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NON-MEDICAL PRESCRIBING/

ADVANCING NON- MEDICAL PRESCRIBING

DESIGNATED MEDICAL

PRACTITIONER MENTOR HANDBOOK

January 2015

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CONTENTS Page

1 INTRODUCTION 1 2 THE PROGRAMME TEAM 1 3 THE MODULES 2 4 MODULE AIMS AND OUTCOMES 3 5 THE MODULE STRUCTURE 5 6 RESPONSIBILITIES 6 7 HOW IT WILL WORK IN PRACTICE 8 8 GUIDELINES FOR COMPLETION OF THE PRACTICE PORTFOLIO 8 9 REFERENCES & READING 11 APPENDICES Appendix 1 Record of Achievement of Practice Outcomes for Non-medical 13 Prescribing Appendix 2 Record of Achievement of Practice Outcomes for Advancing 16

Non-medical Prescribing Appendix 3 Cause for Concern 19 Appendix 4 Record of Supervised Practice Meetings 22 Appendix 5 Learning Contract 26 Appendix 6 Consent & Confidentiality Form 27 Appendix 7 Clinical Management Plan Template 31

DISCLAIMER The information contained in this handbook is, as far as possible, accurate and up-to-date at the time of printing. The express permission of Teesside University must be obtained to reproduce any, or all of this publication, other than for personal use or for those purposes permitted by law.

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1 INTRODUCTION Welcome to Teesside University, School of Health & Social Care. Thank you for agreeing to be a Designated Medical Practitioner (DMP) mentor. This handbook is designed to provide you with the information you will require to facilitate your allocated student studying either the modules Non-medical Prescribing at level 6 or Advancing Non-medical Prescribing at level 7. The role of the DMP is essential for the successful implementation of the educational programme leading to the professional qualification to prescribe. It is recognised that competence in practice is achieved by supported exposure to practical learning experiences and that reflective dialogue will help ensure that theoretical concepts are used to support decision-making. It is therefore the responsibility of you as the DMP to make a judgement upon the student's competence to practise as a non-medical prescriber. Registrants who will be prescribing for children must be supervised by a DMP who is experienced and competent in prescribing for children. This handbook should be read alongside the National Prescribing Centre document Training Non-Medical Prescribers in Practice. http://www.npc.nhs.uk/non_medical/resources/designated_medical_practitioners_guide.pdf To further support you and to provide more detailed information on the programme please take a look at our Practice Support website. This will not only provide further information on the programme but also additional information about the support for clinical colleagues who provide support for students across the School of Health & Social Care. There is a range of programmes on the site the Non-Medical Prescribing link can be found on the left of the website and is clearly identified. http://soh-practicesupport.tees.ac.uk 2 THE PROGRAMME TEAM Bernadette Martin is the programme lead. She is based in room H1.20 of the Centuria Building at Teesside University and can be contacted by telephone on 01642 384966 or by email at B.Martin@tees.ac.uk. She is responsible for the planning, co-ordination and evaluation of the modules. You should direct any questions, queries, or concerns to Bernadette in the first instance. Debbie Osborne supports the programme and can also be contacted. She is based in room H1.31 in the Centuria Building. Telephone 01642 738257, email D.Osborne@tees.ac.uk

Jayne Cornforth is the Lead Midwife for Education (LME) and supports midwives who undertake the module. She can be contacted on 01642 384984, email j.cornforth@tees.ac.uk

