Headlines: August 23rd, 2007

A report today highlights concerns over the increasing number of drugs being prescribed by nurses and shows there have been particularly big rises in their prescribing of drugs that are seen as requiring complex clinical judgments. The figures have been obtained under the Freedom of Information Act for the medical weekly ‘Pulse’, which is read by 80 per cent of the country’s GPs.It says the figures show the full extent of what it calls ‘the UK’s nurse prescribing revolution’ and that there has been ‘an explosion in nurse prescriptions for antidepressants, antibiotics and cardiac medication.’ The article highlights the gulf between the amount of training given to doctors and that for nurse prescribers.

Pulse says the figures show an overall increase in nurse prescriptions of 49 per cent in the year since they were given access to the full range of drugs. The use of drugs requiring more complex judgments, though, has increased more sharply and in some cases, including antibiotics and antidepressants whose use requires high-level clinical skills, is up by more than 200 per cent.

There are now 10,000 independent or supplementary nurse prescribers in the UK, three-quarters of them working in primary care. ‘Pulse’ points out that their training courses consist of only 26 days of theory and 12 days of mentored practice. The article quotes Professor Hugh McGavock, a former member of the Committee on Safety of Medicines, who has serious concerns over the issue. “Nurses’ knowledge of diagnosis is pathetically poor. It takes medical students five years to be competent at differential diagnoses. Only a country with not enough doctors would go down this cheapy line,” he said.

Professor Tony Avery, who is carrying out a review of nurse prescribing for the Department of Health, said the figures raised some concerns, particularly over use of antibiotics.