Nurse/Non Medical Prescribing in End of Life Care Speaker Presentations
Chaired by Claire Henry, Chief Executive at the National Council for Palliative Care today’s important national conference focused on the important issue of Nurse/Non Medical Prescribing in End of Life Care.
It is widely recognized that pain and symptom control at the end of life is not always optimal, the development of non medical/nurse prescribing has a key role in improving pain and symptom control for patients at the end of life. The conference, which included national updates, extended in depth sessions and case studies focusing on developing skills as non medical/nurse prescriber’s in end of life care.
Penny Franklin Associate Professor Plymouth University opened the day with a national updated on Nurse/Non Medical Prescribing and discussed:
- developing confidence and competence in your ability to prescribe
- demonstrating compliance with the NMC Code for revalidation
- the benefits of nurse/non medical prescribing in end of life care
Penny Franklin Associate Professor Plymouth University Full Presentation Click Here
In her presentation Penny stated:
"Integrated Prescribing for End of Life Care, Direct management of pain and adjuvant management, Patient led assessment/care pathways/patient led prescribing/Patient Participation Groups, Choice of where to die and Changing professional profile/ interdisciplinary/ multi-specialty"
"Non-medical Prescribing and Integrated end of life care: Holistic overview and provision of care, Round the clock access to pain and symptom control, Patient centred care pathway- personal care plans and In partnership with patients and carers- independent advocates."
"In Summary Non-medical Prescribing growing and developing across disciplines...Need to demonstrate and maintain competence and confidence...Prescribing for care at end of life is complex...Needs to be based on best evidence...Needs to be clearly communicated and with transparency...Need for integrated working- work force planning...All working to best evidence and National Standards...Care pathways and patient/carer involvement"
Penny Franklin Biography:
Penny Franklin is a National Expert in the field of Non-medical Prescribing and has published widely. She is an Executive Member of the Association for Prescribers and is Prescribing Lead for the Community Practitioners and Health Visitors Association. She is a member of the Nurse Prescribers Advisory Group for the British National Formulary. Penny is a Registered General Nurse, Registered Children’s Nurse and Registered Health Visitor and is an Independent and Supplementary Prescriber. Penny has an MA in Complementary Health Studies. She is a Fellow of the Institute of Health Visiting and the Higher Education Academy and is an Honorary Associate Professor and Senior Associate Lecturer for the University of Plymouth.
Deborah Robertson Consultant Editor, The Journal of Nurse Prescribing Senior Lecturer & Programme Leader Non-medical Prescribing, University of Chester followed with a presentation on ‘Non Medical/Nurse Prescribing for Symptom Control in End of Life Care’ and discussed:
- nurse prescribing for symptom control: current issues
- improving confidence in prescribing practice
- empowering nurses to prescribe in end of life care
- improving non medical prescribing practice
- supporting non medical prescribers: infrastructure needed to support the safe and effective development and implementation of Non Medical Prescribing
- developing advanced roles around non medical prescribing
Deborah Robertson Consultant Editor, The Journal of Nurse Prescribing Senior Lecturer & Programme Leader Non-medical Prescribing, University of Chester Full Presentation Click Here
(Due to unforeseen circumstances Penny Franklin Associate Professor Plymouth University covered Deborah Robertson’s session)
Deborah Robertson's presentation states:
“Prescribing in end of life care is often more complex, Consideration of the condition itself, Consideration of the symptoms, Consideration of other medications, Contributes to polypharmacy, Risk of interactions, Increased risk of adverse drug reactions and Concordance issues”
“Improving Non-Medical Prescribing Practice: All relevant members of the palliative care team can prescribe, Clear lines of communication between all prescribers, Appreciation of roles and responsibilities within the team, Ensure CPD is actively managed to maintained competence and confidence and Support for the role”
“In Summary NMPs ARE prescribing in end of life care…Symptom management is an important area…Individual patient care planning is required…Increase in number required…Support in place, including budgets!...Role for Specialist/Advanced Practice”
Deborah Robertson Abstract:
Deborah Robertson presentation’s explored the key areas of prescribing for symptom control and management in end of life care. Deborah’s presentation explored the current issues around pain management and how, by improving and supporting Non-Medical Prescribing in this area we can address some of these issues. The presentation also discussed advanced practice roles and specialist palliative care situations and how implementing Non-Medical Prescribing can enhance and improve service design and provision.
