...formulary--the Nurse Prescriber's Formulary. The scheme (labelled 'V100') was piloted eight demonstration sites (set up in 1994; Morris, 1994). Initially, the course was only open to district nurses and health visitors. Practice nurses were not included in this group unless they had a health visiting or district nursing qualification.

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The consultation document (DoH, 2000) announced the Government's intention to extend the nurse prescribing role, necessitating a longer course with increased pharmacology training, allowing the qualified prescriber to prescribe from the Nurse Prescribers' Extended Formulary. This was, again, a limited formulary designed mainly for minor illnesses and therefore not very useful in the management of long-term conditions.

The final Crown Report (DoH, 1999) recommended the setting up of two types of nurse prescriber, independent and supplementary. The independent prescriber can assess and diagnose. For the supplementary prescriber, a doctor assesses and diagnoses. Following this, a Clinical Management Plan (CMP) is drawn up, allowing the supplementary prescriber to prescribe from then on. The DoH (2005b) describes it as:

'a voluntary prescribing partnership between an independent prescriber and a supplementary prescriber, to implement an agreed patient-specific clinical management plan with the patient's agreement.'

The CMP appears in some cases to be a major obstacle to...

NOTE: All illustrations and photos have been removed from this article.



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