I am almost ready to start this new role for me, but have come across a possible snag.
It would be advantageous for me to be able to write scripts to restart clients who have fallen off their script after not picking up etc. I would see them of course, and write the scripts. (In a GP-based, shared-care service this would not be a problem, nor would it be if I was full time or just seeing 'my' clients at core service).

To allow for me to prescribe in time-critical situations like this, all clients of the service are being asked to agree to a Clinical Management Plan and the docs will sign them up. This means if someone needs a script at an unusual time, I can do one based on the CMP and my reassessment. This is entirely in the spirit of NMP to improve access to prescribed medication in a timely way.

However it makes it difficult to anticipate the supply of FP10 MDA's pre-printed with my details and NMC number etc for one thing, and creates other problems.

The service has a supply of script forms used generically by the doctors there, (scripts re prepared by keyworkers using the software at core service and printed out ready for signature. They use the generic FP10 which give the core service details, not the individual doctors) would there be a problem with my writing my details onto these scripts? Has anyone come across this and got a solution?

If I have to stick to 'my' script forms it will make the logistics very difficult.

Jim,
Won't the GP service system print your details on the script?
If not you will need to order the pads for handwriting.
The wording that is on a Nurses script has to be worded exactly with your correct details on.

I don't understand your problem - just print off a script when you need to or hand write one if you aren't printing them. I keep a stock of pre printed ones for handwriting, as a clinic we run has little IT, but print the rest at the practice, which is much easier and quicker. You can get boxes of 500 blue scripts for the printer.

Thanks Simon and Bev, I probably haven't explained the problem clearly. At the core service key workers are central to client management and prepare scripts in advance much of the time, on the 'generic' forms (which have the service details, not the doctors, and practice number pre-printed). The keyworker may not know who the prescriber will be in advance. If they know it is me, they will obviously use 'my' forms, but it may not happen in every case and I am trying to avoid wasting blue forms as the Trust get iffy at how many are being used, as they have to account for them apparently and too many wasted ones get them grilled by the powers that be.

Just how detailed does the prescriber information need to be, and is there any problem handwritng my NP details (name and NMC number) on a blue form as far as you know?

This is all due to the number of scripts generated at the core service using a computer prescribing package that does audit as well. Handwritten scripts are more complex to record and track.

Also , unlike shared care, consultations at core service are almost always 3 way; client, keyworker, prescriber, which will add another dimension to this work that I have not previously experienced, in that the key worker will likely have a mor detailed knowledge of the client than I will.

I will be building up a personal case load, but the 'timely access to prescribed treatment' element of NMP means that I will be asked to see people at short notice for re-assessment, reinduction etc. At the moment the requirement for individual clinical management plans is creating problems, hope they get that legislation changed soon! Meanwhile we are asking all current clients to sign up to CMPs as will all new ones as they come into treatment.

As things stand at the moment I cannot start scripts for new people who will not have CMPs. Has any one worked a way around that?

More paper and red tape handicapping effective services..............mutter, moan, whinge......

Jim,
http://www.ppa.org.uk/english_prescriptions/prescription_form_types.pdf
I think you need some blank hand writing prescriptions don't you?
You have to have a CMP or you are acting illegally and patients have to be diagnosed by a Doctor (Yawn).
If it is a patient previously s/b a Doctor then I would imagine it could be ok for you to fax an agreement between yourself and the Doctor.
It's incredibly tedious and unecessary stuff.

Thanks Simon, the box of 500 FP10MDA-SS might do the trick for all scripts assuming a core service can use them, (it's not a hospital nor a GP). Will check it out.

(Ever feel that what you want to achieve has never been contemplated by those who hold the key to the paperwork?)

Jim,
For handwriting you need FP10MDA-SP.
It goes back to nobody ever considered Nurses would be prescribing in this field. I know this from when the legislation changed in 2005 and my calls to Home Office and DOH.
It does sound like you are getting to understand the problems we have and why clinical management plans need to go!

Hi Jim, You shouldn't handwrite your details on scripts. Re CMPs I just print generic ones off, write the name etc on, and they get scanned on the notes. As you say hopefully it will change -with care plans, shared care, supervised dispensing, etc they are so cumbersome. We have a similar situation in that the drug workers are more involved with a lot of the clients than me - they do the bulk of the work with those in shared care. I see quite a lot who for various reasons aren't in shared care as well. It works well for us.

Beverley, Yes I have a load of generic, covers-everything-you-might-want-to-prescribe-by-way -of-controlled drugs CMPs ready to roll. It would be very easy to get the paperwork to look right whilst completely over-riding the spirit of CMPs;i.e the informed consent of the client and involvement of the doctor; that the law currently requires. Trouble is that requirement is in itself in contradiction of the spirit of non-medical prescribing-- easier, more timely access to prescribed medication.
It's almost enough to make you vote Tory if super Dave's speech today is to be believed.

Will keep on trucking and let you know how it goes, haven't seen a client myself for 3 weeks now..........

I don't think prescibing for dependence will be one of the Tory manifesto commitments (if Ian Duncan Smith's Social Justice Policy Review recommendations for the party are any indication).

Frankly, if the Tories get in, I think those of us in prescribing services will be looking for other jobs. And those working for the NTA will be too!?

I think I was seduced by the bit where he wanted to free up clinicians from the dictats of management bureaucracy and targets.....

An episode of madness on my part, feel better now after a lie down, thought for a moment I might be turning middle-aged or something.....

Jim,
Be careful of being seduced when you might be turning middle-aged. Surely you didn't believe all that spin about faster access to medication did you?
Next you'll be telling me the Chief Nursing officer is making all Nurses who prescribe a band 8a.
The CNO looks after our interests so well Gawd bless 'er.
Next you'll be believing that the RCN represents it's members and the NMC is a not for profit organisation :-)

With 2 1/2 years of prescribing one finds ways of making the system work as best it can! As far as getting the client to agree to us prescribing as far as I see it them agreeing to the shared care etc is good enough. Mine don't get a choice - they want a script so they get me signing it! They are happy with that anyway -they are all keen to bring their friends in at present as its flexible and they don't have to wait; word gets round the estate! The fact that I am overloaded is beside the point!

Hi Jim - missed this thread - our NP's in Kirklees have their own ( purple ) pads with their name etc - does this help ? Give them a ring if you are still without your own FP10 MDA's. Cheers
Gill

I don't understand the question - Lifeline in Huddersfield have been turning out FP10-MDA scripts for ages without a hint of the prescribers name printed.

Jeff

quote:

Originally posted by Jeff Green:
I don't understand the question - Lifeline in Huddersfield have been turning out FP10-MDA scripts for ages without a hint of the prescribers name printed.

Jeff

Jeff,
If a Nurse or a Pharmacist is prescribing then it MUST state the name and professional id. number. It also must state 'supplementary prescriber' on the prescriptions.
It sounds like the Doctors in this service sign other Doctors rx's Jim cannot do this.