MHRA criticises RCN syringe driver guidance

Nurses should not mix licensed medications for use in palliative care even under the direction of a clinical management plan (CMP), further MHRA guidance makes clear.

Last year, Independent Nurse revealed that nurses could be struck off for unwittingly breaching prescribing rules by mixing two licensed medications in a syringe driver to create a new unlicensed product.

Nurses were then advised by both the Royal College of Nursing and the National Council for Palliative Care (NCPC) to work within the law by using supplementary prescribing and developing a CMP. But the MHRA has criticised the RCN and NCPC guidance for not making it clear that nurses cannot actually mix the drugs under a CMP nor ask a GP to do so.

A spokeswoman for the MHRA said: ‘There are no provisions in medicines legislation which would enable nurse independent prescribers to prepare unlicensed medicines or give directions for others to do so.

‘A doctor cannot instruct a supplementary prescriber to mix medicines as the CMP only enables the supplementary prescriber to order, not actually prepare, an unlicensed product.’

An MHRA consultation closes this week on proposals for amendments to the legislation for mixing medicines.

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