NMPs in Substance Misuse Services – An increasingly visible force

Posted by guest blogger Rosie Mundt-Leach, Head of Nursing for Addictions South London and Maudsley NHS and Membership Secretary, National Substance Misuse Non-Medical Prescribing Forum (NSMNMPF)

Non-Medical Prescribers (NMPs) have become an increasingly visible force within the substance misuse treatment staff mix. Although the majority of NMPs are nurses, there are also a significant number of specialist pharmacists who have taken on the prescribing role. Until 2012 NMPs were subject to legal restrictions in their practice and were only able to continue prescribing controlled drugs for the treatment of substance misuse and could not initiate new treatment programmes. The law changed in 2012 and now (with the exception of highly specialised treatments such as diamorphine) NMPs can play a full role in prescribing treatments across all addiction care pathways.

The commercial diversification of the substance misuse sector has enabled NMPs to find roles in every type of provider organisation. The Forum has members employed in the NHS, third sector, community interest companies and the independent sector. NMPs are working in community pharmacies, acute hospital liaison, prisons, community drug and alcohol teams, in-patient detox/rehab and primary care.

The widening of the scope of the NMP role has contributed to the increasing popularity of Non-medical prescribing, but arguably the main factor driving the growth of numbers is the relatively lower cost of employing NMPs compared to doctors.

Public Health England guidelines – Non-medical prescribing in the management of substance misuse – looks at the practicalities of having NMPs working in services and some of the strategic issues that commissioners and managers need to consider when training or employing NMPs:

http://www.nta.nhs.uk/uploads/nmp-in-the-management-of-substance-misuse.pdf

In my role as Head of Nursing for South London and Maudsley NHS Addictions services, I see the benefit of having NMPs every day. We have NMPs in our shared care services and CDATs and they are able to provide a comprehensive treatment programme for patients at all stages of treatment. We now encourage as many eligible staff as possible to undertake the training and find that those who do, increase in their confidence and enjoy the additional responsibility. The services definitely benefit from having an increased flexibility in staffing structures. They certainly haven’t replaced doctors but the increased prescribing workforce means we are able to target resources where they are most needed to meet the needs of people in treatment.

Qualified and trainee NMPs have a free forum for professional education and support, namely the National Substance Misuse Non-Medical Prescribing Forum, which has its own website:

http://www.nmpsm.org/

There are members in England, Scotland, Wales and Northern Ireland and associates in Eire.

– Rosie Mundt-Leach, NSMNMPF Membership Secretary