Competition. That is precisely what you are up against. That is because these days, everyone wants to become a prescribing pharmacist. Consequently, because of the demand, it is also challenging to be accepted on a course.
Moreover, the majority of pharmacists should be prescribers by 2025, according to plans outlined by Health Education England.
Rejected. Declined. Unsuccessful. These are terms that you may be familiar with if you’re struggling to be accepted on a prescribing course – it took me three years to finally get on a course. In hindsight, my unsuccessful application was not all my fault.
But there were certain aspects of my application that could have been improved. Continue reading, and I’ll explain.
What is nonmedical prescribing?
Nonmedical prescribing refers to the prescribing of medications by trained professionals who are not physicians. This can include nurses, pharmacists, and other healthcare professionals.
Nonmedical prescribing is becoming more common as it is recognized as a way to improve patient care. Nurses, and pharmacists, in particular, are well-suited to prescribe medications, as they often have close relationships with their patients and are familiar with their medical history.
There are many reasons why a patient might see a nonmedical prescriber instead of a physician. In some cases, the nonmedical prescriber may be more convenient or accessible. In other cases, the patient may prefer to see a healthcare professional who is not a doctor, or the nonmedical prescriber may be more knowledgeable about a particular condition.
Pharmacist nonmedical prescribing is regulated by the General Pharmaceutical Council (GPHC). In order to prescribe medications, a pharmacist must have completed an accredited pharmacy program and passed the national licensing exam. Once licensed, a pharmacist can complete additional training to become certified in nonmedical prescribing.
Which universities provide accredited nonmedical prescribing courses
The General Pharmaceutical Council (GPHC) is the governing body that regulates pharmacist nonmedical prescribing. There are many universities that offer accredited courses in nonmedical prescribing.
Check out the list of accredited universities that offer nonmedical prescribing courses.
- University of Manchester
- King’s College London
- Queen’s University Belfast
- Cardiff University
- University of Nottingham
For more Information about the GPHC and nonmedical prescribing, visit their website.
The Nonmedical prescribing application form
Before you consider applying to university, you must ensure; that (1) you meet the General Pharmaceutical Criteria; and (2) have access to a designated prescribing practitioner. I shall discuss these in more depth in future articles.
Most application forms are divided into the following sections; (1) personal, professional and academic qualifications; (2) personal statement; (3) suitability to apply for the course.
Let us explore each section in depth.
GPHC nonmedical prescribing criteria
GPHC prescribing course criteria are: that all participants be registered pharmacists with at least two years post-registration experience, that the course is delivered by experienced and accredited educators, and that the syllabus covers all key areas of safe and effective prescribing that the assessment is rigorous and includes a practical component.
The GPHC criteria to undertake the qualification can be found on their website. And universities seem to be requiring evidence for is; demonstrating you have clinical or therapeutic experience in which to develop your prescribing practice.
Before we discuss how to address the above requirement, you must understand the following; the independent prescribing course is not designed to teach you clinical skills. Moreover, it is designed for students who have experience in assessing, diagnosing and treating patients.
At this point, you may be wondering how to demonstrate this. Well, evidence could include; (1) evidence of training in your defined scope of practice; (2) a diploma in pharmacy practice or equivalent within your scope; (3) evidence of training in history taking and physical examination skills; (4) attendance of continued education events linked to your scope; (5) submission of CPD or re-validation records linked to your intended scope; lastly (6) you may be required to attend an interview with a member of the admission team.
If you are still unsure at this point to demonstrate the above criteria, then try answering the following questions; (1) What is your scope of practice?- in-depth Information is provided below.
To summarise, ensure your scope of practice is well defined. For example, the following scope of practice would be too broad; treating hypertension. Instead, the following would be more appropriate; hypertension stages 1 & 2 in 30-60 years old with no signs of end-organ damage. (2) What experience do you have in your intended scope of practice?- taking the example of hypertension- you could mention the following; undertaking blood pressure checks, assistance with treatment choices and recommendations to the doctor and offering health and lifestyle advice to patients.
