Status: National Occupational Standards (NOS)
This unit is about prescribing controlled drugs - e.g. methadone, other opiates or other controlled drugs - to substance users as part of their treatment plan. It covers both reduction and maintenance prescribing.
There is one element:
AH1.1 Prescribe controlled drugs for substance users
This unit is for medical practitioners who are qualified and competent to prescribe controlled drugs for substance misusers.
Users of this competence will need to ensure that practice reflects up to date information and policies.
This workforce competence has indicative links with the following dimension and level within the NHS Knowledge and Skills Framework (October 2004):
HWB7: Interventions and treatments
Level 3: Plan, deliver and evaluate interventions and/or treatments
This section provides explanations and definitions of the terms used in this workforce competence. In competences, it is quite common to find words or phrases used which you will be familiar with, but which, in the detail of the competence, may be used in a very particular way.
This section provides guidance on possible areas to be covered in this competence.
This competence contains no scope.
You must ensure that:
1. you keep prescription forms in a safe place and maintain an audit trail of prescriptions for all controlled drugs
2. you check that dependency has been confirmed using a combination of clinical assessment and testing
3. you liaise with other services and check the individual's medical history and that no other clinician is prescribing controlled drugs for the individual
4. you only prescribe controlled drugs (e.g. methadone, other opiates or other controlled drugs) to substance users as part of a wider treatment plan with specific goals and as an enhancement to other psychological, social and medical interventions
5. you prescribe controlled drugs in line with the individual's treatment plan and condition (e.g. drug dependency, co-morbidity, other medication taken by the individual)
6. you follow guidelines and protocols, where available, in selecting the type of drug, induction regime, dosage, frequency of dispensing and frequency of administration
7. you consult an appropriate clinical supervisor, if you are unsure about the drug to be prescribed or your level of competence in prescribing it
8. where required, you obtain a licence for prescribing the controlled drug
9. you state, on the correct form for prescribing controlled drugs,
10. you write the prescription in your own handwriting, in ink, unless you have a specific handwriting exemption from the Home Office
11. there is no blank space on the form in which the individual could add further items
12. you sign and date the prescription
13. you agree the dispensing regime with the pharmacist and liaise regularly about the specific individual and the prescribing regime
14. you make yourself available to take emergency telephone calls from the pharmacist in cases of a prescription error
15. you record the prescription for controlled drugs on the appropriate monitoring record
16. records of the individual's treatment are available only to those authorised to see them
17. you take part in regular clinical reviews of the individual's progress including compliance with the prescribing regime
18. you review your prescribing practice in view of new guidelines and/or evidence.
You need to apply:
Assessment and testing
K1. how to make a clinical assessment and carry out tests to establish the individual's dependence
Communication
K2. the importance of regular liaison with other services involved, and appropriate ways of maintaining this liaison
Drugs and medication
K3. national guidelines and local protocols for the prescription of controlled drugs
K4. types, properties, functions, effects, indications and contra-indications of controlled drugs that can be used in the treatment of drug dependency
K5. methods of drug administration
K6. how to calculate the correct dose of the drug and frequency of administration
K7. how to relate the prescription to the individual's condition and treatment plan
K8. when a licence is required for prescribing a controlled drug and how to obtain one
K9. the correct form to be used when prescribing controlled drugs and the information required
K10. the importance of keeping prescription forms in a safe place
K11. the importance of supervising the consumption of controlled drugs
K12. the importance of regular liaison with the dispensing pharmacist
K13. how to record prescriptions clearly and accurately on appropriate documentation
K14. how to review your prescribing practice in view of new guidelines and/or evidence
Information handling
K15. the importance of keeping full, legible and accurate records in date order, and how to do so
K16. the principle of confidentiality under data protection legislation: what information may be given to whom
Monitoring and evaluation
K17. the importance of carrying out regular clinical reviews of the individual's progress, and how to do so
K18. the importance of carrying out regular reviews of your own prescribing practice, and how to do so
Organisational context
K19. organisational requirements and policies relevant to the functions being carried out
K20. an appropriate clinical supervisor to consult when you are unsure about the medication to be prescribed or your level of competence in prescribing it
Substance misuse
K21. the range of different substances and their effects
K22. the importance of only prescribing controlled drugs to substance users as part of a wider treatment plan and how the use of controlled drugs complements other psychological, social and medical interventions.
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