Deborah Robertson Biography:
Dr Deborah Robertson joined the faculty of Health and Social Care at University of Chester in, from the University of Dundee, to help teach NMP, and where she continues to be employed as a Senior Lecturer in the Department of Public Health and Wellbeing. Deborah would describe herself as an RGN first and foremost but she also holds a BSc (Hons) and a PhD in Pharmacology. She worked for 3 years as a postdoctoral research fellow in the Department of Psychiatry at the University of Dundee and published her work in the area of stress and depression.
She has been programme leader for the Non-Medical Prescribing Course for more than 5 years and her teaching areas on the programme focus on her areas of expertise, namely Pharmacology, Legal Aspects of Prescribing and Public Health. She has been part of the North West Collaborative of Higher Education Institutions in NMP since her appointment and has been involved in the development and continued provision of e-learning resources for NMP education. Deborah holds a postgraduate diploma in professional education and her current pedagogical interests involve e-learning and the delivery of the Non-Medical Prescribing Course.
Deborah is co-author, with Paul Barber, of a popular textbook, Essentials of Pharmacology for Nurses now in its third edition, published by McGraw- Hill.
For the past 4 years Deborah has been consultant editor for the journal Nurse Prescribing a role which is challenging but one she thoroughly enjoys.
Following the morning tea break Niamh Molloy Pain Management Nurse University Hospital Waterford delivered an extended session on ‘Nurse/Non Medical Prescribing for Pain’. The conference continued with case studies in practice on:
- Controlled drugs and the use of drugs beyond product licence
- Nurse prescribing for in-patient pain
- Nurse/Non Medical Prescribing in the community setting
Following the final tea break Gail Linehan Director of Care Services and Strategy Development St Raphael’s Hospice provided an in-depth presentation on ‘Anticipatory Prescribing: ‘Just in Case’ boxes to support patients to die at home’ Anticipatory prescribing can provide access to essential medications for symptom control at the end of life. Current best practice recommends that medications to manage pain, breathlessness, nausea and vomiting, and agitation are prescribed with authorisation for administration when it is recognised that someone is entering the final days of life. NICE 2015
Margaret Gibbs Specialist Senior Pharmacist with Jan Thirkettle Advanced Nurse Practitioner St Christopher’s Hospice closed the day with a presentation on ‘Nurse/Non Medical Prescribing in end of life care: Overcoming the Challenges’ in there presentation Margaret and Jan discussed:
- why are nurses who are trained to prescribe in end of life care not prescribing?
- difficult issues in end of life care prescribing
- tips and advice from St Christopher’s
Margaret Gibbs Specialist Senior Pharmacist with Jan Thirkettle Advanced Nurse Practitioner St Christopher’s Hospice Full Presentation Click Here
Margaret Gibbs Biography:
Margaret Gibbs trained as a pharmacist in Brighton where she later obtained a post-graduate certificate in Applied Therapeutics. She gained an MSc in Pain Management from Cardiff School of Medicine. She has worked mostly as a clinical pharmacist in hospitals but enjoyed short spells working in the community. Margaret has been the Hospice pharmacist at St Christopher’s since 1999. She provides information and guidance on all medicine-related matters to other healthcare professionals both within the hospice and outside. She has written and contributed to a number of publications, teaches varied groups of professionals and users within the hospice and at outside organisations and locations. She chairs the Hospice Medicines Optimisation Group and instigated and was chair of the UK Palliative Care Pharmacists Network for 7 years. She has been on the guidelines group for two recent NICE guidelines involving Controlled Drugs
Jan Thirkettle Biography:
Jan Thirkettle has worked in palliative care since 1999 as a nurse on the ward and a clinical nurse specialist in the community. Jan joined St Christopher’s in 2010 and has worked for Pilgrims Hopsices in East Kent prior to St Christopher’s. Jan registered as a NIP in 2011. Jan uses the skills learnt on the prescribing module on a daily basis seeing patients in a clinic setting and since July 2012 Jan has managed the outpatient Clinical nurse specialist team at St Christopher’s. Also Jan has recently been lucky enough to be offered the consultant nurse position in the new Single point of contact team at St Christopher’s.
Future events of interest:
Masterclass: Medico-Legal Aspects of Non Medical Prescribing in today's NHS
Choice of 2016 Dates
Tuesday 14 June 2016
Hallam Conference Centre, London
Nurse/Non-Medical Prescribing for Pain
Friday 8 July 2016
Hallam Conference Centre, London
Effective Nurse/Non-Medical Prescribing in End of Life Care
Friday 16 September 2016
Hallam Conference Centre, London
15 April 2016