The Cumberlege Report (1986) or Neighbourhood nursing: a focus for care was the report of a
Department of Health and Social Security (DHSS) committee advocating that community nurses in the
United Kingdom
The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the European mainland, continental mainland. It comprises England, Scotlan ...
be permitted to prescribe from a restricted list of treatments.
Context
A committee was created in 1985 by the DHSS to review the care provided by nurses and health visitors outside hospitals and report on how resources could be used more effectively.
The committee focussed on
primary care
Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care ...
nursing.
Welsh and Scottish reviews also took place, on different timelines.
was appointed chair.
Report
The Cumberlege Report was published in 1986. The Report stated that patient care would be improved and resources used more effectively if nurses were able to prescribe items from a limited list.
The Report also recommended that a neighbourhood nursing service be established, with eventual removal of differences between distruct nurses, health visitors and school nurses.
It suggested a "
nurse practitioner
A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe ...
" role be created to designate more highly skilled nurses with prescribing powers and also that
general practice
General practice is the name given in various nations, such as the United Kingdom, India, Australia, New Zealand and South Africa to the services provided by general practitioners. In some nations, such as the US, similar services may be describe ...
s should not be subsidised to employ practice nurses.
Impact
The Cumberlege Report recommendations were included in ''Promoting Better Health'', a 1987
white paper
A white paper is a report or guide that informs readers concisely about a complex issue and presents the issuing body's philosophy on the matter. It is meant to help readers understand an issue, solve a problem, or make a decision. A white pape ...
.
A
Whitley Council Whitley may refer to:
Places
;United Kingdom
*Whitley, Berkshire, a suburb of Reading
*Whitley, Cheshire, a village near Warrington
* Whitley, Coventry, a suburb of Coventry, West Midlands
*Whitley, Essex, near Birdbrook
* Whitley, Wigan, Greater ...
was told to review nurse pay.
In 1989, the Department of Health created a committee with
Dr June Crown as chair, to examine nurse prescribing.
It issued the ''Report of the advisory group on nurse prescribing (Crown Report)'', which recommended which items nurses might prescribe and the circumstances in which they might prescribe them. The report stated that doctors often merely signed-off nurse prescribing decisions and that 'There is wide agreement that action is now needed to align prescribing powers with professional responsibility.'
The Crown Report noted that patients particularly likely to benefit from changes were those with a
catheter
In medicine, a catheter (/ˈkæθətər/) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgi ...
or
stoma, those with
postoperative wounds, and
homeless people
Homelessness or houselessness – also known as a state of being unhoused or unsheltered – is the condition of lacking stable, safe, and adequate housing. People can be categorized as homeless if they are:
* living on the streets, also kn ...
not registered with a
general practitioner.
In 1992, the ''Medicinal Products; Prescriptions by Nurses etc Act'' was enacted.
A trial of community nurse prescribing took place and then the Secretary of State gave
district nurse
District Nurses work manage care within the community and lead teams of community nurses and support workers. The role requires registered nurses to take a NMC approved specialist practitioner course. Duties generally include visiting house-bound ...
s and
health visitors prescribing powers from a Nuse Prescriber's
Formulary in 1998.
By the 2010s, there were approximately 54,000 nurse and midwife prescribers in the UK.
In 1997, Crown again headed a review into prescribing and in 1999 recommended an extension to prescribing. The ''Review of Prescribing, Supply and Administration of Medicines (Crown II Report)'' led to nurses being able to prescribe from the Formulary, plus licensed pharmacy and general sales list medicines, and some prescription-only medicines, under a "dependent prescribing" or "supplementary prescribing" framework.
In 2001, supplementary prescribing was extended to pharmacists and some other health professionals.
From 2006, the Extended Formulary was eliminated and those who had permission to prescribe from it were able to independently prescribe any licensed medicine except
controlled drugs
The prohibition of drugs through sumptuary law, sumptuary legislation or religious law is a common means of attempting to prevent the Recreational drug use, recreational use of certain intoxicating substances.
While some drugs are illegal to p ...
.
See also
*
Medicines Act 1968
The Medicines Act 1968 is an Act of Parliament of the United Kingdom, more properly: An Act to make new provision with respect to medicinal products and related matters, and for purposes connected therewith. It governs the control of medicines for ...
*
Briggs Report 1972
*
Salmon Report 1966
*
Platt Report 1964
References
{{reflist
Nursing in the United Kingdom
1986 documents
1986 in the United Kingdom
Welfare in the United Kingdom