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Contributor list ix Acknowledgements xi Introduction xiii Dilyse Nuttall and Jane Rutt–Howard 1 Prescribing in Context 1 The prescribing journey 1 Defining non–medical prescribing 2 The non–medical prescribing vision 3 Changes in clinical practice 6 The economic context 8 The private sector 9 The public health context 10 Need and expectations 11 Differentiating between prescribers 12 Nurse non–medical prescribers 21 Pharmacist non–medical prescribers 25 Allied health professional non–medical prescribers 26 Access to education programmes 30 Summary of the context of prescribing 31 References 33 2 Professional, Legal and Ethical Issues in Relation to Prescribing Practice 37 PART 1: PROFESSIONAL ISSUES 38 The regulatory framework for prescribing 38 PART 2: LEGAL ISSUES 49 The UK legal system 49 Legal aspects of autonomy and gaining consent 61 The importance of consent 66 PART 3: ETHICAL ISSUES 84 Consequentialism 85 Deontology 85 Virtue ethics 85 Doctrine of double effect 88 Conclusion 90 Table of cases 90 References 91 Acts 94 3 Factors Influencing Prescribing 95 The prescriber 95 The patient 103 The product 110 Other professionals 117 References 119 4 Effective Consultation and ‘the Consultation Umbrella’ 123 Jane Rutt–Howard Presenting the consultation umbrella 124 Consultation models in context 125 The value of therapeutic communication 129 The consultation umbrella – explained 137 Clinical decision–making 151 Conclusion 158 References 159 5 Essential Pharmacology, Therapeutics and Medicines Management for Non–medical Prescribers 162 Anne Fittock, Jane Alder, Alison Astles, David Kelly, Joseph Quinn and Samir Vohra Pharmacology as part of prescribing practice 163 Brief introduction to pharmacological terms 164 Guide through processes to build and develop one’s own formulary, with examples 175 BNF: practise using this essential resource 180 Prescribing in co–morbidity 181 Management and avoidance of drug interactions 183 Management and avoidance of adverse medicine reactions 185 Drugs with a narrow therapeutic index or range 190 Medicines management 193 Other resources to support your learning 194 References 195 6 The Multidisciplinary Prescribing Team 198  Defining ‘the multidisciplinary prescribing team’ 198 The benefits to prescribing 200 Understanding roles 204 Non–medical prescribing lead 210 The multidisciplinary non–medical prescribing team 211 Commissioning and the MDPT 214 Education and learning 216 Conclusion 217 References 219 7 Clinical Skills 222 Vital signs 223 Conscious level 223 Respirations 225 Temperature 227 Pulse 229 Blood pressure 230 Additional vital signs 232 Clinical examination 234 Examination of body systems 236 Numeracy skills 254 Conclusion 257 References 259 8 Prescribing for Specific Groups 261 Prescribing in liver disease 261 Prescribing in renal disease 267 Prescribing in pregnancy 272 Prescribing for older people 279 Prescribing for children and young people 283 Other groups 291 References 295 9 Enhancing Non–medical Prescribing 298 Current practice in prescribing 298 UK history of prescribing 299 Non–medical prescribing in other countries 302 The impact of prescribing 302 Issues emerging from the introduction of non–medical prescribing 305 Medicines management 320 Conclusion 321 References 322 Patient Case Studies 327 Case study 1: Harold 327 Case study 2: Barbara 328 Case study 3: Clare 328 Case study 4: Julie 329 Case study 5: Annette 329 Case study 6: Yasmin 329 Case study 7: Amy 330 Case study 8: Louis 330 Case study 9: Callum (with CMP) 330 Health Professional Case Studies 332 Case study A: Debbie 332 Case study B: Mark 333 Case study C: Rebecca 333 Case study D: Gail 334 Case study E: David 334 Case study F: Andrew 335 Case study G: Andrea 336 Case study H: Lisa 336 Case study I: Christine 336 Case study J: Simon and Janice 336 Index 337