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NON-MEDICAL PRESCRIBING

MODULE GUIDEAND

PORTFOLIO DOCUMENT

September 2019

MODULE CODE: CCH3042-NMODULE LEADER: Debbie Osborne

CONTENTS

1 INTRODUCTION

2 THE MODULE STRUCTURE

3 MODULE LEADER/MODULE TEAM CONTACT DETAILS

4 LEARNING AND TEACHING STRATEGIES

5 MODULES AIMS AND OUTCOMES

6 RESPONSIBILITIES

7 ASSESSMENT STRATEGY

8 ASSESSMENT CRITERIA

9 EVALUATION STRATEGY

10 INDICATIVE RESOURCES

PRACTICE PORTFOLIO DOCUMENT

11 GUIDELINES FOR COMPLETION OF YOUR PORTFOLIO

12 PORTFOLIO DOCUMENTS

1 INTRODUCTION

Welcome to the Level 6 Non-Medical Prescribing (V300) module which was developed in response to the Government’s Modernisation Agenda. This has extended the range of professionals who can prescribe, and medicines that can be prescribed, by independent and supplementary non-medical prescribers.

Independent prescribing is becoming a widely integrated feature of health service delivery, with nurses, physiotherapists, podiatrists, radiographers and dieticians qualified to prescribe in nearly all Trusts in England. This year has seen the legislation change to include paramedics; it is important though that these AHPs are working in advanced practice roles and for organisations who have the governance arrangements in place to support prescribing practice. Currently this includes NHS trust or GP employers only. This supports the achievement of ambitions set out in Equity and Excellence: Liberating the NHS (Department of Health (DH) 2010A). Two to three per cent of the nursing workforce are qualified independent prescribers and are prescribing predominantly in primary care, with substantial numbers also in secondary care settings. As mentioned above to further empower AHPs to deliver improved clinical outcomes physiotherapists and podiatrists have from August 2013 had their supplementary prescribing rights extended to independent prescribing. Further to this in April 2016 therapeutic radiographers gained independent prescribing rights and dieticians supplementary prescribing rights; paramedics gained independent prescribing rights in Spring 2018. Nurses, physiotherapists, podiatrists and paramedics will also gain supplementary prescribing, diagnostic radiographers will continue to be able to train as supplementary prescribers and prescribe within a Clinical Management Plan (CMP).

Supplementary prescribing legislation in 2005 initially prepared health professionals to expand their roles. Nurses have trained as independent prescribers since 2006 and the expansion of independent prescribing by physiotherapists, podiatrists and therapeutic radiographers supports enhanced patient-centred care. This now includes paramedics who can also prescribe on a supplementary basis. New roles and new ways of working to improve quality of services, deliver safe, effective services focused on the patient experience have been developed across inter-professional working within health care. Non-medical prescribing has facilitated partnership working across professional and organisational boundaries and within the commissioning and provider arena. The benefits of non-medical prescribing to patients with a wide range of conditions have ensured that choice and faster access to medicines are a realistic service improvement.

You must use this document in conjunction with your own professional standards for prescribing; these can be found on the

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module VLE site. You must develop a working knowledge of your own profession specific prescribing standards alongside your own professional codes of professional practice.

2 THE MODULE STRUCTURE

The length of the module is 18 weeks. During this time, you will undertake 26 days’ theory time this will include direct teaching, seminars, tutorials and self-study. You will spend 12 days’ supernumerary supervised practice shadowing and working alongside a prescribing Designated Medical Practitioner (DMP). You have a week-long induction in Week 1; this will introduce you to the University and the School of Health & Social Care (SOHSC). You will also be introduced to the principles of non-medical prescribing and be prepared for your supervised practice experience. This will be followed by 16 weekly study days; you will attend the University each Tuesday from 9.30am – 4.00pm. Week 18 will be block week in which you will prepare for and undertake an Objective Structured Clinical Examination (OSCE).

If for any reason you are unable to complete the module in the allocated time it is important that you discuss this with a member of the module team. There are University support mechanisms in place which can support an extension of your studies should you need to use these. It is important that you discuss with the team any difficulties you may encounter to ensure we support you appropriately to complete your studies. The School Student Guide provides further detailed information. The link to this can be found on the module blackboard.

Your organisation has agreed that you will undertake 12 days’ supernumerary supervised practice. It is necessary to ensure that you and your DMP can work together for enough time for your DMP to be able to confidently assess that you have met the practice outcomes for the module. It is expected that a programme of experience will allow you to work with other prescribing and non-medical prescribing team members for you to experience a variety of learning opportunities. Your DMP must agree your learning plan, you must negotiate how your practice learning is organised with your DMP and must be the person responsible for verifying that you have competently met the practice outcomes.

You must attend all theory sessions as agreed at application. Attendance will be closely monitored.

3 MODULE LEADER/MODULE TEAM CONTACT DETAILS

The Module Leader is Debbie Osborne and you should initially direct any queries or issues to Debbie. She is based in room H1.31 in the Centuria Building. Telephone number 01642 738257, email [email protected]

Liam Redden supports the module and can be emailed on [email protected]

Christine Robinson is the Lead Midwife for Education (LME) and supports midwives who undertake the module. She can be contacted on 01642 738293 and email [email protected]

The module is supported by an established and experienced team of pharmacists, and non-medical prescribers from both primary and secondary care. You will be offered the opportunity for professional/discipline-specific tutorials by specialist academic mentors to enable you to identify individual learning needs and to develop a Learning Contract to guide and facilitate academic learning. You will be directed to the most appropriate academic in Week 1 of the module. All midwives must meet the LME; this will be arranged within Week 1 of the module.

4 LEARNING AND TEACHING STRATEGIES

Non-medical prescribing requires that you have the knowledge, skills, and professional competence necessary to embrace this new role. It also requires you to demonstrate a comprehensive and detailed understanding of the concepts of accountability and lifelong learning in a significant way. To this end the module aims to incorporate knowledge and reflection in a way that enables the development of self-awareness and for you to build upon previous learning as well as acquiring new competencies for safe and effective prescribing.

The module will help you to build upon your already extensive knowledge and experience. This will ensure that you are knowledgeable, flexible and adaptable, and able to incorporate both the theory and practice of non-medical prescribing in a critical and reflective manner. You will be supported to achieve the module aims through the development of a robust knowledge that is based upon the best available evidence, combined with a flexible and adaptable approach to both the theory and practice of non-medical prescribing.

The taught component of the module will consist of theoretical preparation to ensure that you develop the knowledge and skills necessary to ensure safe and effective prescribing. The module focuses upon the principles and practice of prescribing and professional accountability, responsibility and ethics required by independent and supplementary non-medical prescribers. Related pathophysiology and pharmacology will be a major focus of the module.

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To facilitate and maximise learning a variety of learning strategies will be employed. You will share your learning with your peers undertaking the module at master’s level and students preparing for community prescribing. Taught sessions will include lectures and group discussions. There will be self-directed study based upon both the indicative content and an assessment of your own learning needs in relation to prescribing. You will be allocated a member of the programme team who will supervise and support your learning. Professional/discipline-specific tutorials will be offered by specialist academic mentors if you feel you need additional support to enable you to identify individual learning needs. If you are a midwife, you will be introduced to the LME Christine in Week 1 of the module who can support your learning and assessment preparation. You will develop a learning contract in practice with both your academic supervisor and your DMP; this will guide and facilitate your learning in practice.

Random case analysis will be used so that you will have the opportunity to analyse treatment situations and examine and critically reflect upon the decision-making process in relation to prescribing. The generic nature of the module content will facilitate you to apply your knowledge and understanding to safely prescribe within your own area of practice speciality. This will be further developed with the support and guidance of your DMP and any suitable non-medical prescriber.

You will be guided in preparing and developing your portfolio that will provide evidence of your ability to critically reflect on and in practice. This will include the use of a learning contract/s and evidence of your successful completion of the practice element of the module. Also included will be a reflective analysis of your knowledge underpinning safe prescribing practice, and evidence of understanding the pharmacology, pharmacokinetics, legal aspects, and application to practice of drugs you will prescribe in practice through the development of three P-Formularies. You will develop an understanding of the differences between supplementary and independent prescribing and you will undertake learning related to supplementary prescribing within a CMP.

