The Cumberlege Report was based on a review of the literature and consultations with various stakeholders, including nurses, doctors, pharmacists, patients, and professional bodies. The report highlighted the central role of nurses in caring for patients in their homes, especially those with chronic conditions, disabilities, or terminal illnesses. The report also recognized the increasing complexity and diversity of nursing roles and responsibilities, and the need for greater autonomy and accountability for nurses. The report argued that nurse prescribing would enhance the quality of care, reduce delays and inconvenience for patients, save time and money for both nurses and doctors, and clarify professional boundaries and responsibilities.
The Cumberlege Report proposed that suitably qualified nurses working in the community should be able to prescribe from a limited list of items, such as wound dressings, ointments, catheters, stoma appliances, and simple analgesics. The report also suggested that nurses should be able to adjust the timing and dosage of medicines within a set protocol, such as insulin or anticoagulants. The report recommended that nurse prescribing should be subject to certain conditions, such as appropriate training and education, regular audit and evaluation, clear documentation and communication, and collaboration with other health professionals.
The Cumberlege Report was followed by another influential report in 1989, chaired by Dr June Crown, which examined the feasibility and implications of nurse prescribing. The Crown Report endorsed the recommendations of the Cumberlege Report, and suggested a number of practical steps to implement nurse prescribing, such as developing a formulary, establishing a legal framework, designing a curriculum, setting standards and criteria, and conducting pilot studies. The Crown Report also extended the scope of nurse prescribing to include other groups of nurses, such as practice nurses, school nurses, occupational health nurses, and mental health nurses.
The Cumberlege Report 1986 was a visionary document that paved the way for nurse prescribing in the UK. It recognized the changing needs and expectations of patients and society, and the evolving roles and competencies of nurses. It advocated for a more flexible and responsive system of prescribing that would benefit both patients and health professionals. It also set the foundation for further research and development in this area. The Cumberlege Report 1986 was a milestone for nurse prescribing that has had a lasting impact on nursing practice and policy.
References
DHSS (1986) Neighbourhood Nursing: A Focus for Care (Cumberlege Report). London: HMSO.
Courtenay M. & Griffiths M. (2010) Non-medical prescribing: an overview. In: Courtenay M. & Griffiths M. (eds) Independent and Supplementary Prescribing: An Essential Guide. Cambridge: Cambridge University Press.
Bradley E. & Nolan P. (2007) Impact of nurse prescribing: a qualitative study. Journal of Advanced Nursing, 59(2), pp. 120-128.
DoH (1989) Report of the Advisory Group on Nurse Prescribing (Crown Report). London: HMSO.
Latter S., Maben J., Myall M., & Young A. (2007) Evaluating nurse prescribersâ education and continuing professional development for independent prescribing practice: findings from a national survey in England. Nurse Education Today, 27(7), pp. 685-696.
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Nurse Prescribing Today
Since the publication of the Cumberlege Report 1986 and the Crown Report 1989, nurse prescribing has undergone significant changes and developments in the UK. In 1992, the first group of community nurses completed their training and became qualified to prescribe from a limited formulary of items. In 1994, the formulary was expanded to include more items and groups of nurses. In 1998, the Nurse Prescribers' Extended Formulary (NPEF) was introduced, which allowed nurses to prescribe from a wider range of medicines, such as antibiotics, steroids, and antidepressants. In 2002, the NPEF was replaced by the Nurse Prescribers' Formulary for Community Practitioners (NPF), which included all items from the previous formulary plus some additional items.
In 2003, a major breakthrough occurred when supplementary prescribing was introduced for nurses and other health professionals. Supplementary prescribing is a voluntary partnership between an independent prescriber (a doctor or a dentist) and a supplementary prescriber (a nurse or another health professional) to implement an agreed patient-specific clinical management plan with the patient's consent. This enabled nurses to prescribe any medicine for any condition within their competence, as long as it was agreed with the doctor and the patient. In 2006, another milestone was achieved when independent prescribing was extended to nurses and other health professionals. Independent prescribing is the ability to prescribe any licensed medicine for any medical condition within one's competence, without the need for a clinical management plan or a doctor's agreement. This gave nurses greater autonomy and responsibility in prescribing medicines for their patients.
Today, nurse prescribing is an integral part of nursing practice and education in the UK. There are over 90,000 qualified nurse prescribers in the UK, who can prescribe from either the NPF or as independent or supplementary prescribers. Nurse prescribing is regulated by the Nursing and Midwifery Council (NMC), which sets the standards and requirements for nurse prescribers' education, training, registration, and practice. Nurse prescribing is also supported by various guidelines, policies, and resources from professional bodies, such as the Royal College of Nursing (RCN), the National Institute for Health and Care Excellence (NICE), and the British National Formulary (BNF). Nurse prescribing is widely recognized as a valuable and beneficial contribution to patient care, health outcomes, and service delivery.
Conclusion
The Cumberlege Report 1986 was a pioneering document that advocated for nurse prescribing in the UK. It identified the problems and inefficiencies in the current system of prescribing, and proposed that community nurses should be able to prescribe from a limited list of items and simple agents. The report also set the foundation for further research and development in this area. The Cumberlege Report 1986 was followed by the Crown Report 1989, which endorsed and expanded the recommendations of the Cumberlege Report, and suggested practical steps to implement nurse prescribing. Since then, nurse prescribing has evolved and progressed significantly in the UK, with various changes and developments in legislation, regulation, education, practice, and policy. Nurse prescribing is now an essential and established part of nursing practice and education in the UK, with over 90,000 qualified nurse prescribers who can prescribe from either a formulary or as independent or supplementary prescribers. Nurse prescribing is widely acknowledged as a positive and effective way of improving patient care, health outcomes, and service delivery.
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