Media Factsheet on National Collaborative Prescribing Programme

1. In March 2018, the Ministry of Health (MOH) announced that senior pharmacists and APNs will be upskilled to legally prescribe medicines to patients and order tests in a collaborative framework overseen by doctors.

2. Collaborative Prescribing is part of MOH’s efforts to transform care in the community and hospitals, by providing holistic service and better continuity through team-based care. Collaborative Prescribing is intended to better integrate care and provide a seamless experience for a patient’s journey, within a team-based model. This could potentially reduce or even prevent delays in treatment and management of disease conditions, and ultimately improve patient outcomes. It will also empower senior pharmacists and APNs to perform more advanced roles and increase workforce productivity.

3. Experienced and qualified APNs and pharmacists will be able to prescribe without the need to obtain a doctor’s countersignature. To ensure prescribing services rendered by the nurses and pharmacists are safe and effective, MOH has put in place two levels of safeguards.

  1. Only APNs and senior pharmacists who have completed the National Collaborative Prescribing Programme will qualify to prescribe.
  2. Healthcare institutions offering CP services are required to set up a Credentialing Committee and a Service Review Committee. The former will verify and approve the participating nurses, pharmacists and their CP services, while the latter will monitor, audit and review these prescribing services to ensure that quality and safety are upheld.

 

National Collaborative Prescribing Programme

4. The National Collaborative Prescribing Programme is a three-month programme, organised by National University of Singapore (NUS). It is conducted twice a year, one starting in February/March and the other starting in August. The next cohort of the programme will start on 14 August 2018.

5. The National Collaborative Prescribing Programme enrolled its inaugural cohort of 38 trainees in March this year. All 38 trainees have successfully completed and graduated from the Programme and have been certified as Collaborative Prescribing Practitioners on 2 July 2018. This group comprised 19 pharmacists and 19 advanced practice nurses (APNs) from the National Healthcare Group, National University Health System and SingHealth.

About the Collaborative Prescribing Practice Model

6. Collaborative prescribing aims to assist and facilitate care transformation in the community and hospitals, by providing a more holistic service with improved continuity for team-based care. The collaborative prescribing practitioner (CPP) is a member of a multidisciplinary clinical team led by a medical practitioner, and his/her scope of practice is a set of services performed as part of a team.

Programme Content

7. The National Collaborative Prescribing Programme is co-hosted by NUS Alice Lee Centre for Nursing Studies and NUS Department of Pharmacy. Collaborative prescribing involves assessing the patient, considering treatment options, reaching a shared decision, prescribing, providing patient education, monitoring and reviewing of the patient. Through this programme, the individual will acquire skills and competencies in history taking, data interpretation, diagnostic formulation, physical examination, clinical decision-making, applied therapeutics, psychosocial aspects of prescribing, collaboration with multidisciplinary team, effective communication and documentation. The programme provides opportunity for nurses and pharmacists to learn together, exchange best practices and create a network for future collaboration.

8. The programme builds on the existing body of competencies of senior pharmacists and experienced APNs. The core components comprise of areas involving safe and professional prescribing, as well as improving prescribing practice and prescribing as part of a team. The core competencies required include inter-professional collaboration, understanding prescribing systems, and professional and ethical considerations of prescribing. Based on differences in baseline skillsets of APNs and pharmacists, a portion of the curriculum is conducted separately to strengthen areas requiring further skills development in the two professions to perform collaborative prescribing.

Programme Structure

9. The programme is conducted over 13 weeks, with one full day a week in teaching session over 9 weeks, and an additional 80 hours of clinical practicum.

    1. Teaching Sessions

      Teaching methods include lectures, case-based discussions, clinical stimulations, role-play, hands-on practice, problem/team based learning, as well as self-directed and e-learning.

    2. Clinical Practicum

      An existing or potential collaborative prescribing practice with a clinical supervisor is required for the programme. The clinical supervisor (together with his/her team) will oversee the clinical practicum to ensure opportunities for hands-on practice and the individual’s competency to practice independently as a CPP.

      The clinical practicum would involve the following breakdown of hours:

      • 30 hours direct supervision
        • 12 hours with named clinical supervisor
        • 18 hours with Senior Resident and above
      • 10 hours indirect supervision by above
      • 30 hours direct supervision by peers i.e. Resident/Medical Officer, APN or pharmacist
      • 10 hours indirect supervision by peers
    3. Assessment

      For successful completion of the CP Programme, the candidate must have achieved a minimum of 75% attendance score, and successfully completed the following assessments:

      • Portfolio reviews (which includes scope of practice, personal drug formulary, personal development plan, drug monograph and clinical application of drug use, learning log, clinical / prescribing logs, Mini-CEX, and case based discussions);
      • Oral presentations;
      • In-class quiz;
      • A final written examination; and
      • A formative and a summative Objective Structured Clinical Examination

Criteria for Admission

10. The entry criteria for the National Collaborative Prescribing Programme are as follows:

      • Advanced Practice Nurses (APNs):
        • Candidates must be at least 1-year post-APN certification and working in current scope of practice for at least 1 year;
        • Candidates must be working in an area with existing or potential need for Collaborative Prescribing service;
        • Candidates must have identified a clinical supervisor who, together with his/her team, will provide supervision to the candidate during the clinical practicum; and
        • Candidates must have met the minimum pass mark in the numeracy test conducted prior to entry of the programme.
      • Pharmacists:
        • Candidates must be at least 3-year post-pharmacist registration with experience in direct patient care setting and working in multidisciplinary / team-based practice for at least 1 year;
        • Candidates must be working in an area with existing potential need for Collaborative Prescribing service;
        • Candidates must have identified a clinical supervisor who, together with his/her team, will provide supervision to the candidate during the clinical practicum; and
        • Candidates must have met the minimum pass mark in the numeracy test conducted prior to entry of the programme.

 

More details on the National Collaborative Prescribing Programme can be found here: http://pharmacy.nus.edu.sg/national-collaborative-prescribing/

 

 

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