You will practice examination techniques and will undertake a formative examination which will be peer reviewed to prepare you for the examination element of the assessment. Directed study utilising the VLE, e-learning@tees, will enable you to further develop numeracy skills which will support preparation for the examination. To further support formative numeracy development, you have access to the Library Succeed@tees drug calculations workshops on the following link: http://tees.libguides.com/drug_calculations You will have access to a wide range of web-based resources through the VLE for example News Feeds via the National Institute for Health & Care Excellence (NICE) Medicines and prescribing support website and the Medicines and Healthcare Products Regulatory Agency (MHRA) website. Profession specific information related to prescribing will be available it is important that you

http://tees.libguides.com/drug_calculations

review this at the beginning of the programme. You will be working in groups using scenario-based examples of prescribing practice to prepare you, for example, to take an effective history and make diagnostic decisions which will influence your prescribing decision-making process. This will support your OSCE assessment.

The integration of theory and practice will be strengthened by your ability to demonstrate the achievement of the practice outcomes. Learning in practice will be related to the achievement of these practice outcomes: you and your DMP will document progress in three meetings during your supervised practice. These will be included in your portfolio and verified by your DMP. It is important that you have exposure to the wider influences which impact upon prescribing, so you should try to spend time with other medical and non-medical prescribers. Service user feedback on your approach to prescribing practice will be documented on three occasions using a 360-degree assessment tool. Your DMP will however be the only person responsible for ensuring and confirming your competence in practice. Registrants who will be prescribing for children must have a DMP who is experienced and competent in prescribing for children. If your field of practice is related to adults, you must secure time with a prescriber who works with children to meet the requirement of completing a child focused case study. The LME will support midwifery DMPs; this will include attending the DMP mentor preparation workshops or meeting with DMPs in practice to check progress.

5 MODULE AIMS AND OUTCOMES

AimsThe aims of the module are to:

Facilitate the development of knowledge and skills required by professionals to prescribe as independent prescribers and/or supplementary prescribers.

Enable you to apply knowledge to clinical practice demonstrating the ability to prescribe safely and effectively in order to meet prescribing standards set by the Nursing and Midwifery Council (NMC)/Health and Care Professions Council (HCPC).

Outcomes On completion of this module you will be able to:

Knowledge and Understanding 1. Synthesise and critically appraise the legal and professional

framework for accountability and responsibility in relation to prescribing practice.

2. Demonstrate a comprehensive and detailed knowledge of drug actions in prescribing practice (pharmacodynamics and pharmacokinetics).

3. Synthesise and critically appraise the factors impacting upon and influencing safe and ethical prescribing practice.

Cognitive and Intellectual Skills4. Synthesise and evaluate relevant evidence, sources of information and

decision support systems to inform prescribing practice.

Practical and Professional Skills5. Demonstrate achievement of the regulatory bodies’ standards of

proficiency as applied for independent and supplementary prescribing. 6. Act autonomously whilst recognising the contributions of the

multidisciplinary team involved in prescribing, supplying, and administering medicines.

7. Demonstrate a comprehensive and detailed knowledge of the clinical decision-making strategies which underpin autonomous prescribing practice in effective communication, consultation/assessment, diagnosis, and treatment which can include over the counter, alternative and complementary health therapies.

8. Demonstrate a comprehensive and detailed knowledge of the skills required to prescribe safely, appropriately and cost effectively taking into account individual choice and wishes.

9. Practice within a framework of clinical governance, professional accountability, and responsibility.

10. Develop and document a Clinical Management Plan within legislative requirements and within the context of a prescribing partnership.

11. Demonstrate the ability to monitor response to medicines and modify treatment or refer as appropriate.

12. Demonstrate a comprehensive and detailed knowledge of the importance of record keeping in the context of medicines management including: accurate recording in patient notes, reporting of near misses, adverse reactions, ability to access patient records and clinical management plans.

13. When working with children take an appropriate history, undertake a clinical assessment, and make an appropriate diagnosis, having considered the legal, cognitive, emotional, and physical differences between children and adults.

14. Recognise and respond to potential risks associated with prescribing of unlicensed medicines.

15. Select, evaluate, and apply appropriate numeracy skills commensurate with the demands of ensuring safe prescribing practice.

Key Transferable Skills16. Demonstrate a critical reflective approach to continuing professional

development.

6 RESPONSIBILITIES

The Designated Medical Practitioner (DMP) Your DMP has a fundamental role in educating and assessing your practice. They will be invited to a mentor preparation workshop which will support their preparation for the role. The generic nature of the module content will facilitate you to apply your knowledge and understanding to safely prescribe within your own area of practice speciality. Your DMP will be further develop and guide your development.

Your DMP is responsible for:

Establishing a Learning Contract in partnership with you. Documenting progress on three occasions during supervised

practice and providing additional opportunities if required to achieve outcomes in a timely manner.

Planning a learning programme which will provide the opportunity for you to meet your learning objectives and gain competency in prescribing.

Facilitating learning by encouraging your critical thinking and reflection.

Providing dedicated time and opportunities for you to observe how you conduct a consultation/interview with patient/clients and/or parents/carers and the development of a management plan.

Allowing opportunities for you to carry out consultations and suggest clinical management and prescribing options, which are then discussed with you.

Helping ensure that you integrate theory with practice. Taking opportunities to allow in-depth discussion and analysis of

clinical management using a random case analysis approach, when patient/client care and prescribing behaviour can be examined further.

Facilitating, observing, and assessing your performance over the continuous period of supervised practice.

Ensuring feedback from other prescribing practitioners who facilitate learning experiences.

Facilitating the opportunity to gain service user/carer feedback using the practice-based, 360° interpersonal skills assessment tool (one fully completed assessed tool with three episodes of service user or carer feedback).

Assessing and verifying that, by the end of the module, you are competent to assume the prescribing role. It is the DMP’s responsibility to decide whether you are making satisfactory progress towards meeting your practice outcomes for non-medical prescribing. This decision will be based upon whether the practice outcomes have been met. If during the practice days, you are deemed by your DMP to be failing to make sufficient progress

towards achievement of these outcomes they should inform both you and a member of the programme team to consider if strategies can be put in place to support you.

Working in collaboration with LME to support midwife students. Identify and document any cause for concern, for example concerns

regarding competence acquisition, or conduct, or unsafe practice, and discuss at the earliest possible stage with the programme team. Unsafe practice can for example include repeated episodes of making an incorrect diagnosis, recommending incorrect treatment options or incorrect completion of prescriptions. A cause for concern form should be completed. If you demonstrate any concern, relating to patient safety you should be aware that the SOHSC consider the Fitness to Practise process. Details of this process can be found in your School Student Guide.

Reconfirming and verifying competence has been maintained should you interrupt, require reassessment or delay your studies.

The contribution of your DMP in relation to providing you with supervision, support, and opportunities to develop competence in practice is therefore crucial. The criteria for fulfilling this role is dictated by the Department of Health and are that the DMP: Has normally had at least three years’ recent clinical experience for

a group of patient/clients in the relevant field of practice. Works within a GP practice and is either vocationally trained or in

possession of a certificate of equivalent experience from the Joint Committee for Postgraduate Training in General Practice Certificate or is a specialist registrar, clinical assistant or a consultant within a NHS Trust or other NHS employer.

Has the support of the employing organisation or GP practice to act as the DMP who will provide supervision, support, and opportunities to develop competence in prescribing practice.

Has some experience or training in teaching and/or supervising in practice.

Normally works with the student prescriber. If this is not possible (such as in nurse-led services or community pharmacy), arrangements can be agreed for another doctor to take on the role of the DMP, provided the above criteria are met and the learning in practice relates to the clinical area in which the student prescriber will ultimately be carrying out their prescribing role.

