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Demonstrating & Improving Prescribing Competence & Practice: News & Speaker Updates

A new and updated Competency Framework to support healthcare professionals to prescribe effectively was published by the Royal Pharmaceutical Society (RPS) on the 14th July 2016. Through national updates, practical case studies and extended expert sessions, this conference focused on demonstrating and improving prescribing competence and practice – implementing the new competency framework, and ten competency dimensions for all prescribers.

Speakers and presentations:

Supporting healthcare professionals to prescribe effectively: The NEW National Competency Framework for all prescribers

Angela Alexander, Professor of Pharmacy Education, University of Reading

  • the updated framework: what has changed?
  • what does good prescribing look like? The ten competency dimensions
  • how the framework can be used
  • levels of prescribing competence
  • how the framework can support revalidation
  • moving forward

Angela Alexander’s Full Presentation Click Here

In her presentation Angela stated: 

“NICE looked at the 2012 competency frame work and developing competency frameworks was not within there area. They approached the RSP to develop the competency frame work, but NICE asked them to collaborate with all prescribing professions GB wide.”

“The RPS will continue to publish and maintain the updated competency framework in collaboration with the other prescribing professions”

“The competency frame work is there to guide you To acquire and maintain competence to be safe, effective prescribers who are able to support patients to get the best outcomes from their medicines. It is there to underpin your professional responsibility for prescribing. It should be used to inform standards, the development of education, and the guidance and advice from regulators, education providers, professional organisations and specialist groups. Also the framework brings professions together and harmonise education for prescribers by offering a competency framework for all prescribers; with this comes shared understanding.”

“It’s a very generic frame work it is not specific to an area – it is not a curriculum. Its for you to contextualise to reflect different area of practice and levels of expertise”

“Whilst it does contain a competency on prescribing professionally there is still a need for prescribers to consider how their own professional codes of conduct, standards and guidance apply to prescribing.”

“The Competency framework has 10 competencies split into 2 domains:

  1. The consultation: focusing on the patient (1-6 competencies)
  2. Prescribing Governance: focusing on the safety and practice of prescribing (7-10 Competencies)

Within each of the ten competencies there are statements which describe the activity or outcomes prescribers should be able to demonstrate.”

“We have now included online medicines as part of the Framework – we never use to ask about this in the consultation with patients, but we should ask this. it is very easy to get prescriptions online via online doctors.”

“There is a big focus on the patient and carer – looking at the there understanding and decision making”

“We have also included development – ie looking at new develops and keep up with information on prescribing, which is also key for revalidation.”

“We would also like to electronically generate prescriptions, but also write prescriptions, which is equally important to the electronic systems”

“Checking a patients/carers understanding of information is key – have a look online for the teach back technique. This is a good way to make sure your patients understand what they need to do”

My advice to you is download the competency framework for all prescribers, Review your own (and others) practice against it, draw up an action plan and share your learning with others”

The key learning from this session is:

The competency framework is for all prescribers. The revised and updated version can be used during training and practice as the basis for both the development and maintenance of competence. This will support a prescriber’s revalidation.

Angela Alexander’s  Biography:

Angela Alexander qualified with a Bachelor of Pharmacy degree in 1973. She has worked in hospital pharmacy, community pharmacy and academia. She has an MSc and a PhD in the field of pharmacy and two further MScs in Educational and Social Research Methods, and Earth Science. At the University of Reading, she is Professor Emerita of Pharmacy Education and past Director of the Centre for Inter-Professional Postgraduate Education and Training (CIPPET).  Angela is a member of the accreditation team for the General Pharmaceutical Council (GPhC).  She was pleased to receive the honour of an MBE, awarded in 2008, for services to pharmacy practice, education and the voluntary sector.