Nonmedical prescribing scope of practice
Choose an area that you are passionate about and develop your skills in this area before you attempt to gain your prescribing qualification.
For example, you may want to develop your skills in diagnosing and treating a single minor illness such as tonsillitis or acne if you are in a community pharmacy. Similarly, in a G.P. practice, you may decide on developing your skills in the diagnosis and management of a single chronic disease such as hypertension or asthma.
However, there is a caveat: you need to have sufficient experience – I’ll discuss in more depth below – within your scope of practice before undertaking your prescribing qualification.
Developing sufficient experience and continued professional development for undertaking the nonmedical prescribing course
Right. Pay attention now because this is important.
Let’s say you are a community pharmacist and you have a passion for helping people reduce their risk of a stroke and so decide to embark on a journey to diagnose and treat hypertension.
Well, the first step will be to develop your theoretical skills regarding the condition itself. This involves you having an in-depth understanding of the disease state, ie. Its causes, diagnosis, and management. Once you have this underpinning knowledge, you need to practice managing these patients in a safe environment.
And finally, once you have been exposed to many patients and feel comfortable managing these patients, albeit under the supervision of an experienced colleague, you are ready to undertake your prescribing qualification.
Selecting your scope of practice
I am hoping from the above, you have realized that selecting your scope of practise isn’t necessarily as simple as following your passion. You will need to consider the following; (1) do you have the underlying theoretical knowledge about the disease state? If not, are you willing to learn?; (2) are there clear guidelines that can help support you as you develop your skills? ; (3) do you have access to patients to whom you can apply your knowledge under the supervision of an experienced colleague?
If you think about it, the above is no different from when we as pharmacists undertook our pre-registration training, and that is; (1) you gained the theoretical skills at university and (2) you applied them under supervision during your pre-reg year.
The similarity exists because that is how you learn. Remember how you gained your driving license? The theory first and then practise under supervision and then exam. It’s no different here.
Factors to consider
Initially, I would suggest you begin to develop your skills and gain experience in areas that meet the following; (1) you’re passionate about that particular area; (2) there are clear, well-defined guidelines to support your decision-making and practice ; (3) you have access to patients and a mentor to support you and ; (4) there a demand for it.
Examples of well-defined scope of practice
Hypertension stages 1, 2, and 3 with no comorbidities. Notice how the scope of practice is narrow, and there are clear guidelines.
An example of a broad scope of practice would simply be stating you were comfortable managing all types of hypertension, including but not limited to patients with evidence of end-organ damage or those who have other pre-existing conditions such as diabetes.
What about asthma? Can you think of defining a narrow scope of practice? If you think about classifying asthma as mild, moderate, or severe, then you are on the right track. But what about a patient who has mild asthma but presents with symptoms of an exacerbation? Do you have the skills to treat this? It might be that you define your scope of practice as mild to moderate well-controlled asthma with no signs of an exacerbation?
Scope of practice and your I.P. course
I wanted to include this section because your scope of practice is not one that can not be expanded as you learn and gain experience.
For example, you may start out by mastering – if such a thing is possible – mild to moderate well-controlled asthma, and during your prescribing course, stick to this area.
But, as you gain more experience and become confident, you may decide to expand your scope of practice to include the management of acute exacerbations, or you may even start to develop your skills in a different area, such as the management of hypertension – again, make sure it’s narrow and then expand – or minor illnesses, etc.
A well-defined scope of practice is not just to satisfy a university but is intended to keep you safe and assist you in developing your skills in an environment that is also safe for patients.
Designated prescribing practitioner details
The following details are usually required regarding the designated prescribing practitioner.
- Full name
- GMC or professional body registration number
- Copy of CV
- Evidence of having experience in teaching and providing education to other healthcare professionals
- Scope of practice
- A confirmatory experience that the DMP/DPP is able to provide ninety hours’ worth of training and supervision
Your background, qualifications and continued professional development
This section isn’t too difficult. However, some universities require a brief description of your current role- and this is where you may slip up. I’d recommend you focus on the patient-facing aspects of your role and how you engage as part of a multidisciplinary, i.e. (1) explain how you assist patients with their minor ailments, such as diagnosing and treating their conditions or referral to an appropriate clinician; and (2) mention the services you currently offer to patients such as vaccinations, blood pressure testing, aesthetic treatments etc.