The Lead Midwife for Education (LME)As detailed above, Christine Robinson (LME) will ensure that if you are a midwife you will be able to access additional support if you need this. You will meet Christine in Week 1 of the module (if not on application) and will be expected to meet with her on a regular basis. The LME works closely with the module team and contributes to your assessment. The LME may work with your DMP if required and will contribute to the DMP preparation workshops.

The StudentYour role is to take responsibility for your own learning and demonstrate a willingness to develop both academically and in practice. You will be expected to discuss your own learning needs with your DMP and you should undertake honest self-assessment, articulate your learning needs, seek and accept formative feedback from your DMP and module team. You are expected to recognise and appraise your own abilities and limitations. You must take full responsibility for all aspects of the learning and assessment on the module. You must ensure that your documentation is detailed, and you must apply sound attention to detail across your portfolio of evidence. Prescribing practice demands attention to detail, you must demonstrate that you have this skill within this module. There is a requirement that you attend 100% of the module; if you are unable to attend a theory day due to sickness, you must inform us.

Very Important Information

If for any reason you do not complete the module in the specified time for example in the case of an interruption, reassessment or delayed submission your DMP MUST reconfirm and verify that you have maintained your competency in the practice area. They will need to confirm this by signing your practice outcomes at the point at which you submit your final assessed work.

On successful completion of this programme you are not legally able to prescribe and therefore must not do so. You can only prescribe once you have received notification from your professional body (HCPC/NMC) that your prescribing qualification has been recorded on the professional register. You must record your prescribing qualification within 12 months of completing your programme. Module TeamIt is recognised that the demands of this module are challenging, and that the intensity of the assessment is demanding. Debbie and Liam will provide support to you and your DMP both in an academic and pastoral capacity. If you require additional support, you should discuss this with us at an early stage who will signpost you to the most appropriate support. You will be assigned a member of the team who will be your first point of call; we are all though here to support you. You should also refer to the School Student Guide, which provides information relating to student support including submission of assignments, feedback return, mitigating circumstances process, extension and late submission process, plagiarism and referencing.

7 ASSESSMENT STRATEGY

Formative

You will undertake formative assessment through peer debate in the classroom, relevant and relating to prescribing practice, a workshop-based peer-review assessment of supplementary prescribing in week 3 and a peer-reviewed formative examination in week 10. You will have the opportunity to update, develop, and enhance your numeracy skills by undertaking online calculation testing. This will be monitored by the module team who will identify and support any additional support you require.

SummativeComponent 1 - Portfolio (70%)

You will complete a detailed portfolio of evidence that comprises of: Formulation and completion of a Learning Contract which identifies

strategies to meet individual learning needs in relation to the module outcomes.

Agreed and verified dates of supervised practice. A practice log that records practice experiences. Six case studies from your learning logs which demonstrate

prescribing and prescription writing in a range of settings – one must include demonstration of prescribing for children.

Completion of three P-Formulary work sheets. Three Clinical Management Plans drawn up whilst in supervised

practice. Clinical Management Plans completed within the workshop with

peers and peer review feedback sheet. Evidence of having passed a two-hour written examination. To gain

a pass grade, you must achieve a minimum of 80% in the 20-question pharmacological element and 100% in the five-question numerical element (pass/fail). Undertaken in week 13. There will be two opportunities to meet this essential evidence prior to the submission of your Portfolio.

Evidence of satisfactory completion of a period of supervised practice experience. This must be 12 days.

Evidence of gaining consent and maintaining confidentiality. Critical reflective analysis of episodes from the practice logs

demonstrating critical appraisal skills and informed decision-making (3,000 words).

A fully completed 360-degree service user or carer feedback tool – three sets of service user or carer feedback must be submitted.

You will submit your portfolio in Week 18.

Please note: registered nurses and midwives must undertake a minimum of 78 hours’ supervised practice. Allied health professionals must undertake a minimum of 90 hours’ supervised practice.

Component 2 - Objective Structured Clinical Examination (OSCE) (30%) You will complete a 15-minute OSCE which will relate to patient safety for example, correct diagnosis, correct treatment options, and correct completion of the prescription form.

You will undertake your OSCE in Week 18.

8 ASSESSMENT CRITERIA

PortfolioYou will demonstrate the ability to submit a Portfolio of Evidence which includes all essential evidence demonstrating your ability to prescribe safely in practice including:

Achievement of the NMC/HCPC requirements for independent and supplementary prescribing/supplementary prescribing.

Record of achievement of Non-medical prescribing practice outcomes.

Evidence of achievement in the written examination. Completion of P-Formularies which include evidence of a detailed

and comprehensive understanding of the pharmacodynamics, pharmacokinetics, legal aspects, and application to practice of drugs of may prescribe in practice.

A 3,000-word written piece which will critically reflect upon episodes of significant learning highlighted in your Learning Logs which: o Demonstrate a comprehensive and detailed knowledge of the

need to prescribe safely, considering issues such as ethical and legal practice, team-working, record-keeping, writing a prescription and numeracy associated with safe prescribing and how these apply to your prescribing practice.

o Synthesise, appraise and evaluate contemporary literature and evidence which informs appropriate decision making in prescribing practice.

o Adhere to the School of Health & Social Care policy for confidentiality and consent.

o Adhere to the School of Health & Social Care guidelines for presentation and referencing.

OSCEYou will demonstrate a critical and safe approach in the following criteria:

Communicate effectively incorporating holistic individual needs using a variety of techniques to elicit the information on which to base your diagnosis.

Interpret and analyse information gathered during history-taking in a structured and logical way.

Analyse and evaluate the information on which to base a probable diagnosis.

Have a comprehensive and detailed knowledge and understanding of the need to consider an appropriate strategy and choice of product in negotiation with the patient.

Correctly complete a prescription or provide a rationale for advising buying the product of choice or lifestyle changes.

Demonstrate a comprehensive and detailed knowledge of how to take the product safely and effectively and the need to review the patient appropriately.

To achieve a pass grade in your OSCE, you must achieve a minimum of 40%.

If you demonstrate unsafe practice in any part of the assessment related to patient safety, for example, incorrect diagnosis, incorrect treatment options and incorrect completion of a prescription form you will be referred. Please ensure you also maintain confidentiality and gain informed consent.

You will be awarded a mark of 0 for any of the above.

It is a requirement that you must pass both components of the module.

Assessment DatesYou will have the opportunity to have formative feedback as follows:

Clinical Management Workshop Tuesday 24 September 2019Formative examination Tuesday 12 November 2019OSCE Workshop Monday 27 January 2020

Summative AssessmentsExamination

1st Attempt Tuesday 03 December 2019Resubmission Tuesday 21 January 2020Reassessment Will be agreed by the assessment board

OSCE 1st Attempt Wednesday 29 January 2020Reassessment Will be agreed by the assessment board

Portfolio

1st attempt Friday 31 January 2020Reassessment Will be agreed by the assessment board

You will submit your 3,000-word critical reflection electronically via the VLE by Thursday 30 January 2020

The Role of the External Examiner

Students often ask questions about how we know that their award is broadly of the same standard as degrees awarded for similar courses by other universities. In the UK we have a system called External Examining which is one of several ways that we confirm that standards are met. An External Examiner is generally an experienced lecturer from another University/Higher Education Institution, who offers an independent view as to whether the work of students on the course is of the correct standard. The External Examiner does this by looking at a sample of work (e.g. assignments, exam answers, and dissertations), discussing the work with your lecturers and normally attending the Assessment Boards to endorse results. They then produce an annual report, which highlights any good practice they have seen and allows them to report any concerns they may have. They also confirm in their Report that academic standards and achievement are comparable with the UK Higher Education sector. The External Examiners’ Reports are made available to students via the ‘courses’ tab in e-vision and are also considered annually at relevant Course Boards.

The external examiner for your module is Hillary Field; Hillary is the prescribing programme lead at De Montfort University.

Please note that students are not permitted to contact external examiners directly and external examiners will not respond to any communication from individual students. If you have any concerns about your module then please speak to us.

