Drug prescribing by nurses in the UK - Editor of the Lancet urges caution

The contentious issue of drug prescribing by nurses is assessed by Richard Horton, Editor of THE LANCET, in a Commentary in this weeks issue of the journal. He concludes that UK government plans to introduce unrestricted prescribing rights to nurses over the next few years could have serious consequences in the provision of health care.

Richard Horton comments: "Nurse prescribing offers enormous benefits to patients. But the evidence indicates that the rate at which nurse prescribing is being implemented holds grave dangers if the policy set out by Milburn [Minister for Health], Jones [Royal College of Nursing], and others is acted upon - and the first supplementary nurse prescribers are supposed to be qualified by the end of this year - the UK will be embarking on a dangerous uncontrolled experiment."

The Commentary is critical of the motives which underlie current UK government thinking on drug prescribing. Horton adds: "Nurses are being manipulated, under the guise of providing quicker and more efficient access to health care to fill the gaps left by too few doctors. Prescribing is not a major advance in professional status for nurses. It is merely redrawing the boundaries of a profession to serve an acute political problem, with little regard for the impact it will have either on nursing or patient care. Moreover, when doctors prescribe, they make mistakes. Only very recently have we begun to understand why [see Lancet 2002; 359: 1373-78]. Surely we must learn more about why errors take place before further widening prescribing responsibilities. To extend the burden of risk so quickly is reckless."

The additional training of nurses required for drug prescribing is highlighted as a crucial issue, yet there exist major inconsistencies within current nursing curricula, Horton observes: "If prescribing rights are extended to all drugs, nurses will need to know basic and clinical pharmacology - including the mechanism of action of drugs,

Contact: Richard Lane

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