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3 THE MODULES Non-medical Prescribing and Advancing Non-medical Prescribing (NMP) have been designed to support nurses, midwives and specialist community public health nurses, physiotherapists, radiographers, and chiropodists/podiatrists to gain a non-medical prescribing qualification. Currently the programme has been successful in supporting nurses to achieve a Nursing and Midwifery Council (NMC) recordable independent and supplementary prescribing qualification. Physiotherapists and podiatrists are from August 2013 able to train to gain and independent and supplementary prescribing recordable qualification with the Health & Care Professions Council (HCPC). Radiographers can currently train to prescribe as a supplementary prescriber and also be recorded on the HCPC register. So you may find you are supporting a physiotherapist or podiatrist in a new role. The professional requirement of 12 days in supervised practice supports the development of practitioners who are able to prescribe safely and effectively. Independent prescribing is becoming a widely integrated feature of health service delivery, with nurses, physiotherapists, podiatrists and radiographers qualified to prescribe in nearly all Trusts in England. This supports the achievement of ambitions set out in Equity and Excellence: Liberating the NHS (Department of Health (DH) 2010A). Two to three per cent of the nursing workforce are qualified independent prescribers and are prescribing predominantly in primary care, with substantial numbers also in secondary care settings. As mentioned above to further empower Allied Health Professionals (AHPs) to deliver improved clinical outcomes physiotherapists and podiatrists have from August 2013 had their supplementary prescribing rights extended to independent prescribing. Nurses, physiotherapist and podiatrists will also gain supplementary prescribing, radiographers will continue to be able to train as supplementary prescribers and prescribe within a Clinical Management Plan (CMP). Supplementary Prescribing legislation in 2005 initially prepared health professionals to expand their roles. Nurses have trained as independent prescribers since 2006 and the expansion of independent prescribing by physiotherapists and podiatrists supports enhanced patient-centred care. New roles and new ways of working to improve quality of services, deliver safe, effective services focused on the patient experience have been developed across inter-professional working within health care. Non-medical prescribing has facilitated partnership working across professional and organisational boundaries and within the commissioning and provider arena. The benefits of non-medical prescribing to patients with a wide range of conditions have ensured that choice and faster access to medicines are a realistic service improvement (DH, 2010b). Modules are delivered at academic Level 6 (degree) and Level 7 (masters). Your student will inform you which module they are studying. Both modules aims and outcomes are detailed below.

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4 MODULE AIMS AND OUTCOMES Non-Medical Prescribing (Level 6- Degree) Module Aims The aims of the module are to:

To facilitate the development of knowledge and skills required by professionals to prescribe as independent prescribers and/or supplementary prescribers.

Enable students to apply knowledge to clinical practice demonstrating the ability to prescribe safely and effectively in order to meet prescribing standards set by the Nursing and Midwifery Council/Health & Care Professions Council.

Module Outcomes On completion of this module students will be able to:

Synthesise and critically appraise the legal and professional framework for accountability and responsibility in relation to prescribing practice.

Demonstrate a comprehensive and detailed knowledge of drug actions in prescribing practice (pharmacodynamics and pharmacokinetics).

Synthesise and critically appraise the factors impacting upon and influencing safe and ethical prescribing practice.

Synthesise and evaluate relevant evidence, sources of information and decision support systems to inform prescribing practice.

Demonstrate achievement of the Regulatory Bodies’ standards of proficiency as applied for independent and supplementary prescribing.

Act autonomously whilst recognising the contributions of the multidisciplinary team involved in prescribing, supplying and administering medicines.

Demonstrate a comprehensive and detailed knowledge of the clinical decision-making strategies which underpin autonomous prescribing practice in effective communication, consultation/assessment, diagnosis and treatment, which can include over the counter, alternative and complementary health therapies.

Demonstrate a comprehensive and detailed knowledge of the skills required to prescribe safely, appropriately and cost effectively taking into account individual choice and wishes.

Practice within a framework of clinical governance, professional accountability and responsibility.

Develop and document a Clinical Management Plan within legislative requirements and within the context of a prescribing partnership.

Demonstrate the ability to monitor response to medicines and modify treatment or refer as appropriate.

Demonstrate a comprehensive and detailed knowledge of the importance of record-keeping in the context of medicines management including: accurate recording in patient notes, reporting of near misses, adverse reactions, ability to access patient records and clinical management plans.

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When working with children take an appropriate history, undertake a clinical assessment, and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults.

Recognise and respond to potential risks associated with prescribing of unlicensed medicines.

Select, evaluate and apply appropriate numeracy skills commensurate with the demands of ensuring safe prescribing practice.

Demonstrate a critical reflective approach to continuing professional development.

The practice outcomes are detailed in Appendix 1. Advancing Non-medical Prescribing (Level 7 - Masters) Module Aims The aims of the module are to:

To facilitate the development of knowledge and skills required by professionals to prescribe as independent prescribers and/or supplementary prescribers.

Enable students to apply knowledge to clinical practice demonstrating the ability to prescribe safely and effectively in order to meet prescribing standards set by the Nursing and Midwifery Council/Health & Care Professions Council.

To develop the critical thinking and decision-making skills to support the need to influence the delivery of improvements in prescribing practice.

Module Outcomes On completion of this module students will be able to:

Demonstrate a comprehensive and critical understanding of the legal and professional framework for accountability and responsibility in relation to prescribing practice.

