNF vol 61 2011 (Joint Formulary
Committee, 2011).
• If you are experienced in this area then you
would want a range of drugs
• Dose – range of dose to prescribe for a specific
drug or as per section 3.2.1. of BNF vol 61 2011
(Joint Formulary Committee, 2011).
CMPs
• Reasons for referral back to IP
• Be specific and not vague-if you put ‘side
effects’ then you would have to refer back for
every single slight problem
• Think about this in reality
• BP above x on x occasions despite maximum
dose
• Cough on ace may not be needing to do back
to see IP if you have given yourself a wide
enough section of BNF so you can try an
alternative
Guidelines & Protocols
• Must include BNF with volume number
and date
• Guidelines referenced properly
• These can be local as long as they are
recognised and robust
Review & Record
• Frequency of review is a heading and
must be completed
• Put a time frame for IP & SP
• IP must be at least yearly
• SP must be more frequent than IP
• Whatever the shared record is then
document it e.g. hospital notes, EMIS.
Adverse Drug Reactions (ADRs)
•
•
•
•
•
•
Inform IP
Document in patients notes
Inform MHRA via yellow card system
Signatures are needed NOT typed names
Dated
Patients signature is not required but document in
notes that they have given informed consent
• When you write out your prescription the
pharmacist you must know that you are
prescribing within a CMP so write SP after your
name
Conclusion
• This is a fictitious CMP so don't worry that
you are signing something illegally
• Get this done soon whilst it is fresh in your
mind
References
Joint Formulary Committee British National
Formulary (61) Ed. London: British Medical
Association and Royal Pharmaceutical
Society (2011)
National Prescribing Centre (2003) (NPC)
Supplementary Prescribing A resource to
help healthcare professionals to understand
the framework and opportunities
http://www.npc.nhs.uk/resources/healthcare_re
source.pdf
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