Remember, the university wants to establish more than just your general experience as a pharmacist. Although it is recommended that you provide an overview of your current role (e.g. managing staff, responsible for the Pharmacy, recruiting staff etc.) – but do not forget to explain how you manage and diagnose diseases of your patients. This is because the university expects upon gaining your qualification, it will be used within a patient-facing role.
Supporting organization
Fairly straightforward. However, it may not be applicable to all applicants- please do check with the university. Here your place of work – usually the line manager- would need to; (1) provide a written reference in support of your application- the exact wording to be used is usually provided by the application and (2) verify your suitability to undertake the course- again this is a deceleration.
Personal statement
This section can vary depending on the university you apply to. The following question is commonly asked; (1) why do you want to undertake the course? – talk about your personal development and career progression but also how the role of the pharmacist is evolving and thus gaining the qualification is in line with the agenda of the NHS ; (2) how do you plan to use your prescribing qualification? Your response will vary depending on your place of work, e.g. within a community pharmacy; you may consider offering more advanced services like a minor illness clinic, aesthetics clinic, or prescribing for patients referred by the doctor. In contrast, within the general practice, you could use your prescribing qualification to diagnose, manage and treat disease – thus, relieving pressures on the G.P.
Nonmedical prescribing personal statement examples
Joining Pharmacy was an important milestone, and, as a person with a sense of respect & love for human life, I embraced the field of Pharmacy. I am passionate about Pharmacy and am encouraged by the direction pharmacy as a profession is heading.
Pharmacy has dramatically evolved over the last three decades from a predominantly product focus to a patient-orientated profession. With the advent of Pharmacy prescribing, community pharmacy will become the most influential sector of the pharmacy profession.
With current and future shortfall in G.P. and nurse numbers, pharmacists who develop their prescribing practice are ideally placed to support their fellow professionals and improve the quality of care for patients.
I feel as medication experts; pharmacist independent prescribing can be a vital source of clinical care. Below are examples of the benefit to patients and the NHS:
- Pharmacist Independent prescribing can provide personalized, timely, flexible access to treatment for patients requiring urgent or critical care, rather than delayed treatment or referral to other services.
- Independent prescribers can optimize the management of long-term conditions rather than waiting for treatment adjustments required from the G.P., i.e. pharmacist-led hypertension clinic.
- Independent prescribers can prescribe timely, effective treatments for patients with special health needs without requiring a separate appointment with the doctor, with the associated potential delay.
As an independent prescriber, I believe It could contribute hugely to the care of patients and support the medicine’s optimization agenda, thus supporting adherence and improvement in health outcomes.
I would like to develop my prescribing skill in the screening and management of uncomplicated hypertension stages 1,2 and 3 in adults aged between 40-79 because; hypertension is a major cause of
mortality in the U.K. and diseases caused by high blood pressure cost the NHS over £ 2 billion every year.
Successful hypertension management depends on good patient education, rational prescribing of antihypertensive medicines and sufficient fo low-up to assess the efficacy of the chosen regimen and address patient adherence issues. As such, this is an ideal opportunity for input from an independent pharmacist prescriber. Furthermore, by contributing and working towards reducing the blood pressure of the nation as a whole, £850 million of NHS and social ca spend could be avoided over ten years.
I am already accredited to undertake Medicine Use reviews, New medication reviews and trained to vaccinate. Independent prescribing is the next stage which will further my career and allow me to develop my diagnosis, clinical and communication s
I would prefer to join your school on account of its excellent research facilities combined with distinguished and dedicated faculty. My admission into your esteemed institution is of paramount importance for my career. With my theoretic knowledge and practical skills coupled with my dedication and sincerity, I am well equipped to meet your expectations. I am confident that if admitted, I would surely satisfy your expectations.
I would eagerly look forward to being amongst your distinguished academic community. I take this opportunity to thank the university faculty for the patient perusal of my application.