9 EVALUATION STRATEGY

Informal feedback from you is welcomed throughout the module. You will be asked to evaluate the module regularly and will receive links via your student email account to undertake evaluation. It is very important that you engage in these evaluations, which provide you with the opportunity to have your say. The module team will ask you to undertake a final evaluation at the end of the module. Comments that you may have and suggestions for improvement that you may wish to make will be valued and appreciated.

The team want to support you to successfully complete your module, if in doubt about anything please ask.

We hope you enjoy your time studying with us.

10 INDICATIVE RESOURCES

These can be found in the Reading List section of your VLE site. You should also link into the web links and Twitter Feeds sections on the VLE.

PRACTICE PORTFOLIO DOCUMENT

11 GUIDELINES FOR COMPLETION OF YOUR PORTFOLIO

The purpose of your Portfolio is to provide a framework through which you can record and demonstrate your progress and achievements whilst studying Non-medical Prescribing.

In order to demonstrate achievement of the module, you are required to present a Portfolio of Evidence that provides a documentary record of your learning and how this relates to the module outcomes.

The portfolio-keeping process includes: Reflection upon existing knowledge and skills. Exploration of the module outcomes. Identification of learning needs. Identification of learning opportunities in your supervised practice

area and who can support you. Matching learning opportunities to learning needs. Development of a plan or Learning Contract to meet learning needs. Implementation of the plan/Learning Contract and collection of

supporting evidence. Keeping a Practice Learning Log. Reflection upon learning and achievement of practice module

outcomes. Including evidence of feedback from service users and carer. Presentation of the Portfolio at the end of the module.

How to Compile your Portfolio

Stage 1 - Identifying Your Learning NeedsThe first step is to look at the practice outcomes and consider what you need to learn to achieve each one. You must have time aside with your DMP at the beginning of the practice placement and review the practice outcomes, consider how these can be achieved and consider your own self-assessment and how your learning needs can be met. A Learning Contract will be developed to show how these outcomes can be achieved. This contract can also be used as a framework for your critical reflection of learning. This meeting must be documented by both you and your DMP on the initial meeting form. The Learning Contract template can be found in in the Portfolio document section.

Stage 2 - FeedbackYou must both set aside time to review progress and provide written feedback on progress. This should be undertaken regularly and should involve discussing cases from practice experiences and reflecting upon and critically analysing. It is important that you consider how theoretical concepts are used to inform these discussions. This stage also includes assessment of your progress towards competence in relation to practice

outcomes and you and your DMP must document this using the intermediate meeting form. There must be documented evidence of a structured meeting at an initial, intermediate and final point in your practice placement.

Stage 3 – Sign OffAt the end of the module, you will submit your portfolio for verification of the award. Your DMP must sign and date the practice outcomes have been met. It is important that you provide a short statement on how you have achieved each outcome on the table of practice outcomes in the portfolio. You should both also provide evidence of a final meeting using the final meeting form and final sign-off point. Please remember the information detailed above relating to any delayed submission/interruption/ referral at first attempt and the need to have your DMP verify that you have maintained competence in all practice outcomes.

Your Portfolio must include the following: Formulation and completion of a Learning Contract which identifies

strategies to meet your individual learning needs in relation to the module outcomes.

Agreed and verified dates of supervised practice. A practice Learning Log that records practice experiences. Six case studies from the Learning Logs which demonstrate

prescribing and prescription writing in a range of settings – one must include demonstration of prescribing for children. An arrangement should be made for you to spend time with a prescriber who does prescribe for children if your DMP does not. Throughout the assessment registrants who will prescribe for children must also demonstrate recognition of the unique implications and developmental context of the anatomical and physiological differences between neonates, children, and young people.

Reflective analysis of episodes from your practice Learning Logs demonstrating critical appraisal skills and informed decision-making.

Completion of three P-Formulary work sheets. Three CMPs drawn up whilst in supervised practice – this should be

undertaken in consultation with your DMP and they must be signed by your DMP or another doctor you work alongside – on successful completion of the module if you are a nurse, physiotherapist or podiatrist you will be able to prescribe independently and on a supplementary basis. Radiography students can currently only undertake this module to prescribe on a supplementary basis.

Clinical Management Plans completed within the classroom workshop with peers and peer review feedback sheet one from the classroom activity and three from practice learning.

Evidence of achievement of the written examination – your assessment feedback sheet which can be found on the Student Intranet (unratified feedback).

Evidence of satisfactory completion of a period of supervised practice experience. Must be 12 days (a minimum of 78 hours for nurses and midwives or 90 hours for allied health professionals). Your DMP must document progress on at least three occasions during the practice learning and provide a final sign-off of your competence.

Your manager must sign the declaration which is detailed at the end of the practice outcomes document. This may be your DMP if you work in a GP practice for example. If you work in a Trust this will be the person who confirmed your clinical capability at application to the module. The person who signs this must be a clinician.

Completion of the consent and maintaining confidentiality student declaration form. You have a professional responsibility to ensure that consent has been agreed, and that confidentiality is maintained. Please read this document carefully.

One fully completed practice-based 360° interpersonal skills assessment tool (three separate service user or carer feedback).

Verification of your DBS status – this must be in date at the point of us informing your professional body that you have successfully completed the module.

Map the RPS Competency Prescribing Framework to the module learning outcomes and practice outcomes- please see the documentation for this in the section of the VLE entitled Royal Pharmaceutical Society (RPS, 2016) Prescribing Competency Framework.

All the practice outcomes must be achieved by the end of the module and the portfolio will be submitted directly to the programme team on the final day of the module for verification. If you are referred on one or more of the practice outcomes you must demonstrate achievement of this outcome at the designated point of negotiated re-assessment which will be agreed by the assessment board. If this is the case you must devise a Learning Contract and Action Plan with your DMP and your academic supervisor to address the outcomes involved. The decision regarding whether you have achieved this Learning Contract and can be declared competent will be made by your DMP.

The practice Learning Logs can also be used as a tool to guide reflection on practice. By recording experiences, in particular those that create uncertainty and conflict, an opportunity for reflection on action can be created. Such reflection articulates the factors that underpin decision-making and facilitates the identification of alternative approaches. However, it is also essential that sustained observation in the practice environment is used to provide evidence of competence in practice.

It is important that you should collect evidence in your portfolio on an on-going basis to demonstrate achievement of the practice outcomes. All portfolio components must be submitted.

Your portfolio will be submitted to the module team at the end of the module. You will complete a receipt for submission of assignment form. This form will be signed by the member of the module team receiving the portfolio and the carbon copy retained by you. You will electronically submit your critical reflection via the blackboard site.

12 PORTFOLIO DOCUMENTS

1. Record of Supervised Practice Meetings2. Record of Achievement of Practice Outcomes3. Learning Logs4. Case Studies – complete 6 – 1 must be for a child5. Practice Placement Prescribing Support Information

6. Signature Sheet 7. Agreed Supervised Practice Hours8. Learning Contract9. P-Formulary Worksheet Framework – complete 310. Clinical Management Plan Template- complete 311. Peer review sheet for CMP workshop12. Non-medical prescribing practice-based 360° interpersonal skills

assessment tool – 3 to be completed by service users in practice and 1 each of mentor and student feedback and reflection

13. DBS verification form14. Consent and Confidentiality 15. Level 6 University Generic Marking Criteria

RPS mapping (See VLE)

RECORD OF SUPERVISED PRACTICE MEETINGS

Initial Meeting

Designated Medical Practitioner comments:

Signature:

GMC Reference number:

Date:

Student comments:

Signature:

HCPC/NMC PIN:

Date:

Record of Supervised Practice Meetings

Intermediate Meeting Designated Medical Practitioner comments:

Signature:


Date:

Student comments:

Signature:

HCPC/NMC PIN:

Date:

FINAL ASSESSMENT SIGN OFF

Final Meeting Designated Medical Practitioner comments:

Competent/Not Competent (please delete as appropriate) I am satisfied/not satisfied (please delete as appropriate) that the student has met the outcomes of the module. This has been evidenced through observation, question and answer discussion throughout the practice experience.

