From 1 May 2006, the Nurse Prescribers' Extended Formulary was discontinued and qualified Nurse Independent (formerly known as Extended Formulary Nurse Prescribers) are now able to prescribe any licensed medicine for any medical condition within their competence, including some Controlled Drugs. Any additional training needs should be addressed through continued professional development.

"You must only ever prescribe within your level of experience and competence, acting in accordance with Clause 6 of the NMC Code of Professional Conduct: Standards for Conduct, Performance and Ethics"    NMC, 2006

Independent Nurse Prescribing

For further information, please click here

Supplementary Nurse Prescribing

This is still utilised in some departments across the UK. However, it has largely been superceded by Independent Nurse Prescribing.

Supplementary Prescribing – based on diagnosis being made by a ‘independent’ medical prescriber based on a Clinical Management Plan developed by both the medical and supplementary prescriber (nurse, allied health professionals) relating to a named patient and their specific medical condition. Both must have full access to medical notes.

There is no legal restriction on the clinical conditions but NHS employers will for clinical governance write their own policies and this potentially might restrict choice of medication.

Nurses adopting supplementary prescribing will be able to prescribe:

• All GSL and P medicines, appliances and devices, foods and other borderline substances approved by the Advisory Committee on Borderline Substances
• All POMs with the current exception of controlled drugs (Home Office is reviewing this)
• ‘Off label’ medicines (medicines for use outside of their licensed indications), ‘black triangle’ drugs and drugs marked ‘less suitable for prescribing’ in the BNF
• Unlicensed drugs may only be prescribed if they are part of a clinical trial with a clinical trial certificate or exemption
  The relationship between the independent medical prescriber and the supplementary prescriber is voluntary and agreement should be made about which medications the supplementary prescriber is confident and competent to prescribe and manage.
  Examples of the format for a Clinical Management Plan is available on the DOH website

For information on the different types of nurse prescribing please see the Department of Health Website

www.dh.gov.uk/policyandguidance/medicinespharmacyandindustry/prescriptions/SupplementaryPrescribing/fs/en