Evidence of relevant ‘patient-oriented practice’ for pharmacist independent prescribing and nonmedical prescribing professionals
With the pharmacy profession being the third-largest professional group in the NHS, the pharmacy profession plays a significant and unique role in the healthcare of patients by delivering patient-centred care. It is clear that Pharmacy makes an important contribution to improving public health and reducing health inequalities.
My role as a pharmacist at Ahmeys pharmacy involves the provision of patient-centred professional services. Below are examples of pharmacy-based healthcare services/clinics provided at Ahmeys pharmacy, for which I am responsible.
1. Consultations on healthy lifestyle advice: services offered include;
- Ahmeys pharmacy stop smoking clinic: A private service offered throughout the week with advance bookings of clients. The clinic offers a one-to-one support service and Advice for those who want to give up smoking and, where appropriate, initiate drug therapy via PGS *Champix etc.) or nicotine replacement therapy. As part of continued professional development, all pharmacists are given training on “behavioural change methods”, as studies show pharmacists who are not given training are more likely to just respond to smokers’ requests for Advice without proactively initiating conversations about smoking.
- Healthy eating, obesity advice and weight reduction programmes: A weight reduction programme has been set up at the Pharmacy (i.e. lipotrim) and offered to those patients who want to lose weight and to those who may benefit from weight loss. As part of the service, patients are given Advice on ;
- Health eating; Increase daily fruit, oily fish and vegetable consumption. In addition, a reduction in the proportion of total fat and salt intake is also advised.
- Increased physical activity and
- Reduction (where appropriate) in alcohol consumption.
- Screening services an example of a service offered at the Pharmacy which is directly relevant to my scope of intended prescribing (hypertension) is Ahmeys pharmacy “Healthy heart Clinic”;
- This clinic involves the screening and management of secondary prevention of Coronary Heart Disease (CHD). Studies show individuals with symptoms of coronary heart disease, stroke, transient ischaemic attack (TIA), peripheral vascular disease (PVD), or multiple risk factors for heart disease are typically three to five times more likely to die, suffer a heart attack or other major vascular event, than people without such conditions and risk factors. The clinic was set up in line with the vision of the NHS on medicine optimization and the effectiveness of a pharmacist’s role in public health. The result of studies shows simple treatments and important lifestyle changes can reduce people’s risks substantially and perhaps even reverse the progression of coronary heart disease. Furthermore, when used appropriately, these interventions can be more cost-effective than any other treatments s currently provided by the NHS.
Clients are identified as at risk of developing CHD by reviewing patient medical records or during medication use reviews and invited to the clinic. At the clinic, a holistic approach to the management of CHD is adopted, which includes:
- Development of pharmaceutical care plans in partnership with the patient;
- The pharmaceutical care plans identify medication needs and patient goals for their desired outcomes. Furthermore, treatment details of treatment for minor health problems are also recorded in the care plans. At Ahmeys pharmacy, a patient-centred approach is used, which has a significant impact on patient care by increasing patient safety and patient experience.
- Stop smoking advice
- Information about other modifiable risk factors and personalized Advice about how they can be reduced, i.e. Advice on physical activity, diet, alcohol consumption, weight and diabetes.
- Advice and treatment to maintain blood pressure below 140/85 mm hg, which include;
- Daily low-dose aspirin (75mgs)
- Statins and dietary Advice to lower serum, i.e. reduce saturated fat intake, increase monounsaturated fat intake and total intake of fruits and vegetables while monitoring simple carbohydrate intake.
- Evidence-based prescribing (Medication review ) to the following ensure;
- Patients with left ventricular dysfunction are prescribed an Ace inhibitor
- Patients who also have myocardial infarction are prescribed a beta-blocker
- Warfarin, aspirin or other new agents (i.e. Apixaban etc.) for people over 60 years old who also have atrial fibrillation and meticulous control of blood pressure and glucose in patients with diabetes.
Description of ongoing continued professional Development for personal statement
All registered pharmacists have a professional obligation to maintain a record of their continued professional development (CPD) and are liable to be responsible for their actions and accountability for keeping their skills and knowledge up to date to fulfil their professional role.