Self assessment, reflection and audit of prescribing practice against the ten competency dimensions

Jan Keenan, Consultant Nurse Cardiology and NMP Lead, Oxford University Hospitals NHS Foundation Trust

  • supporting prescribers to undertake reflection and self assessment of prescribing practice against the ten competency dimensions
  • learning from prescribing practice
  • undertaking an audit of prescribing practice
  • why are so many qualified prescriber not using their prescribing qualification in practice: the barriers to prescribing post qualification

Jan Keenan’s Full Presentation Click Here

In her presentation Jan stated: 

“Reflection is not a tool to learn only from difficult situations, sometimes we need to learn to reflect on successes. We need to look at why they are successes. So we need to look at the positives and the negatives”

"The reflective learning processes includes identifying a situation you encounters in your work or personal life that you believe could have been dealt with more effectively. Then move on:

  • Describe the experience – What happened?  When and where did the situation occur?  Any other thoughts you have about the situation?
  • Refection – How did you behave?  What thoughts did you have?  How did it make you feel?  Were there other factors that influenced the situation?  What have you learned from the experience?
  • Theorizing - How did the experience match with your preconceived ideas, i.e. was the outcome expected or unexpected?  How does it relate to any formal theories that you know?  What behaviours do you think might have changed the outcome
  • Experimentation - Is there anything you could do or say now to change the outcome?  What action(s) can you take to change similar reactions in the future?  What behaviours might you try out?"

“Approaches to reflection can be in passing, just walking up to a colleague and asking if you can run through a decision with them. Just walking up to a colleague and discussing a what you are thinking is a type of reflection. There ae also more formal approaches including revalidation, theoretical approaches, clinical supervision and appraisal”

Jan Keenan’s Biography:

RN; DipN; MSc; PGDip.Ed. Consultant Nurse, Cardiology and Non-Medical Prescribing Lead, Oxford University Hospitals NHS Trust; Past President, British Association for Nursing in Cardiovascular Care; Hon. Teaching Fellow, Oxford Brookes University and PhD Candidate, University of Southampton

Jan Keenan has an extensive background in cardiac nursing, and for the last 25 years has been working at the Oxford Heart Centre. Jan has an educational, clinical and academic background but her true passion lies in clinical practice, and in particular the development and evolution of services that place our patients at the centre of care and expertise, delivered by nurses alongside all our inter-related professional groups.

Jan takes a clinical lead in service provision and development of nurse led services, in particular in relation to people with coronary heart disease, but also in relation to a growing number of sub-specialities in Cardiology. As a nurse prescriber Jan was one of the first nurses in acute care to take on a prescribing role, and thereafter rapidly became a champion of non-medical prescribing. In addition as Non-Medical Prescribing lead for the Oxford University Hospitals NHS Foundation Trust Jan encounters nurses and AHPs working in primary secondary and tertiary care who are developing innovative approaches to care. Jan has also published independently and collegiately in the fields of cardiac nursing, advanced practice and nurse prescribing and has an unashamed reputation for championing the value of nurse led services.

As NMP lead Jan says it is an absolute privilege to meet nurses and allied health professionals with an interest in prescribing as part of advanced practice and she takes a great interest in supporting the development of services around the patient, that offer improved access to treatment by those who truly are the experts in their field.

Future events of interest:

Nurse/Non Medical Prescribing in Cancer Care
Monday 5 June 2017 
De Vere West One Conference Centre, London

Electronic Prescribing In Hospitals: Moving Forward
Thursday 13 July 2017 
Manchester Conference Centre, Manchester

Nurse/Non Medical Prescribing on the Wards
Thursday 13 July 2017 
Manchester Conference Centre, Manchester

Nurse/Non Medical Prescribing in Cardiology
Monday 18 September 2017 
De Vere West One Conference Centre, London

Nurse/Non Medical Prescribing for Pain
Friday 29 September 2017 
De Vere West one Conference Centre, London

Nurse/Non Medical Prescribing in End of Life Care
Friday 6 October 2017 
De Vere West One Conference Centre, London

19 May 2017


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