Hi there Simon,

Congratulations on the handwriting exemption - got a frame for it yet?

The poor old DH are having problems with this one; the home office are ok with blue scripts, handwriting exemptions etc., while the DH actually don't really, will get back to you, need to speak to a colleague etc etc. And here was me thinking that they might have cracked 'communication between departments' - silly female!!

Pen

pen.,
not sure about the female bit...
home office were fine, but put on exemption my name as a doctor but they were cool and are changing it and sending me another one!. They did confirm i am first nurse to apply, all we need is dh to agree blue scripts and emis to allow us to computer generate rx. maybe soon we will be in business!.
I have a feeling we are almost there now.
Think nurse prescribers should have a meet at rcgp conference, hope you can come pen.

Come on Doctors time we heard some support/advice from you!

If we do meet at the RCGP Conference, why not at the Nurse Prescribing session by Jane Haywood?

Excellent idea!, shows how in depth i read the programme lol.
Here is another thought if a patient was not on an instalment prescription, would it be legal to write prescription on a lilac pad ????

Hi all

Great idea about meeting at the conference (still don't know if I am going but feedback would still be very useful). According to the conversation I had yesterday with the lady at the DH - who is in charge of these things - dunno!! They didn't actually consider what prescription nurses were going to be able to prescribe on! However, you should be able to use purple for written and green for comp generated for non-installment; just the same as you would for any other medication via CMP.

Of course - they could always come up with another colour - place your bets now!

Pen

I have asked the PCT to order me blue instalment pads, and am waiting to see what happens; I will let you know if/when they arrive. I also plan to do a template CMP for drug misuse - and to keep it simple! Has anyone else done one? I went to a nurse prescriber's meeting recently and it seems that people are using template CMPs routinely for other conditions.
I plan to attend the RCGP conference on Thursday only, but am not planning to go to Jane's seminar - it would be good to meet up though.

Beverley Harniman

Beverley,
yes i asked practice manager to order me some i think they are fp10mdass, if i am allowed to use them i will and if not i can use for scrap paper. i know when doctor orders computer ones they do take some time to come. I have cmp's in form of a template for subutex (i thought better be prepared) britlofex detox and naltrexone, also have a blank one. On each you just enter the details on computer and it stores it as a word document atttachment. NTA asked for copies of mine. Wonder if we could put them on here so people could have a look. Not sure how secretary set it up as a template though. Oh each one i have a space for any additional prescriptions also, to cover situations that you get when you can prescribe one thing and not another and think to hell with it!, and just get doctor to sign one.
Well maybe we could all meet between sessions or for lunch?
Simon
ps i would apply for handwriting exemption also you can print the form of the home office website, just needs signing by your Doctor/Consultant

This all sounds brilliant to me.

Simon, if you can work out how to persuade the computer to print your name and number at the bottom of the script (not so easy, maybe, as discussed earlier, as your number doesn't fit emis boxes) I think you will be able to use your doctors computer scripts, because they are completely blank. If you are going to use blue scripts the same as ours, when they arrive in the sugery they are not specific for any particular prescriber..the computer prints on your identity.

Excellent to hear the Home Office hoops were so quickly jumped!

Contacted the Essex area/strategic/authority (??) who would be happy to print the blue scripts with nurses name and number (as they do Dr's handwritten ones) - if they had confirmation that we were able to use the daily dispensing ones; however, I am ever hopeful that once primary care prescribing of CD's comes into force they will all start reading from same hymn sheet - when they decide which one it is.

On the subject of templates for CMP's, I know of several nurses who have specific templates set up for acute/chronic conditions which they print off as required for a patient, it is then attached to any other CMP's for that patient and cross-referenced for interactions etc - dunno if that helps.

Simon, are you keeping yours filed in the patients notes? As they are so bulky (sometimes), I have put in alphabetical binder and made notation in notes - is that OK or am I committing a fraudulent despicable act?? Are you using the same template as the one on the DH/NP website? If so you should be able to do it as an attachment of some sort but as I am hopeless at this techno stuff I wouldn't have a clue how.