Demonstrate a systematic and critical understanding of drug actions in prescribing practice (pharmacodynamics and pharmacokinetics).

Demonstrate a systematic and critical understanding of the factors impacting upon and influencing safe and ethical prescribing practice.

Demonstrate a systematic and critical understanding of the breadth and depth of knowledge of non-medical prescribing in order to have a critical awareness of the need to identify and deliver service improvement in professional practice

Integrate and synthesise diverse knowledge, evidence, concepts, theory and practice which inform prescribing practice and promote understanding and/or good practice and solve foreseen and unforeseen problems.

Challenge orthodoxy and formulate new/alternative hypotheses or solutions related to prescribing practice.

Demonstrate achievement of the regulatory bodies’ standards of proficiency as applied for independent and supplementary prescribing.

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Demonstrate the ability to manage the implications of ethical dilemmas whilst recognising the contributions of the multidisciplinary team involved in prescribing, supplying and administering medicines.

Demonstrate a systematic and critical understanding of the clinical decision-making strategies which underpin autonomous prescribing practice in effective communication, consultation/assessment, diagnosis and treatment, which can include over the counter, alternatives and complementary health therapies.

Demonstrate a comprehensive and critical understanding of the skills required to prescribe safely, appropriately and cost effectively taking into account individual choice and wishes.

Operate ethically within a framework of clinical governance, and have a critical understanding of the issues governing professional accountability and responsibility.

Develop and document a Clinical Management Plan within legislative requirements and within the context of a prescribing partnership.

Demonstrate the ability to monitor response to medicines and modify treatment or refer as appropriate.

Demonstrate a systematic and critical understanding of the importance of record-keeping in the context of medicines management including: accurate recording in patient notes, reporting of near misses, adverse reactions, ability to access patient records and clinical management plans.

When working with children take an appropriate history, undertake a clinical assessment, and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults.

Act autonomously in implementing a response to potential risks associated with prescribing of unlicensed medicines.

Collaborate effectively with independent prescribers, the wider multidisciplinary teams and organisations to influence and enhance prescribing practice.

Competent in the numeracy skills commensurate with the demands of research and scholarship in ways appropriate to prescribing practice.

Demonstrate the independent learning ability required for continuing professional development.

The practice outcomes are detailed in Appendix 2. 5 THE MODULE STRUCTURES

Your students are required to complete 12 supervised practice days with you (minimum 78 hours for nurses, 90 hours for AHP’s). It will be necessary to ensure that you and your student are able to work together for sufficient time for you to be able to confidently assess that they have met the practice outcomes. It is expected that a programme of experience will allow the student to work with other team members in order to experience a variety of learning opportunities. You must be the person responsible for verifying that they have met the practice outcomes. Students will have 26 theoretical days which will include taught days in the University and self-directed study.

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6 RESPONSIBILITIES The Designated Medical Practitioner (DMP) As the DMP you have a fundamental role in educating and assessing student. You will be invited to a mentor preparation workshop which will support your preparation for the role. It is important that as part of your assessing role you attend a mentor preparation workshop. The generic nature of the module content will facilitate students to apply their knowledge and understanding to safely prescribe within their own area of practice speciality. This will be further developed with the support and guidance from you. You are responsible for:

Establishing a Learning Contract with your student.

Documenting progress on three occasions during supervised practice and provide any additional opportunities if required to achieve outcomes in a timely manner.

Planning a learning programme which will provide the opportunity for your student to meet their learning outcomes and gain competency in prescribing.

Facilitating learning by encouraging critical thinking and reflection.

Providing dedicated time and opportunities for your student to observe how you conduct a consultation/interview with patient/clients and/or parents/carers and the development of a management plan.

Allowing opportunities for your student to carry out consultations and suggest clinical management and prescribing options, which are then discussed with you.

Helping ensure that your student integrates theory with practice.

Taking opportunities to allow in-depth discussion and analysis of clinical management using a random case analysis approach, when patient/client care and prescribing behaviour can be examined further.

Facilitating, observing and assessing your students’ performance over the continuous period of supervised practice.

Assessing and verifying that, by the end of the course, your student is competent to assume the prescribing role. It is your responsibility to decide whether or not they are making satisfactory progress towards meeting the practice outcomes for non-medical prescribing. This decision will be based upon whether or not the practice outcomes have been met. If during the practice days students are deemed by yourself to be failing to make sufficient progress towards achievement of these outcomes you should inform both the student and the Module Leader in order to consider if strategies can be put in place to support your student.