Signature:


Date:

Student comments:

Signature:

HCPC/MNC PIN:

Date:

RECORD OF ACHIEVEMENT OF PRACTICE OUTCOMES Assessment of your prescribing within your area of clinical practice

Practice OutcomeBy the end of the module the student will be able to:

Evidence (to be completedby the student)

DMP Signature &

Date

StudentSignature

Demonstrate a comprehensive and detailed knowledge of drug actions in prescribing practice (pharmacodynamics and pharmacokinetics).

Critically appraise the factors influencing safe and ethical prescribing practice at individual, local and national levels.

Synthesise and evaluate sources of information/advice and decision support systems in prescribing practice.

Demonstrate a detailed and comprehensive understanding of the roles and relationships of others involved in prescribing, supplying, and administering medicines.

/tt/file_convert/5e16ee351833d01ae76462b0/document.docx 26©TU-SOHSC (2019)



DMP Signature &

Date

StudentSignature

Demonstrate and have a detailed knowledge of effective consultation/assessment skills including:

Ability to communicate effectively with patient/clients, clients, parents, and carers.

Ability to conduct a relevant physical assessment/examination of patients with those conditions for which they may prescribe.

Ability to undertake a thorough history, including medication history and current medication (including over the counter, alternative and complementary health therapies) to inform decision-making.

Ability to engage in the process of effective clinical decision-making.

Ability to assess patients’ needs for medicine taking account of their wishes, values, ethnicity, and the choices they may wish to make.Demonstrate and have a comprehensive and detailed understanding of the need prescribe safely, appropriately and cost effectively.Practice within a framework of professional accountability and responsibility. Incorporate patients' choice into the decision-making process.




DMP Signature &

Date

StudentSignature

Develop and document a Clinical Management Plan within legislative requirements and within the context of a prescribing partnership.Demonstrate the ability to monitor response to medicines and modify treatment or refer the patient as appropriate. Demonstrate and have a detailed knowledge of the importance of record keeping in the context of medicines management including:

Accurate recording in patient notes Reporting of near misses Adverse reactions Ability to access patient records and clinical

management plansDemonstrate effective partnership working with independent prescribers and the wider care team.Take an appropriate history, undertake a clinical assessment and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults.Recognise and respond to potential risks associated with independent prescribing of unlicensed medicines.Employer endorsement of the student’s competence to prescribe in their defined area of practice.

Signature……………………………………………………………… Name …………………………………………………………………….

Position.…………………………………………….................Date ………………. NMC/HCPC PIN /GMC Reference …………………….


LEARNING LOGS

Date Service user/Learning

Experience

Description of Event Module Outcome

Number Met1-16

Your Significant Learning


CASE STUDY

History (including findings from examination)

Diagnosis

Strategy (including product choice)

Information given

Monitoring arrangements

Include a Prescription


Practice Placement Prescribing Support Information Placement Type – i.e. ward/community/practice settingDesignated Medical Practitioner StudentAvailability of other prescribing health care/medical professionals working in the placement who can provide student support/exposure/experience.

Specialist expertise or interest offering learning opportunities

for prescribing students

Total number of

Prescribing Professionals in placement

Medical Officers

Non-medical independent/supplementary prescribers

Pharmacists


Non-Medical Prescribing Practice Experience Signature list

Please sign and print your name in the table below if you are involved in supporting the practice education of the Non-Medical prescribing student or provide any written information within this portfolio.

Do not identify a placement directly by name

Date Type of Placement

Name Signature


AGREED DATES FOR SUPERVISED PRACTICE

Date No of hours completed (excluding breaks)

1

2

3

4

5

6

7

8

9

10

11

12

Total number of hours

AGREED:

Student’s signature: HCPC/NMC PIN:

DMP’s signature: GMC Reference number:


LEARNING CONTRACT

Student Name:

Designated Medical Practitioner Name:

Negotiated Learning Outcomes:

Strategies:

Resources:

Date of Contract: Date to be completed by:

Signature of Student: HCPC/NMC PIN:

Signature of DMP: GMC Reference number:


P-FORMULARY WORKSHEET FRAMEWORK

Choose three drugs that you will prescribe regularly when qualified as a non-medical prescriber and complete the following worksheet using each heading in relation to all three drugs.You should, where relevant, demonstrate application of each drug to your practice. Follow and use these headings in your work.

For each drug ensure that you fully understand: Approved or generic name Drug class to which the drug belongs Its application to your practice

Basic Pharmacology The general mechanism of action of the drug at a molecular, cellular, tissue

and organ level The ways in which these actions produce therapeutic and adverse effects

Clinical Pharmacokinetics How the drug is absorbed, distributed, metabolised and excreted Cautions, contra-indications, and side effects The half-life of the drug The optimal route, dose, and frequency of administration

Therapeutic Drug Monitoring How drug therapy can be monitored The drugs therapeutic window

Adverse Drug Reactions How to recognise adverse drug reactions and how these can be minimised

Drug Interactions The potential for drugs to interact and to cause beneficial and harmful side

effects. The ways in which interactions can be predicted and avoided

Legal Aspects Legal category of the drug License implications

Altered PhysiologySpecial measures to be taken when prescribing drug to individuals including:

Elderly patients Children Women of child-bearing potential Pregnant and breast feeding women Patients with renal disease Patients with liver disease.

CLINICAL MANAGEMENT PLAN TEMPLATE

Name of Patient: Patient medication sensitivities/allergies:

Patient identification e.g. ID number, date of birth:

Independent Prescriber(s): Supplementary Prescriber(s):

Condition(s) to be treated: Aim of treatment:

Medicines that may be prescribed by SP:

∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕Preparation Indication Dose schedule

.

Specific indications for referral back to the IP

.

Guidelines or protocols supporting Clinical Management Plan:

Frequency of review and monitoring by:

∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕∕Supplementary prescriber: Supplementary prescriber and independent

prescriber:

Process for reporting ADRs:

Shared record to be used by IP and SP:

Agreed by independent prescriber(s)

Date Agreed by supplementary prescriber(s)

Date Date agreed with patient/carer


Supplementary Prescribing Workshop

Peer review feedback sheet

1. Understands the importance of the need to formulate a comprehensive case study on which to base Clinical Management Plan (CMP).

2. The team understands the importance of the need to build a complete patient history which needs to be clearly structured.

3. Your team CMP clearly identifies scope for prescribing.

4. Your team understands the need to utilise contemporary evidence/protocols to support development of CMP.

5. The team understands the importance of applying appropriate pharmacological and pharmacokinetic knowledge when developing plan.


CONFIDENTIAL

NON-MEDICAL PRESCRIBING PRACTICE-BASED 360° INTERPERSONAL SKILLS ASSESSMENT TOOL

TO BE COMPLETED BY SERVICE USER/and/or CARER/PARENTThe health professional who has given this form to you should explain the purpose of this request with you before you complete it. It is essential that your informed consent is given freely.

Teesside University greatly values the involvement of service users/patients and carers in the learning and development of registered health professionals undertaking a non-medical prescribing qualification. This form helps us to assess their learning. These students must demonstrate a safe and competent approach to non-medical prescribing which reflects their understanding of your needs as a service user/patient and as a person and that they have prioritised these preferences where at all possible. It is important to all service users and carers or parents that health professionals are skilled in communication and by completing this questionnaire you are adding your contribution to the assessment process of the student. If you consent to completing this form, the person who has given it to you will write their name and sign in the box below to indicate that you have given your informed consent.

I confirm that informed consent has been obtained from the service user/carer/parent (delete as appropriate) completing this form. Name of Designated Medical Practitioner (DMP) Mentor or Supervising Health Professional: …….....................................................................................................

Signature of Designated Medical Practitioner (DMP) Mentor or Supervising Health Professional: ……..........................................................................................

Thank you for agreeing to help assess the student’s progress in managing your prescribing needs.

If you wish, please ask the DMP/Supervising Health Professional (the person who gave you this form) or your family to help you complete this form. All questions are optional, and the student will not know who has been asked to complete the form. The student will see your comments, however, please be assured that your identity will remain confidential.


