Doctors' leaders have condemned the UK government's decision to give nurses and pharmacists virtually unlimited prescribing powers.
James Johnson, the BMA's chairman, has called for an urgent meeting with the secretary of state for health, Patricia Hewitt, to discuss the proposals, which took the BMA by surprise when they were announced last week. “It is difficult to see how healthcare professionals who are not trained to diagnose disease can safely prescribe appropriate treatment,” he said.
Mrs Hewitt told the chief nursing officers' annual conference in London last week that from spring 2006 qualified “extended formulary nurse prescribers” and “independent pharmacist prescribers” would be able to prescribe any licensed drug for any medical condition, with the exception of controlled drugs, such as diamorphine.
There are now over 6,100 extended formulary nurse prescribers who are qualified to prescribe from the Nurse Prescribers' Extended Formulary, which was introduced in April 2002 and which contains around 240 prescription only medicines. The “independent pharmacist prescriber” will be a new position.
Mrs Hewitt said, “Today's announcement means that the young person wanting to control their asthma or the terminally ill patient being cared for at home by a multidisciplinary healthcare team will soon find it easier and more convenient to get the medicines they need.”
However, Paul Miller, the chairman of the BMA's Central Consultants and Specialists Committee, described the extension of prescribing powers as “an irresponsible and dangerous move.”
He said, “Patients will suffer. I would not have me or my family subject to anything other than the highest level of care and prescribing, which is that provided by a fully trained doctor.”
The controversy was top of the agenda at this week's meeting of the BMA's General Practitioners Committee. Hamish Meldrum, the committee's chairman, said: “This announcement raises patient safety issues, and we are extremely concerned that the training provided is not remotely equivalent to the five or six years' training every doctor has undertaken.”
Christine Beasley, the chief nursing officer, denied that the move would put patients at risk. “As nurses and pharmacists undergo rigorous training before being able to prescribe, patients can be confident that they are receiving the safest, best possible care,” she said.
But Dr Meldrum said, “While we support the ability of suitably trained nurses and pharmacists to prescribe from a limited range of medicines for specific conditions, we believe only doctors have the necessary diagnostic and prescribing training that justifies access to the full range of medicines for all conditions.”
A spokeswoman for the Department of Health said that nurses would be expected to prescribe only within their area of expertise, “in the same way that you wouldn't expect an orthopaedic surgeon to be prescribing complex dermatology treatments.” (See p 1154.)