Working in collaboration with LME to support midwife students.

Identify and document any ‘cause for concern’, e.g. concerns regarding competence acquisition, or conduct, or unsafe practice, and discuss at the earliest possible stage with the Module Leader. Unsafe practice can for example include repeated episodes of making an incorrect diagnosis, recommending incorrect treatment options or incorrect completion of prescriptions. A Cause for Concern Form should be completed and can be found in Appendix 3. If your student demonstrates any concern relating

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directly to patient safety for example you should contact the Module Leader to discuss as the student may be considered for referral to the School of Health & Social Care Fitness to Practise process.

Examples of Supervision Your contribution in relation to providing supervision, support and opportunities to develop competence in practice is crucial.

Dedicated time and opportunities for your student to observe how you conduct a "consultation/interview" with patients and/or their carers, and the development of a subsequent management plan.

Opportunities to allow in-depth discussion and analysis of clinical management using a random case analysis approach, when patient care and prescribing behaviour can be examined further.

Facilitate student learning by encouraging critical thinking and reflection with the use of their Practice Portfolio or Learning Log.

Allow opportunities for your student to carry out consultations and suggest clinical management and prescribing options, which are then discussed with you.

The Student The student’s role is to take responsibility for their own learning and demonstrate a willingness to develop both academically and in practice. They will be expected to discuss their own learning needs with you and they should undertake honest self-assessment, articulate their learning needs, seek and accept formative feedback from you. Your student will need to recognise and appraise their own abilities and limitations. ProgrammeTeam Bernadette Martin, as Programme Leader, has overall responsibility for both modules and will provide general information related to the modules, guidance and support where necessary. Bernadette will be your first point of contact for any queries or concerns and provide academic and pastoral support or referral to central support services or other relevant staff where appropriate. Discipline-specific tutorials will be offered by specialist Academic Mentors in order to enable students to identify individual learning needs and to develop a Learning Contract to guide and facilitate academic learning. The LME works with the module team and supports midwifery students if your student is a midwife you will be introduced to the LME at the mentor preparation workshop. It is recognised that the demands of the modules are challenging and that the intensity of the assessment is demanding. The module team will provide substantial support to students both in an academic and pastoral capacity. Students who require additional support will be signposted to the most appropriate student support.

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7 HOW IT WILL WORK IN PRACTICE

Supervised learning in practice will comprise a total of 12 days of the student’s time. You should be willing and able to devote a sufficient part of your time during this period of supervision to provide appropriate guidance for your student.

Learning in practice will be related to the medical conditions and circumstances in which the student is likely to prescribe.

The DMP may be a doctor with whom the student normally works. However, arrangements can be agreed where another suitable doctor acts as supervisor.

8 GUIDELINES FOR COMPLETING THE PRACTICE PORTFOLIO Your student is required to use a Practice Portfolio as a framework through which to acquire and demonstrate competency. The purpose of the portfolio is to provide your student with a framework through which they can record and demonstrate their progress and achievements whilst studying the modules. It will also provide you with a framework through which to monitor student progress and achievement of practice outcomes. The Practice Portfolio In order to demonstrate achievement of the module outcomes, your student is required to keep a Practice Log. This should provide a documentary record illustrating the nature of individual learning. Included within this document is a complete list of all the module outcomes as well as the practice outcomes. This will enable you to see the practice element of the module within the context of the whole module. The portfolio-keeping process includes:

Reflection upon existing knowledge and skills

Exploration of the module outcomes

Identification of learning needs

Identification of learning opportunities in the practice area

Matching learning opportunities to learning needs

Development of a plan or Learning Contract to meet learning needs

Implementation of the plan/Learning Contract and collection of supporting evidence

Keeping a Practice Log

Critical reflection upon learning and achievement of practice module outcomes

Presentation of the portfolio at the end of the module

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How to Compile the Portfolio