Please rate how effective you/and/or your carer/parent felt the student was in relation to the following areas by ticking one box for each statement:

Poor OK Good Excellent N/A

1. You were greeted in a friendly manner which you felt was appropriate; the student’s whole approach made you feel at ease.

2. You felt you were included and able to engage in the process of your prescribing consultation.

3. You felt you were listened to and that your carer/parent were included and involved in discussion and decision making.

4. You were given the opportunity to explain your thoughts and feelings about your treatment and any way this maybe affecting you and what was important to you.

5. You were given clear, understandable and accessible information about your medicines (e.g. what it is for, how to use it, possible unwanted effects and how to report them, expected duration of treatment) and these were where possible in a format you preferred.

6. The words and language used ensured you understood and made you feel valued, empowered to be involved in, and in control of your treatment with medicines.

7. The student guided you on how to identify reliable sources of information about your medicines and treatments.

8. You were given the opportunity to ensure that you understood and could re-cap what had been agreed. The student checked your understanding of and commitment to managing, monitoring and any follow-up treatment/assessment. This may have included referral to another prescriber.

9. You felt supported and empowered in your decisions and made to feel that your views and choices were respected.

10. If appropriate you felt the student encouraged


and supported you to take responsibility for your medicines and self-manage your condition.

11. You had confidence in the student’s overall ability to meet your treatment with medicines with dignity and compassion.

Please see the next pageIs there anything the non-medical prescribing student did particularly well?


Are there any areas where you feel the student could develop?

Thank you for your help in supporting the learning of this student - it is greatly appreciated


To be completed by Designated Medical Practitioner (DMP) Mentor or Supervising Health Professional

This tool should facilitate assessment of the student non-medical prescriber’s ability to communicate with the service users/and/or carers/parents in their care. Underpinning evidence to support the areas assessed include:

NMC (2015) The Code DH (2015) NHS Constitution HCPC (2013) Standards for Prescribing NMC (2006) Standards of Proficiency for Nurse and Midwife Prescribers RPS (2016) A Competency Framework for all Prescribers

Please use the table below to provide an assessment of the student’s abilities in the areas identified. You can reflect on either one individual interaction or a combination


http://www.tees.ac.uk/

of interactions by the student non-medical prescriber. Please ensure that you assess them towards the time of their intermediate meeting so that discussion of this form within that meeting reflects their performance at that time.

You must ensure that there is service user or carer feedback is collected on three occasions.

Name of Student Non-medical prescriber: ………………………………………………..

Module being studied: ……………………………………………………………………….

Date of completion of form: …………………………………………………………………


Please rate how effective you felt the student was in relation to the following areas by ticking one box for each statement:


1. The student introduced themselves appropriately and professionally.

2. They conducted themselves appropriately and professionally.

3. The student used language appropriate for the setting and made the service user/carer/parent feel valued.

4. The student’s non-verbal communication was effective in establishing a therapeutic relationship

5. Explored the service user’s/carer’s/parent’s understanding of the consultation and aims for a satisfactory outcome for the individual and prescriber.

6. Worked with the service user/carer/parent in partnership to empower them to make informed choices, agreeing a plan that respects individual preferences including the right to refuse or limit treatment.

7. The student identified and respected the service user’s/carer’s/parent’s thoughts in relation to diversity, values, beliefs and expectations about their health and treatment with medicines.

8. Explained the rationale behind and the potential risks and benefits of management options in a way the service user/carer/parent understood. This may include referral to another prescriber.

9. If appropriate, assessed adherence in a non-judgemental way and demonstrated understanding of the different reasons non-adherence can occur (intentional or non-intentional) and how best to support individuals.

10. The student appropriately guided the service user/carer/parent on how to identify reliable sources of information about their medicines and treatments and demonstrated knowledge of these sources.

11. The student sought feedback on the prescribing


decision that was agreed and provided.12. The student demonstrated sound working in

partnership with the service user/carer/parent.13. The student demonstrated compassion in all

aspects of the consultation and treatment advice given.

14. The core values of dignity and respect were upheld at all times.

Please give a summary of areas on which the student needs to focus in order to develop their practice and also of the areas in which they are demonstrating good practice:

Name of Designated Medical Practitioner (DMP) Mentor or Supervising Health Professional: ………………………………………………………………………………

Signature of Designated Medical Practitioner (DMP) Mentor or Supervising Health Professional: ………………………...............................................................

NMC/HCPC PIN:



To be completed by Student

This tool should facilitate assessment of your ability to communicate with the service users/carers/parents in your prescribing treatment. Underpinning evidence to support the areas assessed include:

NMC (2015) The Code DH (2015) NHS Constitution HCPC (2013) Standards for Prescribing NMC (2006) Standards of Proficiency for Nurse and Midwife Prescribers RPS (2016) A Competency Framework for all Prescribers

Please use the table below to provide a self-assessment of your abilities in the areas identified. You can reflect on either one individual interaction or a combination of interactions you have had with service users/carers and parents. Please undertake this self-assessment towards the time of your intermediate meeting so that discussion of this form within that meeting reflects your performance at that time.

You must ensure that there is service user or carer feedback is collected on three occasions.

Name of Student: ……………………………………………………………

Module being studied: …………………………………………………………………..

Date of completion of form: …………………………………………………………………


Please rate how effective you felt you were in relation to the following areas by ticking one box for each statement:


You introduced yourself appropriately and professionally.You conducted yourself appropriately and professionally.You used language appropriate for the setting and made the service user/carer/parent feel valuedYour non-verbal communication was effective in establishing a therapeutic relationshipYou explored the service user’s/carer’s/parent’s understanding of the consultation and aims for a satisfactory outcome for the individual and for you as the prescriber.You worked with the service user/carer/parent in partnership to empower them to make informed choices, agreeing a plan that respected individual preferences including the right to refuse or limit treatment.You identified and respected the service user’s/carer’s/parent’s thoughts in relation to diversity, values, beliefs and expectations about their health and treatment with medicines. If appropriate you assessed adherence in a non-judgemental way and demonstrated understanding of the different reasons non-adherence can occur (intentional or non-intentional) and how best to support individuals. You took a partnership approach to the prescribing decisions made, this may have included referral to another prescriber.The service user’s or carer’s decisions were respected and valued.You sought feedback on the prescribing decision that was agreed and provided.You appropriately guided the service user/carer/parent on how to identify reliable sources of information about their medicines and treatments and demonstrated knowledge of these sources. Your approach was inclusive of all those significant in the service user’s care and the carer’s/parent’s support.The core values of dignity and respect were upheld at all


times.You demonstrated compassion in all care given.

Please give a summary of areas on which you feel you need to focus in order to develop your practice and also of the areas in which you feel you are demonstrating good practice:


Signature of Student: …………………........................................................................



SUMMARY REFLECTION

To be completed by Student

Please use this form to reflect on your communication skills and demonstration of professional attitudes and values in clinical practice. You will need the following in order to do this:

Practice-based assessment of communication skills by:

Service user/and/or Carer/Parent Designated Medical Practitioner (DMP) Mentor or Supervising Health

Professional Self-assessment

You may also want to draw upon the standards upon which this assessment has been developed. These are:

NMC (2015) The Code DH (2015) NHS Constitution HCPC (2013) Standards for Prescribing NMC (2006) Standards of Proficiency for Nurse & Midwife Prescribers RPS (2016) A Competency Framework for all Prescribers

This form must be completed in advance of the final meeting with your DMP and brought to that meeting for discussion.

Name of Student: …………………………………………………………….

Module studied: ………………………………………………………………………….

Date form completed: ………………………………………………………………………..


1. Discuss the common themes which are evident across the assessment form, including any discrepancies in the way you have been perceived by others and by yourself.

