Non-Medical Prescribing: An Overview of the Cumberlege Report and Its Recommendations (PDF)
What is the Cumberlege Report and Why is it Important?
In 1986, a landmark report was published that changed the landscape of community nursing and prescribing in the UK. The report, titled Neighbourhood Nursing: A Focus for Care, was authored by Baroness Julia Cumberlege, a former nurse and politician who chaired an advisory group on district nursing. The report, also known as the Cumberlege Report, examined the care given to clients in their homes by district nurses (DNs) and health visitors (HVs) and made recommendations for improving their role and practice. One of the most significant recommendations was that community nurses should be able to prescribe from a limited list of items and simple agents agreed by the Department of Health and Social Security (DHSS), without having to rely on general practitioners (GPs) for prescriptions. This was seen as a way to enhance patient care, reduce delays and bureaucracy, and make better use of resources.
cumberlege report 1986 pdf download
The Cumberlege Report was a visionary document that paved the way for non-medical prescribing in the UK. It recognised the potential of community nurses to provide holistic, patient-centred care that meets the needs of individuals and populations. It also acknowledged the challenges and barriers that community nurses faced in their everyday practice, such as lack of autonomy, support, recognition and education. The report aimed to address these issues by proposing a new model of community nursing that empowers nurses to work independently and collaboratively with other professionals.
The Cumberlege Report is an important piece of history that has influenced the development of community nursing and prescribing over the past three decades. It is also a relevant source of information and inspiration for current and future practitioners who want to learn more about the origins, rationale and evidence behind non-medical prescribing. In this article, we will explore the background and context of the report, its main recommendations and findings, its impact and implications, and how to access and download it.
The Background and Context of the Report
The Cumberlege Report was commissioned by the DHSS in 1985 as part of a wider review of community health services. The aim was to examine how community nursing could be improved to meet the changing needs of society and health care. At that time, there was a growing recognition that more people were living with chronic conditions, disabilities and complex needs that required long-term care in their own homes. There was also a shift towards promoting health promotion, prevention and self-care as part of primary health care. These trends created new opportunities and demands for community nursing services.
However, there were also many problems and difficulties that hindered community nursing practice. One of them was prescribing. Community nurses often had to request prescriptions from GPs for items such as wound dressings, ointments, catheters and incontinence pads that they needed to provide care for their clients. This process was time-consuming, inefficient and frustrating for both nurses and GPs. It also created delays in treatment, increased costs and reduced patient satisfaction. Moreover, it undermined the professional autonomy and accountability of community nurses who had to depend on GPs for clinical decisions.
The Cumberlege Report recognised that prescribing was a key issue that needed to be addressed to improve community nursing practice. It also realised that prescribing was not just a technical skill but a complex process that involved assessment, diagnosis, planning, implementation and evaluation of care. Therefore, the report did not only propose that community nurses should be able to prescribe from a limited list of items, but also that they should receive appropriate training, supervision and support to do so safely and effectively.
The Main Recommendations and Findings of the Report
The Cumberlege Report made a number of recommendations for improving community nursing practice, but the most notable one was that community nurses should be able to prescribe from a limited list of items and simple agents agreed by the DHSS. The report argued that this would benefit patients, nurses and the health care system in several ways, such as:
Improving patient care by reducing delays, increasing convenience, enhancing continuity and facilitating self-care.
Empowering nurses by increasing their autonomy, responsibility, confidence and satisfaction.
Optimising resources by saving time, money and paperwork.
Strengthening teamwork by improving communication, collaboration and trust between nurses and GPs.
Advancing nursing knowledge by stimulating research, education and development.
The report also suggested that the list of items and agents that community nurses could prescribe should be based on the following criteria:
They should be relevant to the needs of the clients and the scope of practice of the nurses.
They should be simple, safe and effective to use.
They should have clear indications, contraindications, dosages and side effects.
They should be readily available and affordable.
The report also recommended that community nurses who wanted to prescribe should undergo a specific training programme that covers the following topics:
The legal, ethical and professional aspects of prescribing.
The pharmacology, therapeutics and administration of the items and agents on the list.
The assessment, diagnosis, planning, implementation and evaluation of care involving prescribing.
The documentation, audit and quality assurance of prescribing practice.
The report also advised that community nurses who prescribe should be supervised and supported by GPs who would act as mentors and advisers. The report also proposed that a system of monitoring and evaluation should be established to ensure the safety, quality and effectiveness of prescribing practice.
The Impact and Implications of the Report
The Cumberlege Report had a significant impact on the development of community nursing and prescribing in the UK. It was followed by several changes in legislation, policy and practice that enabled non-medical prescribing to become a reality. Some of these changes include:
The Medicinal Products: Prescription by Nurses etc. Act 1992, which gave legal authority for nurse prescribing from a limited list of items.
The Crown Report 1999, which extended nurse prescribing to include some prescription-only medicines (POMs) for minor ailments.
The Health and Social Care Act 2001, which introduced supplementary prescribing for nurses (and other professions) in partnership with doctors.
The Nurse Prescribers' Extended Formulary 2002, which expanded nurse prescribing to include more POMs for common conditions.
The Non-Medical Prescribing Programme 2005, which allowed nurse independent prescribers (and other professions) to prescribe any licensed medicine for any medical condition within their competence.
The Cumberlege Report also stimulated a lot of research and evaluation on non-medical prescribing. The evidence from these studies has generally supported the benefits and outcomes of non-medical prescribing for patients, professionals and the health care system. Some of these benefits include:
Improved access, convenience, satisfaction and adherence for patients.