Stage 1 - Identifying Learning Needs The first step is to look at the practice outcomes and assess what your student needs to learn to achieve each one. You must set time aside at the beginning of the practice placement and review the practice outcomes, consider how these can be achieved and encourage your student to consider their own self-assessment and how learning needs can be met. A Learning Contract will be developed to show how these outcomes can be achieved. This contract can also be used as a framework for the critical reflection of learning. This meeting must be documented on the initial meeting form in Appendix 4. The Learning Contract template can be found in Appendix 5. Stage 2 - Feedback You must both set aside time to review progress and provide feedback on progress. This should be undertaken regularly and should involve discussing cases from practice experiences and reflecting upon and critically analysing. It is important that theoretical concepts are used to inform these discussions. This stage also includes assessment of your student’s progress towards competence in relation to practice outcomes and you must document this using the intermediate meeting form in Appendix 4. Stage 3 – Verifying Achievement At the end of the module, your student will submit their portfolio for verification of the award. You must sign and date the practice outcomes have been met. It is important that your student provides a short statement on how they have achieved each outcome on the table of practice outcomes in Appendix 1/2. You should also provide evidence of a final meeting and final sign-off using the final meeting form in Appendix 4. Confirmation of the result will be agreed by the School of Health & Social Care Assessment Board at the end of the module term. The Portfolio of Evidence will include:

Formulation and completion of a Learning Contract which identifies strategies to meet individual learning needs in relation to the module outcomes.

Agreed and verified dates of supervised practice.

A Practice Log that records practice experiences.

Six case studies from Learning Logs which demonstrate prescribing and prescription writing in a range of settings – one must include demonstration of prescribing for children. An arrangement should be made for your student to spend time with a prescriber who does prescribe for children if you do not.

Reflective analysis of episodes from the Practice Logs demonstrating critical appraisal skills and informed decision-making.

Completion of three P-Formulary worksheets.

Three Clinical Management Plans drawn up whilst in supervised practice – this should be undertaken in consultation with you – on successful completion of their module if your student is a nurse they will be able to prescribe

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independently and on a supplementary basis. AHP students can currently only prescribe on a supplementary basis.

Clinical Management Plans completed within the workshop with peers and peer review feedback sheet.

Evidence of having passed the written examination.

Evidence of satisfactory completion of a period of supervised practice experience. Must be 12 days. You must document progress on at least three occasions during the practice learning and provide a final sign-off of competence.

Evidence of gaining consent and maintaining confidentiality. It is likely that your student will include evidence which relates to particular individuals, informed consent must be obtained, anonymity must be ensured, and the School of Health & Social Care Consent Form completed (Appendix 6). You are responsible for ensuring and verifying that consent has been agreed and that confidentiality is maintained.

A Clinical Management Plan template can be found in Appendix 7.

Students will also undertake an Objective Structured Examination (OSCE) which accounts of 30% of the overall module. This is undertaken in the University; the assessment includes demonstration of:

Completion of a 15-minute OSCE which will relate to patient safety for example, correct diagnosis, correct treatment options and correct completion of the prescription form.

Level 7 students will undertake an additional five-minute viva in which they will synthesise and critically evaluate the: Pharmacology related to drug of choice Clinical decision-making strategy employed Contemporary literature underpinning management strategy Pathophysiology related to the condition All the practice outcomes must be achieved by the end of the relevant module and the portfolio forwarded to the Module Leader for verification. Students who are referred on one or more of the practice outcomes must demonstrate achievement of this outcome at the designated point of negotiated re-assessment. If this is the case your student must devise a Learning Contract and Action Plan with you and Bernadette in order to address the outcomes involved. The decision regarding whether or not your student has achieved this Learning Contract will be made by you. The Practice Log can also be used as a tool to guide reflection on practice. By recording experiences, in particular those that create uncertainty and conflict, an opportunity for reflection on action can be created. Such reflection articulates the factors that underpin decision-making and facilitates the identification of alternative approaches. However, it is also essential that sustained observation in the practice environment is used to provide evidence of competence in practice.

