26th April 2023
The Department of Health’s New Models of Prescribing Review and Implementation Plan 2023 was recently launched at a multi-disciplinary event at Castle Buildings hosted by Chief Pharmaceutical Officer Cathy Harrison.
New Models of Prescribing Review and Implementation Plan 2023
This summary report outlines strategic recommendations arising from the independent evaluations of New Models of Prescribing (NMOP) pilot projects and learning from the development of new processes.
Cathy Harrison, Chief Pharmaceutical Officer, pictured at the launch of the New Models of Prescribing Review and Implementation Plan
Findings presented will shape future models to improve patient access to medicines, particularly at interfaces between secondary and primary care.
The NMOP pilot projects were led by multidisciplinary teams and were independently evaluated.
Involving extensive stakeholder engagement the New Models of Prescribing transformation project was established by the Health and Social Care Board (now the Strategic Performance and Planning Group, SPPG) and funded by DoH.
The project was established to scope out the arrangements needed to enable prescribers to work in a more effective and autonomous way.
In 2020/21, a number of small pilot projects were initiated to test what was needed to allow direct prescribing to the patient by a range of professionals. These included:
- Dietitian led direct ordering of oral nutritional supplements for care home residents
- Outpatient and community physiotherapists writing prescriptions for respiratory symptoms, musculoskeletal problems and lymphoedema (long-term condition that causes swelling in the body’s tissues) among other conditions
- Heart failure nurses prescribing at outpatient appointments to manage symptoms quickly
- Medical prescribers working in Belfast Trust’s Home Treatment Team prescribing urgent medicines to prevent rapid deterioration of a patient’s mental health
Event speakers from L-R are Claire Erki, BHSCT, Donna McLoughlin, NHSCT, Monique Kritzinger, BHSCT, and Gail McKeown, SEHSCT
Processes to enable prescribing and alternative mechanisms for supply of medicines and appliances were implemented, key principles were tested, and governance and policy frameworks were evaluated via the projects. Prescribing was permitted where there was:
- an urgent need for medication (within 72 hours of consultation),
- a requirement for titration/tapering of medicines with early review, or
- a need for specialised items outside the clinical expertise of a GP.
Andrea Linton, Pharmacy and Medicines Management Co-ordinator, SPPG said, “The new models of prescribing improved access to medicines, reduced duplication of effort and utilised the skills and experience of a wider range of prescribers. Patients across all four projects reported a high level of satisfaction with the new methods of accessing their medication and GP capacity was increased by displacing consultation and prescribing activity.”
The pilot projects have enabled longer-term funding to be secured under the Integrated Prescribing Programme building on the success of NMOP, to consider other patient journeys that may need to access to prescriptions, and benefiting more patients across Northern Ireland.
Event hosts and organisers from L-R are Dr Brenda Bradley, SPPG, Chris Garland, DoH, Andrea Linton, SPPG and Cathy Harrison, DoH
Cathy Harrison, Chief Pharmaceutical Officer, DoH said “The experience of the pilot projects can serve as an example of the capacity and commitment required to deliver NMOP in other areas. Learning will be taken forward to new clinical areas and across the region benefiting patients and healthcare professionals alike.”
Attendees at the launch event included representatives from the Department of Health, Health and Social Care Trusts, the Public Health Agency, the Strategic Planning and Performance Group the Medicines Optimisation and Innovation Centre and General Practice.