2. What factors may have affected your assessment by the different people?

3. Why are the issues which have been identified in this tool important in prescribing practice?

Signature of Student: ……………………………………………………


This assessment tool has been developed with service users/carers at Teesside University and with the following resources:

Department of Health (2015) The NHS Constitution – the NHS belongs to us all. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf

The Health & Care Professions Council (2013) Standards for prescribing. http://www.hpc-uk.org/aboutregistration/standards/standardsforprescribing/

The Nursing & Midwifery Council (2006) Standards of proficiency for nurse and midwife prescribers. https://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/

The Nursing & Midwifery Council (2015) The Code. https://www.nmc.org.uk/standards/code/

The Royal Pharmaceutical Society (2016) Prescribing competency framework.http://www.rpharms.com/unsecure-support-resources/prescribing-competency-framework.asp


http://www.rpharms.com/unsecure-support-resources/prescribing-competency-framework.asp

http://www.rpharms.com/unsecure-support-resources/prescribing-competency-framework.asp

https://www.nmc.org.uk/standards/code/

https://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/

https://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/

http://www.hpc-uk.org/aboutregistration/standards/standardsforprescribing/

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf

Disclosure and Barring (DBS) Status Verification

I confirm that there have been no changes to my DBS Status for the duration of the module.

Name

Signature

HCPC/NMC PIN

Date

DBS Certificate Number

DBS date of certificate


School of Health & Social Care

Confidentiality and Informed Consent Guidelines for Students

Trust, integrity and competence are the hallmarks of a professional and of professionals-in-training.

Being a health and social care professional is a very privileged role. The people we seek to serve, our service users, may be in a vulnerable position or state. Health and social care professionals have entrusted to them the most intimate and sensitive information and experiences. The ONLY way that a health and social care professional can carry out their role effectively, efficiently and safely is by not betraying this trust. Confidentiality and Informed Consent are essential in the health and social care setting, as maintaining confidentiality and gaining consent promotes trust and individual choice for each service user.

Without trust the work of the health and social care professional is compromised and can be virtually impossible. Service users have an expectation, and a legal right, that anything they entrust to a health and social care professional is used only for the benefit of the service user; to enhance or maintain their health, wellbeing and safety. This right is enshrined in legislation to which everyone as a professional, or professional-in-training, must adhere. Of particular importance are the NHS Constitution (2013), NHS Care Record Guarantee (2011) and the General Data Protection Regulation (2018).

It is essential that as a student you abide by your respective professional code of conduct/codes of practice when gaining informed consent and maintaining confidentiality.

It is important that you are aware that any breach of confidentiality or failure to gain informed consent, in any setting, will be deemed to be unprofessional conduct and may result in the University Fitness to Practise procedure being invoked. By ‘setting’ the School is referring not only to the practice environment but also within the University and a student’s digital presence i.e. social networking.

1. Confidentiality

When a service user/fellow student discloses information to a health or social care professional (including you as a student) it is reasonable to expect that this information is held in confidence. The professional has a duty of confidence not to disclose the information in a form that might identify the individual without their


https://ico.org.uk/for-organisations/guide-to-the-general-data-protection-regulation-gdpr/

https://ico.org.uk/for-organisations/guide-to-the-general-data-protection-regulation-gdpr/

https://digital.nhs.uk/media/329/Care-Record-Guarantee/pdf/Care

https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england

https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england

permission. This also applies to information disclosed to you by carers of service users and colleagues (fellow students, academic or practice staff):

Patients entrust us with, or allow us to gather, sensitive information relating to their health and other matters as part of their seeking treatment. They do so in confidence and they have the legitimate expectation that staff will respect their privacy and act appropriately. In some circumstances patients may lack the competence to extend this trust, or may be unconscious, but this does not diminish the duty of confidence. It is essential, if the legal requirements are to be met and the trust of patients is to be retained, that the NHS provides, and is seen to provide, a confidential service.Department of Health (2003) p7 Confidentiality. NHS Code of Practice

You must treat information about service users as confidential. You must only disclose confidential information if: you have permission; the law allows this; it is in the service user’s best interests; or it is in the public interest, such as if it is necessary to protect public safety or prevent harm to other people.Health & Care Professions Council (2016) - Standards of Conduct, Performance and Ethics

As a nurse or midwife, you owe a duty of confidentiality to all those who are receiving care. This includes making sure that they are informed about their care and that information about them is shared appropriately. Nursing and Midwifery Council (2015) The Code: Professional standards of practice and behaviour for nurses and midwives

1.1 Maintaining Confidentiality in the Practice Setting

i. Students must not hold any personal information about service users on any electronic or digital resource e.g. memory sticks, PCs (the specific exceptions to this have been agreed at course approval and include the Postgraduate Diploma/MSc in Cognitive Behavioural Therapy and the Postgraduate Certificate/UCAPD Low Intensity Assessment and Intervention Skills for Psychological Wellbeing Practice where this data is stored on an encrypted Ironkey or equivalent).

ii. Documentation must not include service user information, i.e. care plans, assessment forms, prescription sheet, psychometric testing (the specific exceptions to this have been agreed at course approval and include the Postgraduate Diploma/MSc in Cognitive Behavioural Therapy and the Postgraduate Certificate/ UCAPD Low Intensity Assessment and Intervention Skills for Psychological Wellbeing Practice).


https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf

https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf

http://www.hcpc-uk.org/assets/documents/10004EDFStandardsofconduct,performanceandethics.pdf


https://www.gov.uk/government/publications/confidentiality-nhs-code-of-practice

iii. To maintain anonymity of service users/carers use generalised terms, young, middle aged, office worker etc.

iv. Information that by its very nature could identify the service user/family/carer/staff members/students or colleagues, i.e. demographic details, unusual circumstances must not be used.

v. Documentation that identifies the workplace/practice setting must not be submitted if it is not in the public domain. In this sense public domain refers to those documents or information that may be accessed by any member of the public whether through a website, by email directly to an organisation or by written form. While these documents are not considered to be confidential care needs to be taken as these documents linked with other detail could identify the individual. This would then constitute a breach of confidentiality.

All School-issued documentation, Trust and Organisation documentation which is included to authenticate attendance at workshops, fire lectures, study days etc. and supervisors’ testimony are permitted.

vi. Maintain anonymity of members of the workforce. (Signatures of staff in the workplace who sign students’ official documentation is the exception.)

1.2 Maintaining Confidentiality in Other Settings

i. Confidentiality must be maintained at all times and not just for practice. Remember you are expected to abide/work within the spirit of your code of conduct/practice at all times.

ii. The University is supportive of methods to promote learning and therefore permits students to record all taught sessions unless instructed otherwise by their tutors. The recordings must be for your sole use. You are not permitted to share your recordings with others (other than with a transcriber to accommodate an identified disability need) or to put recordings in the public domain in any manner. However, many sessions within the School involve student discussions where students may disclose personal information. If this is the case the student must either not record or stop recording to maintain their peers’ confidentiality. You must inform your tutor at the beginning of a session that you will be recording the session to ensure they can give appropriate guidance during the session.

iii. Be careful when using social networking sites e.g. Facebook, Twitter, as sharing information about fellow students may result in confidentiality being breached and a fitness to practise procedure instigated.


iv. Breaching confidentiality i.e. giving any service user information to a third party that has no right and need to know this information will result in the instigation of a fitness to practice procedure.

2. Informed Consent

It must be emphasized that the concept of consent is twofold with respect to the health profession students. Firstly there is consent to deliver care and secondly consent to share information not directly relevant to care delivery, i.e. for educational purposes.

2.1 The guiding principle when working with a service user/fellow student is thatthey have a right to determine what happens to them, it is a fundamental part of good practice. Legally and ethically an individual should give valid consent before any intervention commences. In a health or social care context where a professional does not respect this principle they may be liable to legal action by the individual or action by their professional body.

For consent to be valid, it must be given voluntarily by an appropriately informed person who has the capacity to consent to the intervention in question (this will be the patient or someone with parental responsibility for a patient under the age of 18, someone authorised to do so under a Lasting Power of Attorney (LPA) or someone who has the authority to make treatment decisions as a court appointed deputy). Acquiescence where the person does not know what the intervention entails is not ‘consent’.Department of Health (2009) Second edition p5 Reference guide to consent for examination or treatment.

