New guidance for nurses prescribing via phone or online consultations

New guidance for nurses prescribing via phone or online consultations

NMC and other regulators set principles to ensure patient safety when accessing care remotely

Nurses who provide online or telephone prescriptions now have a set of guiding principles to follow.

The principles, jointly agreed by 13 healthcare regulators and professional bodies, including the Nursing and Midwifery Council (NMC), are to ensure the safety of patients when they access services remotely.



What the prescribing principles cover

The new principles state that nurses who prescribe medication online or over the phone should:

• Raise concerns if patient identification and verification checks are not adequate.
• Understand how to identify vulnerable patients and take appropriate steps to protect them.
• State their name, job role and professional registration details, and explain to the patient how the remote consultation will work.  
• Explain that they can only prescribe if it is safe to do so. If not, they will refer or signpost to the appropriate services.
• Obtain informed consent and follow mental capacity law and codes of practice.
• Undertake a clinical assessment and access medical records.
• Give patients accessible information about all the options available to them.
• Ensure all information is shared with relevant colleagues and health and social care providers to support ongoing monitoring and treatment.
• Keep notes explaining and justifying the decisions made.
• Stay up to date with training, support and guidance on providing healthcare remotely.

The document also makes clear that healthcare professionals should continue to follow guidelines from regulatory bodies and take clinical guidance into account in their decision-making.

It says it is up to the employer and healthcare professional to outline when remote prescribing is not an option.

Maintaining the quality of care

Roughly 10% of nurses and midwives on the NMC register hold prescribing qualifications, according to the regulator.

NMC chief executive Andrea Sutcliffe said that the quality of care must remain the same in remote consultations as in a face-to-face care.

‘The Code already sets out how [nurses] can demonstrate they are appropriately supporting and protecting people seeking their care,’ Sutcliffe said.

‘I hope this guidance helps to clarify further what safe and effective consultations and prescribing practice looks and feels like.’

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Survey reveals mental and physical impact of the cancer nurse shortage

Patients tell Macmillan of unmanageable staff workloads and unmet needs, such as depression, anxiety and pain

A lack of cancer nurses is affecting the mental and physical health needs of patients, a new survey from charity Macmillan Cancer Support suggests.

The RCN said the findings were ‘heartbreaking’ for the nursing profession, while Macmillan joined calls for UK governments to address the nurse staffing crisis urgently.

Respondents say their nurses have ‘unmanageable workloads’

The survey gathered responses from 6,905 patients. More than two thirds (68%) of those recently diagnosed with or treated for cancer said they were not getting the support they need.

One in five people (19%) said the healthcare professionals caring for them had unmanageable workloads. These patients were around a third more likely than others to have unaddressed physical and emotional needs, such as depression, anxiety, pain and trouble sleeping.

Sarah Mills, who was diagnosed with colorectal cancer in 2018, told Macmillan her clinical nurse specialist was ‘always insanely overloaded’. 

'This is not the fault of any radiographer, nurse or administrator – they are just human beings who can only fit so much into a certain number of hours,’ she said.

‘Shielding patients from a chronic workforce shortage’

RCN interim director of nursing policy and practice Bronagh Scott described the survey’s findings as tragic. 

‘This will break the heart of every nurse who goes into the profession to provide top-quality, person-centred care, rather than shield patients from the worst effects of a chronic workforce shortage,’ she said.

Macmillan chief executive Lynda Thomas said: ‘We’re calling on [government] to provide fully-funded plans to grow and sustain the health and care workforce without delay.’

A new report from Together for Short Lives (TSL), a charity supporting children with life-limiting conditions, also called on ministers to take action to address the children’s palliative care workforce crisis.

Denied care because of a shortage of children’s nurses

Together for Short Lives says that, on average, children’s hospices report a vacancy rate of 12.2%. 

RCN director for England Patricia Marquis said families experiencing the trauma of these circumstances deserved to have enough nurses to care for their children.

‘But the cold, hard reality is that children suffering from life-limiting conditions or approaching the end of their lives are being denied care because of a shortage of children’s nurses,’ she said.

A Department of Health and Social Care spokesperson said cancer patients deserved ‘the best possible care’ and a £33.9 billion investment in the NHS would help in recruiting the staff the service needs. ‘Our Interim NHS People Plan has set out immediate actions to reduce vacancies.’

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