Enhanced autonomy, confidence, competence and satisfaction for prescribers.
Reduced workload, improved communication, collaboration and trust for doctors.
Saved time, money and resources for the health care system.
The Cumberlege Report also inspired further developments in non-medical prescribing. For example, it led to the creation of the Association for Nurse Prescribing (ANP), a professional organisation that represents and supports nurse prescribers in the UK. It also influenced the development of non-medical prescribing in other countries, such as Australia, Canada, New Zealand and the USA. Moreover, it paved the way for other professions to become involved in non-medical prescribing, such as pharmacists, physiotherapists, podiatrists and optometrists.
How to Access and Download the Report
How to Access and Download the Report
If you are interested in reading the Cumberlege Report in full, you may wonder how to access and download it. Unfortunately, the report is not widely available online or in print. However, there are some ways to find it if you are persistent. Here are some tips and tricks:
Search for the report on Google Scholar or other academic databases. You may find some links to PDF versions of the report or its chapters. However, these links may not work or may require a subscription or payment to access.
Look for the report in your local or university library. You may be able to borrow a hard copy of the report or request it through inter-library loan. However, the report may be out of print or out of stock.
Contact the Department of Health and Social Care (DHSC) or the National Archives. You may be able to request a copy of the report from them. However, they may charge a fee or have a long waiting time.
Ask someone who has a copy of the report to share it with you. You may know someone who has a personal or professional interest in the report and has a copy of it. Alternatively, you may find someone who has a copy of the report on social media or online forums and ask them politely to send it to you.
Whichever method you choose, be prepared to spend some time and effort to get hold of the report. It may not be easy, but it will be worth it if you want to learn more about this influential and important document.
The Cumberlege Report was a groundbreaking report that introduced non-medical prescribing for community nurses in the UK. It was based on a comprehensive and rigorous examination of the care given to clients in their homes by district nurses and health visitors. It made a strong case for allowing community nurses to prescribe from a limited list of items and simple agents agreed by the DHSS, without having to depend on GPs for prescriptions. It also recommended that community nurses who prescribe should receive appropriate training, supervision and support to do so safely and effectively.
The Cumberlege Report had a significant impact on the development of community nursing and prescribing over the past three decades. It led to several changes in legislation, policy and practice that enabled non-medical prescribing to become a reality. It also stimulated a lot of research and evaluation that supported the benefits and outcomes of non-medical prescribing for patients, professionals and the health care system. Moreover, it inspired further developments in non-medical prescribing, such as extending it to other professions and other medicines.
The Cumberlege Report is an important piece of history that has influenced the evolution of community nursing and prescribing in the UK. It is also a relevant source of information and inspiration for current and future practitioners who want to learn more about the origins, rationale and evidence behind non-medical prescribing. However, accessing and downloading the report can be challenging, as it is not widely available online or in print. Therefore, you may need to use some tips and tricks to find it if you are interested in reading it.
We hope that this article has given you an overview of what the Cumberlege Report is and why it is important. If you want to know more about non-medical prescribing, you can also check out our other articles on this topic.
Here are some frequently asked questions about the Cumberlege Report:
Who is Baroness Julia Cumberlege?
Baroness Julia Cumberlege is a former nurse and politician who chaired the advisory group on district nursing that produced the Cumberlege Report. She has been a member of the House of Lords since 1990 and has held various positions in health and social care policy and practice. She is also the founder and chair of Cumberlege Eden & Partners, a consultancy firm that provides leadership development programmes for health professionals.
What is non-medical prescribing?
Non-medical prescribing is when health professionals who are not doctors can prescribe medicines for patients within their scope of practice and competence. Non-medical prescribers include nurses, pharmacists, physiotherapists, podiatrists and optometrists. There are two types of non-medical prescribing: independent prescribing and supplementary prescribing. Independent prescribing is when non-medical prescribers can prescribe any licensed medicine for any medical condition within their competence. Supplementary prescribing is when non-medical prescribers can prescribe medicines from a patient-specific clinical management plan agreed with a doctor.
What is the difference between the Cumberlege Report and the Crown Report?
The Cumberlege Report and the Crown Report are both reports that made recommendations for non-medical prescribing in the UK. The Cumberlege Report was published in 1986 and focused on community nursing and prescribing from a limited list of items and simple agents. The Crown Report was published in 1999 and extended non-medical prescribing to include some prescription-only medicines (POMs) for minor ailments.
What is the current status of non-medical prescribing in the UK?
Non-medical prescribing is now well established and widely practiced in the UK. According to the NHS Digital, there were 94,734 qualified nurse prescribers, 3,649 qualified pharmacist prescribers, 1,011 qualified physiotherapist prescribers, 1,003 qualified podiatrist prescribers and 1,001 qualified optometrist prescribers in England as of March 2020. Non-medical prescribers can prescribe any licensed medicine for any medical condition within their competence, as well as some controlled drugs under certain circumstances.
How can I learn more about non-medical prescribing?
If you want to learn more about non-medical prescribing, you can read our other articles on this topic, such as:
What is Non-Medical Prescribing and How Does it Work?
How to Become a Non-Medical Prescriber: A Guide for Nurses
The Benefits and Challenges of Non-Medical Prescribing: A Review of the Evidence
The Future of Non-Medical Prescribing: Trends and Opportunities
You can also visit the websites of the following organisations that provide information and support for non-medical prescribers:
The Association for Nurse Prescribing (ANP)
The Royal College of Nursing (RCN)
The National Prescribing Centre (NPC)
The Medicines and Healthcare products Regulatory Agency (MHRA)