1. When to use supplementary prescribing and How to write a clinical management plan
Kimberley Tordoff

2. Introduction
On completion of this course you will gain a qualification of being an IP & SP
Therefore you must demonstrate the ability to complete a clinical management plan required for supplementary prescribing
Errors on your clinical management plan (CMP) may lead you to fail your portfolio
IP = Independent Prescriber
SP= Supplementary Prescriber

3. Uses of CMP Long term conditions Useful if working in a new area
Useful for prescribing Controlled Drugs (CDs)
Widely used before the whole BNF opened

4. CMPs Blank templates on Department of Health website
You may use your own version as long as ALL the legally required information is there
Choose the one appropriate to your practice (do you have access to the notes or not?)
Only put one condition to be treated or one symptom
For CMPs to work they need to be quick and simple (NPC 2003)
Remember for chronic conditions...depression, asthma, chronic obstructive pulmonary disease

5. CMPs You are the SP and the doctor is the IP
If more than one SP all must be listed by name and all must sign in the relevant section to enable more than one SP in a team to use the plan.
Use the patient details & address in your module guide
Fill in the patient details including an NHS number (false)
Condition to be treated
Aim of the treatment; be specific e.g. BP between x & x or x, peak flow over x.

6. CMPs
Preparation can be the name of 1 drug if it is that specific, but a plan works better if it is over a range of drugs or the whole class of drugs
Include the section of the BNF e.g. Section 3.2.1of BNF vol (Joint Formulary Committee, 2011).
If you are experienced in this area then you would want a range of drugs
Dose – range of dose to prescribe for a specific drug or as per section of BNF vol (Joint Formulary Committee, 2011).
BNF= British National Formulary

7. CMPs Reasons for referral back to IP
Be specific and not vague-if you put ‘side effects’ then you would have to refer back for every single slight problem
Think about this in reality
BP above x on x occasions despite maximum dose
Cough on ace may not be needing to do back to see IP if you have given yourself a wide enough section of BNF so you can try an alternative

8. Guidelines & Protocols
Must include BNF with volume number and date
Guidelines referenced properly
These can be local as long as they are recognised and robust

9. Review & Record Frequency of review is a heading and must be completed
Put a time frame for IP & SP
IP must be at least yearly
SP must be more frequent than IP
Whatever the shared record is then document it e.g. hospital notes, EMIS.
EMIS = Egton Medical Information System

10. Adverse Drug Reactions (ADRs)
Inform IP
Document in patients notes
Inform MHRA via yellow card system
Signatures are needed NOT typed names
Dated
Patients signature is not required but document in notes that they have given informed consent
When you write out your prescription the pharmacist you must know that you are prescribing within a CMP so write SP after your name
MHRA = Medicines and Healthcare products Regulatory Agency

11. Conclusion
This is a fictitious CMP so don't worry that you are signing something illegally
Get this done soon whilst it is fresh in your mind

12. References
Joint Formulary Committee British National Formulary (61) Ed. London: British Medical Association and Royal Pharmaceutical Society (2011) National Prescribing Centre (2003) (NPC) Supplementary Prescribing A resource to help healthcare professionals to understand the framework and opportunities

13. This work was produced as part of the TIGER project and funded by JISC and the HEA in For further information see:
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