Intended for healthcare professionals

Head To Head

Should primary care be nurse led? Yes

BMJ 2008; 337 doi: (Published 04 September 2008) Cite this as: BMJ 2008;337:a1157

Current Nurse CD Prescribing Rules

Professor Sibbald writes that suitably qualified nurses have been
able to prescribe any licensed medicine for any medical condition, with
the exception of controlled drugs since the DH guidance dated 10th
November 05. But she does not reference any such guidance beyond this
In fact nurse independent prescribers may now prescribe most opioids and
major sedatives mainly but not exclusively in connection with palliative
care and by most routes ( oral, parenteral, transdermal, rectal and
buccal ). Also any CD that is included in a patient`s clinical management
plan and agreed by a doctor ( DH guidance last modified 31/7/07 ).
Problems may still arise when CDs are administered by an unlicensed route
eg diamorphine and Midazolam in a syringe-driver which would still require
a doctor`s authority.

Competing interests:
None declared

Competing interests: No competing interests

20 September 2008
Don C Aston
34, Burman Road, Shirley B90 2BG