Centre for Professional Development
NON-MEDICAL PRESCRIBING APPLICATION GUIDANCE NOTES
(V300 Independent/Supplementary prescribing)
NURSE / MIDWIFE APPLICANT GUIDANCE
Applicants must provide evidence that they have met the NMC’s criteria for eligibility to undertake a
nurse independent/supplementary prescribing programme. The criteria are:

You must be a registered first level nurse, midwife and/or specialist community public health
nurse

You must have at least three years’ experience as a practising nurse, midwife or specialist
community public health nurse and be deemed competent by your employer to undertake the
programme. Of these three years, the year immediately preceding application to the programme
must have been in the clinical field in which you intend to prescribe, e.g. neonates, mental health.
Part-time workers must have practised for a sufficient period to be deemed competent by their
employer

You must provide evidence of your ability to study at the appropriate level. If you are unable to
provide this evidence, you will be requested to comply with the Accreditation of Prior and
Experiential Learning (APEL) process in order to consider your application. Further details will be
sent to you as necessary on receipt of your application.
In addition, you will need to have written confirmation from:

Your employer of their support for you to undertake the preparation programme.

The programme lead about your selection on to the preparation of prescribers education
programme. This will be provided to the applicant and employer.

A designated medical practitioner who meets eligibility criteria for medical supervision of nonmedical prescribers and who has agreed to provide the required term of supervised practice.
1
Responsibilities of Employer
The NMC requires employers to undertake an appraisal of an applicant’s suitability to prescribe before
they apply for a training place. Employers must also have the necessary clinical governance
infrastructure in place including a Disclosure and Barring Service check (formerly a Criminal Records
Bureau check) to enable the registrant to prescribe once they are qualified to do so.
Where the applicant is not undertaking a module to prepare them in diagnosis and physical assessment
alongside the nurse/midwife independent/supplementary prescribing programme, then the employer is
responsible for confirming that:




The applicant has been assessed as competent to take a history, undertake a clinical
assessment, and diagnose, before being put forward
There is clinical need within the applicant’s role to justify prescribing
The applicant has sufficient knowledge to apply prescribing principles taught on the programme
of preparation to their own area and field of practice
The applicant must be able to demonstrate appropriate numeracy skills
Employers should not put applicants forward if they haven’t demonstrated the ability to diagnose in their
area of speciality. It should be possible to identify whether an applicant has these skills through
Continuing Professional Development (CPD) reviews within the work place setting.
Applicants must remember they work as a part of a team of prescribers.
The University of Lincoln must be satisfied that any applicant to the programme of preparation has the
ability to study at the appropriate level. In addition, the University of Lincoln must support the designated
medical practitioner (DMP) with a suitable competence framework to assess learning in practice. They
are also responsible for ensuring that the DMP meets the eligibility criteria listed in this document.
Applying to undertake the programme should be a collaborative arrangement between the employer, the
University and the applicant, in order to confirm that the applicant is competent to undertake the course,
is in a role that enables them to prescribe, and that the necessary infrastructure will be in place to allow
them to do so.
The application form will identify whether an applicant has applied and commenced a programme of
preparation previously. Where this is the case, the reason for not completing must be stated. This will
allow a decision to be made by the employer in collaboration with the University as to whether it is
appropriate for them to re-apply.
Prescribing for children and young people
The NMC ‘Standards of proficiency for nurse and midwife prescribers’ were published in May 2006. This
document states that:
‘Only nurses with relevant knowledge, competence, skills and experience in nursing children should
prescribe for children. This is particularly important in primary care (e.g. out of hours, walk-in-clinics and
general practice settings). Anyone prescribing for a child in these situations must be able to demonstrate
competence to prescribe for children and refer to another prescriber when working outside their area of
2
expertise or level of competence’ (NMC. 2006, page 7).
‘It is the responsibility of the employer to ensure that the registrant is able to apply the prescribing
principles to their own area of practice’ (NMC.2006, page 6).
All nurse / midwife independent / supplementary prescribing programmes must incorporate an additional
learning outcome to ensure that on successful completion of the programme, they can take an
appropriate history, undertake a clinical assessment and make an appropriate diagnosis, having
considered the legal, cognitive, emotional and physical differences between children and adults.
In addition the assessment must demonstrate the registrant’s ‘recognition of the unique implications and
developmental context of the anatomical and physiological differences between neonates, children and
young people.’ (NMC. 2006, page 6).
In keeping with the existing standards of proficiency for nurse / midwife prescribers the assessment
should take place within the context of their work setting.
If there is any doubt about the ability of the applicant to demonstrate knowledge, skill and competence in
the areas described above, further training in relevant aspects of the legal, cognitive, emotional and
physical differences between children and adults and in taking an appropriate history, undertaking a
clinical assessment and making an appropriate diagnosis for a child, should be undertaken prior to them
completing a prescribing course.
A medical practitioner who is experienced and competent in prescribing for children should confirm the
demonstration of competence.
If an applicant who is already a prescriber moves into a new role which requires them to prescribe for
children for the first time, or after a break in practice, it would be considered good practice for them to
have a period of preceptorship and they may require additional education and supervision in relation to
assessment, diagnosis and prescribing for children (NMC Circular 22/2007).
PHARMACIST APPLICANT GUIDANCE
The GPhC requires that pharmacists applying to undertake an independent prescribing programme must:


Be a registered pharmacist with the GPhC or the Pharmaceutical Council of Northern Ireland
(PSNI)
Have at least two years appropriate patient-orientated experience in a UK hospital, community or
primary care setting following their pre-registration year
Applicants must have identified an area of clinical practice in which to develop their prescribing skills and
have up-to-date clinical, pharmacological and pharmaceutical knowledge relevant to their intended area
of prescribing practice. They must also demonstrate how they reflect on their own performance and take
responsibility for their own CPD.
3
General Pharmaceutical Council [On-Line] Entry Requirements
http://www.pharmacyregulation.org/education/pharmacist-independent-prescriber/entry-requirements
[Accessed 28.06.13]
ALLIED HEALTH PROFESSION APPLICANT GUIDANCE
The HCPC requires that Radiographers applying to undertake a supplementary prescribing programme
and all physiotherapists and podiatrists applying to undertake a supplementary or independent
prescribing programme must:
a) Be registered with the HCPC in one of the relevant allied health professions.
b) Be professionally practising in an environment where there is an identified need for the individual to
regularly use independent / supplementary prescribing (physiotherapists and podiatrists) or
supplementary prescribing (radiographers).
c) Be able to demonstrate support from their employer / sponsor including confirmation that the entrant
will have appropriate supervised practice in the clinical area in which they are expected to prescribe.
d) Be able to demonstrate medicines and clinical governance arrangements are in place to support safe
and effective supplementary and / or independent prescribing.
e) Have an approved medical practitioner, normally recognised by the employer / commissioning
organisation as having:
i) experience in the relevant field of practice
ii) training and experience in the supervision, support and assessment of trainees, and
iii) agreed to:
- Provide the student with opportunities to develop competences in prescribing
- Supervise, support and assess the student during their clinical placement
f) Have normally at least 3 years relevant post-qualification experience in the clinical area in which they
will be prescribing.
g) Be working at an advanced practitioner or equivalent level.
h) Be able to demonstrate how they reflect on their own performance and take responsibility for their own
Continuing Professional Development (CPD) including development of networks for support, reflection
and learning.
i) Provide evidence of a Disclosure and Barring Service (DBS) check within the last 3 months.
ELIGIBILITY GUIDANCE FOR DESIGNATED MEDICAL PRACTITIONERS
4
The curricula for preparing nurse and pharmacist prescribers include no less than 12 days of learning in
practice. The curricula to prepare allied health professionals (initially chiropodists/podiatrists,
radiographers and physiotherapists) and optometrists as supplementary prescribers will include similar
requirements.
This period of learning in practice is to be directed by a DMP who will also be responsible for assessing
whether the learning outcomes have been met and whether the registrant has acquired certain
competencies. The outcomes and competencies will be identified by the University of Lincoln.
Eligibility criteria for becoming a DMP
The DMP must be a registered medical practitioner who:
 Has normally had at least three years recent clinical experience for a group of patient/clients in
the relevant field of practice

Is within a GP practice and is either vocationally trained or is in possession of a certificate of
equivalent experience from the Joint Committee for Post-graduate Training in General Practice
Certificate or is a specialist registrar, clinical assistant or a consultant within a NHS Trust or other
NHS employer

Has the support of the employing organisation or GP practice to act as the DMP who will provide
supervision, support and opportunities to develop competence in prescribing practice

Has some experience or training in teaching and/or supervising in practice

Normally works with the registrant. If this is not possible (such as in nurse-led services or
community pharmacy), arrangements can be agreed for another doctor to take on the role of the
DMP, provided the above criteria are met and the learning in practice relates to the clinical area in
which the registrant will ultimately be carrying out their prescribing role.
Competencies for designated medical practitioners
Before taking on the role of DMP the doctor, and the organisation, should consider the competencies
needed to effectively undertake this role. The West Midlands Deanery has identified the following broad,
core competency areas for GP trainers which can be adapted and used as a check list for potential
DMPs:
 the ability to create an environment for learning

personal characteristics

teaching knowledge

teaching skills.
The components which make up the core competencies are available from the GP Trainer website at
www.trainer.org.uk/members/theory/evaluation/competencies_wm.htm
What is a designated medical practitioner expected to do?
The DMP has a crucial role in educating and assessing non-medical prescribers. This involves:
5

Establishing a learning contract with the registrant

Planning a learning programme which will provide the opportunity for the registrant to meet their
learning objectives and gain competency in prescribing

Facilitating learning by encouraging critical thinking and reflection

Providing dedicated time and opportunities for the registrant to observe how the DMP conducts a
consultation/interview with patient/clients and/or parents/carers and the development of a
management plan

Allowing opportunities for the registrant to carry out consultations and suggest clinical
management and prescribing options, which are then discussed with the DMP

Helping to ensure that the registrant integrates theory with practice

Taking opportunities to allow in-depth discussion and analysis of clinical management using a
random case analysis approach, when patient/client care and prescribing behaviour can be
examined further

Assessing and verifying that, by the end of the course, the registrant is competent to assume the
prescribing role.
6