Nurse prescribing:
a case for clinical
Mark Jukes, Jeannette Millard, Cheryl Chessum
he whole fabric and structure of the NHS,
nursing and primary health care is currently
undergoing rapid change. Recent years have
seen many developments in health policy, in particular regarding arrangements for the delivery of primary health care (Box 1). As part of these changes,
several key policy documents from the Department
of Health (DH) have suggested that nurses’ skills
and experience should be developed to enable them
to deliver high-quality care in areas that are designated priority clinical targets, or are currently within the professional domain of doctors (DH, 1999a;
Since April 2002, level 1 nurses have been given
the opportunity, following a period of additional
training, to become independent nurse prescribers,
enabling them to prescribe from a wide range of
drugs. New prescribing rights for nurses, sanctioned
in April 2003 – specifically the expansion of the
extended independent nurse prescribers’ formulary
and the implementation of supplementary prescribing – aim further to revolutionize many aspects of
health care.
Making a Difference (DH, 1999b) predicted that
23 500 nurses and health visitors would be able to
prescribe within a few years, and one of the recommendations made by the NHS Plan (DH, 2000a) is
that the majority of nurses should either be prescribing by 2004, or should be supplying and


Box 1. Contextual changes
G Introduction of NHS Direct and Walkin centres,one-stop health shops.
G The abolition of traditional health
authorities which have been
replaced by strategic health authorities.
G The introduction of primary care
trusts that will have responsibility
for commissioning all NHS services.
G The introduction of care trusts that
will act as the single provider for
health and social care.

British Journal of Community Nursing, 2004, Vol 9, No 7