You must explain to service users the care or services you are planning to provide, any risks involved and any other possible options. You must make sure that you get their informed consent to any treatment you do carry out. You must make a record of the person's decisions and pass this on to others involved in their care. In some situations, such as emergencies or where a person lacks decision-making capacity, it may not be possible for you to explain what you propose, get consent or pass on information. However, you should still try to do all of these things as far as you can.

A person who is capable of giving their consent has the right to refuse to receive care or services. You must respect this right. You must also make sure that they are fully aware of the risks of refusing care or services, particularly if you think that there is a significant or immediate risk to their life.


http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_103643

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_103643

You must keep to your employers’ procedures on consent and be aware of any guidance issued by the appropriate authority in the country you practise in. Health & Care Professions Council (2016) - Standards of Conduct, Performance and Ethics

As a student it is important that you inform the individual of your status and that permission is given for you to carry out any intervention/record the session. The individual must also be informed and consent given where the activity is not part of the individual’s care but is for the purpose of furthering your education.

2.2 Gaining Informed Consent for Summative Assessments.

You must adhere to your respective professional guidelines for documenting informed consent. Evidence of this must be visible in any of your written work submitted if individual service user/carer/family information has been utilised in your assessed work.

The anonymity of the service user and the generalised nature of information must be ensured at all times.

Informed consent for summative assessments may only be given by service users with capacity. In this respect consent for educational purposes is different to consent for care delivery. Care delivery for people lacking capacity may be undertaken when acting in the service user’s best interests. However this argument does not stand when gaining consent for educational activities – the service user’s best interests are not served by the writing of a case study/reflective account for example. If a service user does not have capacity to consent to their information being used in a summative assessment you must inform the module leader to negotiate an alternative.

Consent is required for:i. Case studies that contain specific service user/carer/family information, i.e.

problems, condition, demographic detail, unusual circumstances, employment.

ii. Reflection that includes service user history or other significant information (as above).

iii. Critical incidences that include service user history or other significant information (as above).

iv. Information about colleagues.




Consent is not required for:i. Critical incidences and generalised reflection, focusing on practice when

discussing one’s own feelings about a situation rather than the specific circumstances of the service user.

Please note that if informed consent has not been obtained for any piece of summative assessment that relates to a service user/carer/colleague, then the Academic Misconduct Regulations will be instigated.

3. Conclusion

At the point of enrolment will be asked to sign a form stating that you understand and will abide by these principles of confidentiality and informed consent. Completion of this form is a requirement of the module. If you are unsure of the principles and how they apply to your practice then it is your responsibility to seek further guidance.


Appendix A

STUDENT DECLARATION FORM

Please complete the below in fullStudent name (please print)Student NumberDate Cohort Undergraduate / Postgraduate (delete as appropriate)Course

As a student I am aware that there are certain procedures and policies I must adhere to:

Please read this form carefully and complete the required information.

This information will be treated as confidential and will be in accordance with the University Data Protection Policy.

1. Confidentiality and Informed ConsentI have read and understood the School Guidelines for Consent & Confidentiality and understand the importance of maintaining confidentiality and gaining informed consent. I also understand the consequences of failing to do so.In addition, I am aware that the recording of lectures/discussions may not be permitted, to protect student confidentiality.

Signature…………………………………………………..……… Date …………………

2. Fitness to PractiseI agree to abide by the relevant professional code of conduct and to work within the professional standards as described by the relevant Professional/Statutory/ Regulatory Bodies such as the NMC or HCPC or other relevant body for the duration of my studies.

I am fully aware that failure to: Comply with the relevant professional guidelines Meet the expected professional standardsmay result in my discontinuation from the course/tt/file_convert/5e16ee351833d01ae76462b0/document.docx 60©TU-SOHSC (2019)

Signature…………………………………………………..……… Date …………………

3. Progression and achievement record. I consent to the processing of confidential data identified on my ongoing achievement record, and agree that this information can be shared between successive mentors, and with relevant education providers, as part of the process of assessing fitness to practice.

Signature…………………………………………………..……… Date …………………

4. Consent for Practical and Classroom Experiential ActivitiesAs part of your course you may be expected to take part in some practical based sessions and some classroom experiential activities, which will develop your professional knowledge and understanding. As these sessions are an important component of your learning you will normally be expected to fully participate in these sessions. You may also have practical assessments where you demonstrate your professional and practical skills. These assessments may be recorded to ensure that they are available for external scrutiny. During these assessments you may also be expected to act as a model for your peers.

1. I confirm that; a. I am willing to participate in activities as a volunteer subject.b. I will behave in a professional manner in accordance with the

relevant discipline specific Professional Code of Conduct throughout any activity.

c. I will act in accordance to the instructions given to me by the module tutor.

d. I will inform the module tutor of concerns that I have about a particular session.

e. I will terminate any tests or activities if the module tutor deems it advisable to do so.

2. I understand that;a. The module tutor will explain the nature and purpose of the activity

and will inform me of any potential risk to my health as a result of my participation.

b. I am free to withdraw from an activity at any time after discussion with the module tutor.

c. It will be my responsibility to report any adverse reactions and to act upon advice given.


d. The module tutor could advise me to see my general practitioner or occupational health as a result of any concerns that an activity could identify.

e. I have a responsibility to seek medical advice if advised to do so.f. In order to ensure my well-being it is in my interest to discuss in

confidence with my module tutor any health issues or prior experiences which may impact upon my ability to participate in an activity.

g. It is my responsibility to inform the module tutor of any personal physical or psychological issues which may mean that it is unsafe for me to participate in an activity.

h. Module tutors may relate any issues of concern in confidence to the relevant Principal Lecturer for Programmes or Collaborative Partner Director as appropriate.

i. Practical assessments may be recorded and made available to other tutors, University academic staff and external examiners to ensure rigour in the assessment process.

Signature…………………………………………………..……… Date …………………


UNIVERSITY MARKING CRITERIA – LEVEL 6

Level 690%-100%Exceptional work. Presentation is logical, error-free and, where appropriate, creative. There is an in-depth understanding of issues/problems and excellent critical/deep engagement with the material and concepts involved. Very skilful interpretation of data. Arguments, ideas and, where appropriate, solutions are presented coherently and fully underpinned by thorough research and reading. 80%-89%Outstanding work with presentation of a very high standard. There is comprehensive understanding of key concepts and knowledge and clear evidence of critical analysis and insight. Accurate interpretation of data with arguments, ideas, and solutions presented effectively and based on strong research and reading.70%-79%Extremely good work with presentation of a high standard. Demonstrates an excellent knowledge base with a clear understanding of the issues and application to practice where appropriate. There is some effective critical and analytical application of relevant research and reading.60%-69%The work is very good, logically structured and presented to a high standard. Demonstrates a strong knowledge base with a clear understanding of the issues and application to practice where appropriate. There is some critical and analytical application of relevant research.50%-59%The work is clearly presented and logically structured. It shows evidence of a sound understanding of the topic and addresses major issues. The work contains some discussion and interpretation of relevant perspectives although further development of the arguments presented would be beneficial. There are examples of critical reflection and evidence of application of theory to practice.40%-49%Adequate presentation. The work displays basic knowledge and understanding of the topic but is largely descriptive. There is an attempt to bring together different ideas and concepts although this would have been strengthened by the inclusion of further key issues. The structure of the work requires attention to its coherence and logical development of content. The link between theory and practice, where appropriate, is somewhat tenuous and its development would enhance the work considerably.30%-39% – FailThe work is poorly presented and contains numerous errors, inconsistencies, and omissions with limited use of source material. The work displays a weak knowledge base and a lack of sufficient understanding of the topic. There is little or no evidence of the application of theory to practice where appropriate. It contains many unsupported statements with little attempt to bring issues together and lacks critical analysis and reflection.


29% and below – FailThe work is very poorly presented and contains numerous serious errors, inconsistencies, and omissions with little use of source material. The work displays a very weak knowledge base and a lack of sufficient understanding of the topic. There is little or no evidence of the application of theory to practice where appropriate. It contains many unsupported statements with little attempt to bring issues together and there is a complete lack of critical analysis and reflection.


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