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9 REFERENCES & READING Chartered Society of Physiotherapy (2013) Practice Guidance for Physiotherapist Supplementary and/or Independent Prescribers in the safe use of Medicines. (2nd Edition) http://www.csp.org.uk/publications/practice-guidance-physiotherapist-supplementary-andor-independent-prescribers-safe-use- Chartered Society of Physiotherapy (2013) Outline Curriculum Framework for Education Programmes to Prepare Physiotherapists and Podiatrists as Independent/Supplementary Prescribers and to Prepare Radiographers as Supplementary Prescribers. http://www.csp.org.uk/documents/outline-curriculum-framework-education-programmes-prepare-physiotherapists-podiatrists-ind Department of Health (2010a) Equity and Excellence: Liberating the NHS https://www.gov.uk/government/publications/liberating-the-nhs-white-paper Department of Health (2010b) Evaluation of Nurse and Pharmacist Independent Prescribing in England. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_126437.pdf Health & Care Professions Council (2013) Standards for Prescribing. http://www.hpc-uk.org/publications/standards/index.asp?id=692 Nursing & Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife Prescribers. http://www.nmcuk.org/Documents/Standards/nmcStandardsofProficiencyForNurseAndMidwifePrescribers.pdf Nursing and Midwifery Council (2007) Additional Requirements to Include Within the Indicative Content of Nurse Independent Prescribing Education and Training Programmes. NMC Circular 30/2007. http://www.nmc-uk.org/Documents/Circulars/2007circulars/NMC%20circular%2030_2007.pdf Nursing and Midwifery Council (2007) Prescribing for Children and Young People. NMC Circular 22/2007. http://www.nmc-uk.org/Documents/Circulars/2007circulars/NMC%20circular%2022_2007.pdf NMC Circular 30/2007. Training Programmes. http://www.nmc-uk.org/Documents/Circulars/2007circulars/NMC%20circular%2030_2007.pdf Nursing and Midwifery Council (2008) Remote Assessment and Prescribing. NMC Circular 16/2008. http://www.nmc-uk.org/Documents/Circulars/2008circulars/NMC%20circular%2016_2008.pdf Nursing & Midwifery Council (2008) Standards for Medicines Management. http://www.nmc-uk.org/Documents/Standards/nmcStandardsForMedicinesManagementBooklet.pdf

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Nursing & Midwifery Council (2008) Guidance for Continuing Professional Development for Nurse and Midwife Prescribers Annexe 1 – NMC circular 10/2008 http://www.nmc-uk.org/Documents/Guidance/NMC-Guidance-for-CPD-for-nurse-and-midwife-prescribers.pdf Nursing and Midwifery Council (2010) Nurse and Midwife Independent Prescribing of Unlicensed Medicines. NMC Circular 04/2010 http://www.nmc-uk.org/Documents/Circulars/2010circulars/NMCcircular04_2010.pdf Further reading which you may find useful: Competencies for designated medical practitioners - The components which make up the core competencies for DMP’s are available from the GP Trainer website at http://www.westmidlandsdeanery.nhs.uk/

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APPENDIX 1

RECORD OF ACHIEVEMENT OF PRACTICE OUTCOMES – NON-MEDICAL PRESCRIBING – Level 6 Assessment of Student Prescribing within their area of Clinical Practice

Practice Outcome By the end of the module the student will be able to:

Evidence DMP Signature & Date

Student Signature

Demonstrate a comprehensive and detailed knowledge of drug actions in prescribing practice (pharmacodynamics and pharmacokinetics)

Critically appraise the factors influencing safe and ethical prescribing practice at individual, local and national

Synthesise and evaluate sources of information/advice and decision support systems in prescribing practice

Demonstrate a detailed and comprehensive understanding of the roles and relationships of others involved in prescribing, supplying and administering medicines

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Practice Outcome By the end of the module the student will be able to:

Evidence DMP Signature & Date

Student Signature

Demonstrate and have a detailed knowledge of effective consultation/assessment skills including: Ability to communicate effectively with patient/clients, clients, parents and carers Ability to conduct a relevant physical assessment/ examination of patients with those conditions for which they may prescribe Ability to undertake a thorough history, including medication history and current medication (including over the counter, alternative and complementary health therapies) to inform decision-making Ability to engage in the process of effective clinical decision-making Ability to assess patient’s needs for medicine taking account of their wishes, values, ethnicity and the choices they may wish to make

Demonstrate and have a comprehensive and detailed understanding of the need prescribe safely, appropriately and cost effectively

Practice within a framework of professional accountability and responsibility

Incorporate patients' choice into the decision-making process.

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Practice Outcome By the end of the module the student will be able to:

Evidence DMP Signature & Date

Student Signature

Develop and document a Clinical Management Plan within legislative requirements and within the context of a prescribing partnership

Demonstrate the ability to monitor response to medicines and modify treatment or refer the patient as appropriate

Demonstrate and have a detailed knowledge of the importance of record-keeping in the context of medicines management including: Accurate recording in patient notes Reporting of near misses Adverse reactions Ability to access patient records and Clinical Management Plans

Demonstrate effective partnership working with independent prescribers and the wider care team

Take an appropriate history, undertake a clinical assessment and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults

Recognise and respond to potential risks associated with independent prescribing of unlicensed medicines