The reflection part of the continued professional development cycle involves identifying learning needs through various methods, which include but are not limited to appraisals, critical incidents, review of experiences, feedback from others, reading publications, attending workshops, and completing a personal development plan to help identify carer goals etc.
Below is an example of how I have made use of critical thinking to reflect on my own performance;
I had been invited to attend a meeting with the local G.P. practice, which identified they were lacking in meeting their hypertension QOF targets. Upon discussion and critical thinking, it was identified that by developing a pharmacy-led “healthy heart clinic” with a focus on hypertension, improvements could be made to patient health outcomes and, therefore, the surgery QOF targets. Furthermore, it was explained to the local practice this initiative is in line with the government’s agenda of medicine optimization and pharmacist playing a greater role in the health of patients.
As a result of the meeting, I suggested the development of a pharmacy-led hypertension clinic. The idea was greeted with a mixed response from those in favour of and those against the development of the clinic.
As part of the development of the clinic, I identified a set of learning outcomes and objectives to form part of my learning and professional development to ensure a safe and patient-orientated service was to be offered by the Pharmacy in line with clinical governance.
Below is a summary of the learning needs which would need to be undertaken :
- I must be able to define hypertension and how it is diagnosed.
- I must be able to differentiate primary hypertension from secondary hypertension.
- I must understand the rationale for treating hypertension and recommended B.P. goals.
- I should feel confident in recommending lifestyle modifications to patients.
- I must have updated to-date clinical knowledge with regards to the management and prevention of secondary coronary heart disease with a focus on hypertension.
- I should be able to recognize hypertensive urgency and emergency and refer as appropriate.
- I should be aware of regulations surrounding patient consent and CQC registration.
- Requirements for audit
As a result of my learning, I was able to update my knowledge and develop the clinic. An audit was carried out to see the effectiveness of the clinic and its impact on patient health outcomes. The results were positive and shared with colleagues and the local practice. Upon further reflection, it was identified there could be a case for the development of nonmedical prescribing within this scope of practice which would further improve patient health outcomes, reduce the burden of G.P.s and improve patient accessibility.
By reflecting on my own performance providing patient-orientated services, I was able to learn as a product of the situation I have found myself and in doing so, I was able to create new knowledge, enhance my skills and challenge established beliefs and attitudes.
Development of your prescribing network
Networking involves the process of making meaningful connections and building mutually beneficial relationships, which is crucial for future success. The benefits of networking include acquiring career information, Advice, and other opportunities. In addition, regular networking can increase confidence, encourage reflection on practice, gather feedback from others, review what others are putting into practice etc.
Below are a few examples of strategies I would adopt to network including but are not limited to;
1. Social media I.e Linkden. This source of networking allows one to connect with peers, colleagues and other individuals with similar clinical backgrounds or future interests.
2. Attending pharmacy conferences and relevant training courses. This source of networking would encourage regular updates of my knowledge and allow networking with other health professionals (i.e. non, medical prescribes). This, allow opportunities to review what other prescribers are putting into practice, gather feedback in order to disseminate to other colleagues and an opportunity to share good practice
Setting up plans to meet with other healthcare professionals at local forums with similar clinical backgrounds and work. This form of networking would allow peer review of prescribing decisions and the sharing of good practices, especially for policy and protocol development.
Nonmedical prescribing course reference example
To whom it may concern Applicant: XXXXXXX Student ID number: XXXXXXX Courses applied for include: PGCert Supplementary Prescribing for Allied Health Professionals (part-time modular) I have only known XXXX for a few short months whilst she undertook a series of clinical webinars for which I was the lecturer. I can confirm from our conversations and interactions that she is extremely driven and has the capacity to undertake the non-medical prescribing course. XXXX is a pharmacist managing a team that delivers services to a wide range of patients. I have no doubt about her ability to utilize her prescribing qualifications to benefit patients in community pharmacy. Faheem Ahmed Independent pharmacist prescriber Senior lecturer MEDLRN Contact Details Mobile No. 07497 619433 Email: faheem@medlrn.co.uk