Pen

OK i got it confirmed by matt griffiths from rcn, who had everything confirmed by ppa we can use FP10MDA! so come on get ome ordered! Don't think they will be ready for thursday though!. Wonder does anyone know if it is legal to use blank computer fp10mda's and handwrite them and rubber stamp prescribers details on the bottom???

I use the DH template CMP and complete it by hand, then get it scanned on to EMIS in the same way that referral letters etc. are scanned on to the client's notes.
I wonder how long we'll have to wait for instalment pads?! But as the university failed (forgot) to inform the NMC that I passed the course the registration still hasn't happened, so can't start prescribing anyway!!

Beverley Harniman

I use the DH template CMP and complete it by hand, then get it scanned on to EMIS in the same way that referral letters etc. are scanned on to the client's notes.
I wonder how long we'll have to wait for instalment pads?! But as the university failed (forgot) to inform the NMC that I passed the course the registration still hasn't happened, so can't start prescribing anyway!!

Beverley Harniman

I use the DH template CMP and complete it by hand, then get it scanned on to EMIS in the same way that referral letters etc. are scanned on to the client's notes.
I wonder how long we'll have to wait for instalment pads?! But as the university failed (forgot) to inform the NMC that I passed the course the registration still hasn't happened, so can't start prescribing anyway!!

Beverley Harniman

Judith,
Do you think it would be legal, now we are allowed to use the fp10mda to hand write the rx and add prescriber details on a stamp???.
Pen and Beverley, my CMP's are on computer as a word document the secretary did it as too technical for me. I just type in a blank box who is independent prescriber, supplementary prescriber, then get prompts for which drugs and review dates etc. it saves these in patient records, difficult to describe how it works but it takes less than a minute. And you can print off a copy if you want. I have a lofexidine detox, naltrexone, a blank one and a subutex one (that i haven't used yet)

Well. it must be legal now, so has anyone done there first cd prescription?

Simon, I've just prescribed some diazepam on a blue script! exciting or what!

As for stamping the computerised scripts yourself, I am sorry, I really don't know, but instinctively I feel they should be either offically stamped, or printed within an accepted software system like EMIS, as otherwise the blank computer scripts feel even more vulnerable to fraud than the ready stamped ones.

However I have no idea of the legal situation. I do know that we do not seem to guard the computerised scripts with the paranoid dedication with which we lock away the old hand writing pads , but probably we should . (eg printer drawers are not lockable are they?)

So I don't know the official answer to your question about stamping them yourself, and I don't know who to ask.

Judith,
yes it is exciting and people who have not had patients who this is necessary for will never understand how important it is!. It is life saving for some.
Regarding the other stuff I will wait for a definite answer not ready to be struck off just yet shame nobody seems to know and emis never seem to help!
kind regards

Sorry Victoria, I've deleted this email and the one on the next page, because I think they are a bit personal for the www.

[This message was edited by judith yates on 15 April 2005 at 08:50 PM.]

Dear Simon


Life saving? Come on lets get some perspective on it. Can you initiate prescribing? Are u giving repeat prescriptions, which incidently my staff have been doing for years.



Life threatening? You bet.



Nurses initiating prescribing, with their own scripts is frightening.



As a doctor I have worked with two nurses who will give me a patient summary and a treatment plan. They can give me a full explanation for their treatment plan. yet neither want to be prescribers?



My analysis of nurse prescribing is easy. If nurses want to be doctors; DO THE WORK AND GET THE DEGREES. IF NOT THEN SHUT UP AND OBEY.

" I've just removed the names from this one Victoria. I am aware that your views may well be shared by others. Sorry to but into your email, but please try to avoid individual name calling . Thanks. Judith"

[This message was edited by judith yates on 15 April 2005 at 08:54 PM.]