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APPENDIX 2 RECORD OF ACHIEVEMENT OF PRACTICE OUTCOMES – ADVANCING NON-MEDICAL PRESCRIBING – Level 7 Assessment of Student Prescribing within their area of Clinical Practice

Learning Outcomes By the end of the module the student will be able to:

Evidence DMP Signature & Date

Student Signature

Demonstrate a systematic and critical understanding of drug actions in prescribing practice (pharmacodynamics and pharmacokinetics)

Demonstrate a systematic and critical understanding of the factors influencing safe and ethical prescribing practice at individual, local and national levels

Integrate and synthesise sources of information/advice and decision support systems in prescribing practice

Have a critical awareness of the need to identify and deliver service improvement within prescribing practice

Demonstrate the ability to manage the implications of ethical dilemmas whilst recognising the contributions of the roles and relationships of others involved in prescribing, supplying and administering medicines

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Learning Outcomes By the end of the module the student will be able to:

Evidence DMP Signature & Date

Student Signature

Demonstrate and have a systematic and critical understanding of the need for effective consultation/ assessment skills including: Ability to communicate effectively with patient/clients, clients, parents and carers Ability to conduct a relevant physical assessment/ examination of patients with those conditions for which they may prescribe Ability to undertake a thorough history, including medication history and current medication (including over the counter, alternative and complementary health therapies) to inform decision-making Ability to engage in the process of effective clinical decision-making Ability to assess patient’s needs for medicine taking account of their wishes, values, ethnicity and the choices they may wish to make

Demonstrate and have a comprehensive and critical understanding of the need prescribe safely, appropriately and cost effectively

Practice within a framework of professional accountability and responsibility

Incorporate patients' choice into the decision-making process

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Learning Outcomes By the end of the module the student will be able to:

Evidence DMP Signature & Date

Student Signature

Develop and document a Clinical Management Plan within legislative requirements and within the context of a prescribing partnership

Demonstrate the ability to monitor response to medicines and modify treatment or refer the patient as appropriate

Demonstrate and have systematic and critical understanding of the importance of record-keeping in the context of medicines management including: Accurate recording in patient notes

Reporting of near misses

Adverse reactions Ability to access patient records and Clinical Management Plans

Demonstrate effective and collaborative partnership working with independent prescribers and the wider care team to influence and enhance prescribing practice

Take an appropriate history, undertake a clinical assessment and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults

Recognise the need to implement a response to potential risks associated with independent prescribing of unlicensed medicines

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APPENDIX 3 CAUSE FOR CONCERN DOCUMENTATION

NATURE OF CONCERN

Signature Date

Practice/Midwife Sign-off

Mentor:

Academic Mentor:

Student:

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ACTION PLAN AND REVIEW

Signature Date

Practice/Midwife Sign-off

Mentor:

Academic Mentor:

Student:

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OUTCOME OF REVIEW

Signature Date

Practice/Midwife Sign-off

Mentor:

Academic Mentor:

Student:

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APPENDIX 4

RECORD OF SUPERVISED PRACTICE MEETINGS

Initial Meeting

Designated Medical Practitioner comments:

Signature: Date:

Student comments:

Signature: Date:

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Intermediate Meeting

Designated Medical Practitioner comments:

Signature: Date:

Student comments:

Signature: Date:

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Final Sign-Off Meeting

Designated Medical Practitioner comments:

Competent/Not Competent (delete as appropriate) I am satisfied/not satisfied (delete as appropriate) that the student has met the outcomes of the module. This has been evidenced through observation, question and answer discussion throughout the practice experience

Signature: Date:

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Student comments:

Signature: Date:

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APPENDIX 5 LEARNING CONTRACT Student Name: Designated Medical Practitioner Name: Negotiated Learning Outcomes: Strategies: Resources: Date of Contract:…………………To be completed by:……………… Signature of Student:……………………………………………………. Signature of DMP:…………………………………………………………….

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OBTAINING INFORMED CONSENT

Rationale As part of the assessment and portfolio-keeping process students are sometimes required to illustrate the relationship between theory and practice by using information relating to specific clients, e.g. care studies, care plans, assessments, projects and reflective pieces. In these circumstances obtaining informed consent is essential. In order to demonstrate compliance with the professional codes/bodies, the attached Obtaining Informed Consent Declaration Form must be completed and submitted with the work. Failure to obtain consent and/or submit the completed declaration form will result in automatic referral/failure and could lead to disciplinary action. Responsibilities The academic support teacher/module tutor supervising the piece of work is responsible for:

Directing the student to the site where they can access a copy of the Obtaining Informed Consent Declaration Form and Guidance Notes prior to the assessment.

