Facilitators | Barriers | |
---|---|---|
Justifying need (n = 14) | ❖ Trust strategy & commitment to promote and fund NMP ❖ Expectations of course and intended NMP role are discussed with interested candidates and their DMPs. Having a defined set of patients/conditions e.g. role as specialist nurse | ❖ Lack of strategic approach in organisations ❖ Lack of support from managers & clinicians ❖ Overly restrictive trust strategy to expanding the number of NMPs ❖ Lack of vision and/or evidence of benefits of commissioning services in new and developing areas e.g. community based pharmacists |
Finding a practice supervisor (n = 18) | ❖ Having an established relationship with potential DMP ❖ NMP lead support for inexperienced DMPs ❖ DMPs who have already been a mentor and have positive experience of NMP | ❖ Lack of support when developing NMP in new areas of practice ❖ Lack of financial incentive to act as DMP ❖ NMP candidates who have to find and secure DMP support in different setting to their usual area of practice, e.g. those working across a number of GP practices |
Preparation for prescribing role (n = 23) | ❖ Systematic and structured approach to selecting students for NMP training, e.g. use of national criteria ❖ Trusts who provide additional training to ensure students have pre-requisites for NMP training e.g. numeracy training, assessment and diagnostic training, mental health pharmacology module ❖ Students are prepared for the prescribing programme with respect to course content & amount of learning that is required ❖ Having a well defined prescribing role that is agreed between NMP and their manager | ❖ Inconsistent approach to selection process ❖ Lack of awareness (amongst candidates and managers) of NMP course academic content and requirement ❖ Inappropriate expectations (amongst candidates, manager or clinicians) with respect to remuneration and how prescribing qualification will be used in practice ❖ Relevance of NMP programme to non-community based nurses ❖ Inconsistent methods of academic assessment of NMP between different education providers |
Confidence & ongoing support (n = 19) | ❖ Trust provision of NMP support groups, meetings and networks ❖ NMPs receive support (from NMP lead, DMP or Peers) during initial implementation and role transition ❖ NMPs receive ongoing support from other NMPs and their own clinical team (including clinical supervision) ❖ Supplementary prescribing used as means to build confidence | ❖ A lack of support approach within trust ❖ Lack of understanding about, and access to appropriate CPD for prescribing role ❖ Providing support for community & mental health based NMPs ❖ A lack of confidence to negotiate prescribing responsibility within mental health settings or problems defining individual scope of practice ❖ Restrictions imposed by enforced use of supplementary prescribing |
Practicalities & legalities (n = 11) | ❖ Procedures for registering and governing NMP up-and-running in organisation | ❖ Confidence reduced by the time lag between course completion, registration with professional body as NMP, and implementation of role ❖ Implementing NMP across range of providers in primary & secondary care |