Prescribing controlled drugs under review

The RCN has met with the DoH and the Home Office to ask for nurse prescribing rights to be extended to all controlled drugs.

Controlled drugs review

If the Advisory Council on the Misuse of Drugs, which is in charge of drug legislation for the Home Office, and the DoH reach a positive conclusion then a consultation on the issue could be opened up early next year.

Professor Matt Griffiths, RCN prescribing adviser, said the changes would mean substance misuse nurses would no longer have to use supplementary prescribing.

‘We’re also lobbying for changes to patient group directions (PGDs) in giving diamorphine,’ he added.

‘At the moment diamorphine can only be given for cardiac pain in specialty hospital units but there are lots of other environments where nurses should be able to use PGDs to administer diamorphine.’

Professor Griffiths pointed out that now out-of-hours care had been reorganised, nurses, emergency care practitioners or paramedics were often first on the scene, rather than doctors.

‘The same goes for minor injury units when someone comes in with a significant injury. These professionals need to be able to be give patients pain relief and make them ready for transfer to hospital,’ he said.

If controlled drugs were opened up to nurse prescribers, district nurses would also have more options for pain relief when dealing with ‘breakthrough’ pain or pain exceeding that expected by care plans, he explained.

‘There is a national shortage of diamorphine at the moment so nurses do need to be able to have other options for pain relief.’

Professor Griffiths also pointed out nurses were also often the ‘gatekeepers’ for controlled drugs anyway, because they were usually the professionals who organised the ordering, storage, disposal and monitoring of them. ‘Nurses are actually the ones who are very good at looking after controlled drugs in line with legislation,’ he said.

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