Drawing the student’s attention to the Access to Health Records Act (1990), in particular: o Section 5.3, which states that third parties may only access the

patient’s records provided that information given by the patient and/or the results of examinations/investigations will not be disclosed.

o Section 5.1 which states that the information obtained from the patient’s health records must not be used in a way as to cause the patient serious physical or mental harm, or that the patient may be identified.

Drawing the student’s attention to the Data Protection Act (1998) in particular: o Reviewing the rationale and each point set out in the Obtaining

Informed Consent Declaration Form o Reminding the student that the completed Declaration Form must

accompany the assignment when submitted.

APPENDIX 6

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The Student is responsible for:

Informing the Practice Mentor/Supervisor of the nature of the assignment/ portfolio and the requirement to complete an Obtaining Informed Consent Declaration Form.

Seeking informed consent from the patient/client and/or patient/client representative and/or carers, and/or colleagues/staff in accordance with points 1-4, as set in the Declaration Form.

Themselves and the Practice Mentor/Supervisor ensuring the Declaration Form is completed.

Ensuring the completed Declaration Form is submitted with the assignment by the required date.

Ensuring that a pseudonym is used for client/patients, relatives, carers and staff mentioned in the assessment.

Ensuring that any documentation submitted as part of the assessment will be rewritten and not photocopied e.g. care plans, assessment forms.

The Practice Mentor/Supervisor is responsible for:

Providing the student with appropriate support and guidance whilst obtaining informed consent form the patient/client and/or patient/client representative.

Signing the Obtained Informed Consent Declaration Form, only if they are confident that the criteria have been met.

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OBTAINING INFORMED CONSENT DECLARATION FORM

Student’s Name

Programme/Pathway/Cohort

Academic Support Teacher/ Module Tutor

DECLARATION BY STUDENT

In order to comply with the requirements of the Access to Health Records Act (1990) and the Data Protection Act (1984), I confirm I have discussed the following with the patient/client* and/or the patient’s/client’s* representative, e.g. parent/guardian, next of kin, carers, colleagues/staff and have obtained permission to use personal relevant data:

* Delete as appropriate 1. The nature of the assessment. 2. The reason I wish to use data relating to the patient/client. 3. That clients’/patients’, carers’, colleagues’/staff anonymity and confidentiality

in relation to any material gathered or produced in the course of this work will be maintained e.g.: a for all persons mentioned pseudonyms and/or general titles will be

used, not individual names. b the patient/client address and any information which could identify their

address will be omitted. c general terms will be used to describe occupation/workplace/school/

hobbies etc. d time, date and location of admission will be omitted; e information which may identify the patient/client/relatives/carer and

colleagues/staff will be omitted from documentation e.g. care plans, pathways of care, risk assessments etc.

4. Those who will have access to the work in addition to myself e.g. typist, teaching staff, other students, Board of Examiners.

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INFORMED CONSENT DECLARATION FORM N.B.: Patient/Client/Carer/Colleagues/Staff column should be completed by using a Code/Pseudonym e.g. Client/Patient A, Client/Patient B in order to provide anonymity and confidentiality. If names are used in the first column a pseudonym must be used and it must be clearly stated that this is a pseudonym. The Code/Pseudonyms used must be the same as those referred to in the assignment.

Patient/ Client/ Carer/

Colleague/ Staff

Module Title

Academic Support Teacher

Informed Consent Gained

Practice/ Mentor

Supervisor Name

Practice/ Mentor

Supervisor Signature

Student Signature

Date

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

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APPENDIX 7 CLINICAL MANAGEMENT PLAN TEMPLATE

Name of Patient:

Patient medication sensitivities/allergies:

Patient identification e.g. ID number, date of birth:

Independent Prescriber(s):

Supplementary Prescriber(s)

Condition(s) to be treated

Aim of treatment

Medicines that may be prescribed by SP:

Preparation

Indication Dose schedule

Specific indications for referral back to the IP

Guidelines or protocols supporting Clinical Management Plan:

Frequency of review and monitoring by:

Supplementary prescriber Supplementary prescriber and independent prescriber

Process for reporting ADRs:

Shared record to be used by IP and SP:

Agreed by independent prescriber(s)

Date Agreed by supplementary prescriber(s)

Date Date agreed with patient/carer