Caught in the Firing Line: Nurse Prescribers

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May 30, 2022 | 6 Comments


  1. Thank you for this further compelling and deeply moving lecture. How can prescribers continue to apparently remain unaware of the critical importance of cases such as these, and the ever-growing GENUINE evidence base that supports the ADRs behind these tragedies?

  2. Someone here, who does a thoroughly good job of discerning where some of the problems come from – the ‘someone’ went through Paroxetine’s worst, was publicly humiliated by Simon Wessely, Wendy Burn and John Crichton but, to be honest, came out the better man..

    Take the Trip…

    The Narrative Controllers

    Professor Sir David Haslam, Chair of NICE Guidelines, in an interview in June 2016 said “The mantra that I’ve given in every lecture is that they’re guidelines and not tramlines.” This is advice that I agree with, but in practice where doctors are regulated, the fear of departing from evidence means that practitioners are more likely to practice defensively and so follow the tramlines.

  3. GP land is in crisis in UK If Nurses hitherto lower in the medical pecking order are being being used to fill gaps they are going to take the rap for harms due to following ‘guidelines’. Now is the time they should take action Perhaps the scandals over deaths from vaccines with data kept secret should alert them to support demands for full data before they prescribe. I wonder how they would access it if the day arrived ?A prescriber wouldn’t be able check through all the trials data before prescribing in a consultation I imagine.. Would it be set out in an accessible form by yet another organisation ? Then how could that be trusted not to become corrupted.

  4. A very sick system fuelled by those who do not give a damn.
    The people who are sincere and genuinely care sadly pay the price for this scandalous corruption.
    The apprentices on the low pecking order, as Susanne eloquently put it, end up being the scapegoats for those who have not got the courage to administer the so called ‘SAFE and EFFECTIVE’ vaccine.
    I feel for those who are so brainwashed and are unable to see beyond the smoke and mirrors.
    We need a brave and courageous activist to set the record straight.

  5. Seems all but GPs are sitting around twiddling their thumbs Which of those named as potentially able to issue ‘fit notes’ will accept the ‘burden’ They may as professionals be equally in/competent to do it .Depends on the extra cash on offer probably.
    Staff working in Dept of Work and pensions were/are used to decide who can claim benefits Sickness claims which previously led to horrendous scandals, mistakes, bullying and deaths fom suicide in a push to get people into work and off ‘benefits’. The stigma against claimants which the government ramped up was disgusting. This is likely to happen again and again will partly at least depend on the individual handling a claim for a sick note. The group who sees people who are unwell most often are ‘carers’ But they are even lower in the pecking order so have not been included in the scheme. Nor is there any publicity advising us of the change and what choice anybody might have as to who they request a ‘fit note’ from. Or the information about what qualifications they have to issue them. This is just a woolly statement from the BMA … ‘they’….. should be ‘working in a suitable environment and have the necessary
    skills and training to have work and health conversations with
    Issuing fit notes also needs to be within their professional ‘scope of
    practice’, the BMA said, and that new guidance and training had been
    developed to advise on this. There is no information as to who has actually received this training .The scheme begins in a few weeks time.
    Emma Wilkinson Pulse Today

    09 June 2022
    A wider range of health professionals will be able to sign off fit
    notes from next month to ease pressure on GPs.

    New legislation being laid down tomorrow will enable nurses,
    occupational therapists, pharmacists, and physiotherapists to legally
    certify fit notes, the Department for Work and Pensions has confirmed
    to Pulse.

    It is the biggest change to the rules around fit notes ….
    providing more‘interactive’ advice on workplace adaptations and support.‘
    The change in law, which will apply across England, Scotland and Wales
    from 1 July follows moves in April to allow for fit notes to be
    certified and issued digitally.

    In a bulletin, the BMA, who has long been in favour of a wider variety
    of healthcare professionals being able to sign fit notes, said not
    everybody working within these professions should issue them but
    should be ‘working in a suitable environment and have the necessary
    skills and training to have work and health conversations with
    Issuing fit notes also needs to be within their professional ‘scope of
    practice’, the BMA said, and that new guidance and training had been
    developed to advise on this.

    The changes follow a consultation last summer about reducing
    ill-health related job loss to which many respondents expressed views
    on the current fit note system despite it not being part of the
    original scope of the consultation.

    Outlining its plans at the time, the Government said it would also
    move to embed electronic fit notes in hospital systems to encourage
    hospital doctors to issue them reducing the burden on GPs.

    Maria Caulfield, minister for patient safety and primary care said
    that improving access to GP services and reducing unnecessary
    bureaucracy was ‘vitally important as we tackle the Covid backlog’.

    ‘Extending powers to provide fit notes to other healthcare professions
    will relieve further pressures on GPs and is another step towards
    helping to deliver an extra 50 million appointments in general
    practice a year by 2024.’

    Chloe Smith, minister for disabled people, health and work said the
    changes would make it easier for patients to get the support and
    advice they need from the right place, ensuring where possible that
    they are able to remain in work.

    ‘These latest fit note changes recognise the valuable role other
    professions play in helping manage people’s health and I hope this
    will also help reduce unnecessary bureaucracy for doctors and general
    practice more widely.’

    ‘This is just another way in which we’re supporting GPs in primary
    care, and we remain on track to deliver 26,000 more primary care staff
    by 2024 to help improve patient access to appointments.’

    BMA England GP committee deputy chair Dr Kieran Sharrock said: ‘This
    announcement is a positive step and we hope that it will go some way
    to both improving the process for people who need confirmation that
    they are too unwell to work, and free-up GPs’ time to care for
    patients who need their expertise.

    ‘The BMA has been clear for many years that it may not always be
    necessary or appropriate for a GP to issue a fit note, especially
    where a patient has seen a different member of the practice team for
    their condition, such as a nurse or physiotherapist.

    RCGP vice chair Dr Gary Howsam said: ‘Allowing other healthcare
    professionals working in general practice, where appropriate, to issue
    fit notes is something the College has called for and would support.

    ‘Such a move should help free up GPs’ time to deliver patient care to
    those who need their medical expertise at a time when the profession
    is working under intense workload and workforce pressures. It would
    also recognise the role of some members of the wider practice team in
    giving patients advice about health and work – as such it’s important
    that appropriate guidance and training is put in place to support them
    to do this safely and effectively.

  6. What we need – and have needed for over ten years now, is a practitioner who will certify:

    “This person is not fit to work, and will remain unable to return to employment. This is because multi-systems, life-changing and life-limiting injuries have resulted from misdiagnosed akathisia, and then long term, enforced use of highly toxic, prescribed drugs which caused life-threatening adverse reactions. All of these adverse drug reactions were serially misdiagnosed as ‘Severe Mental Illness’.
    Diagnostic category: Cascade Iatrogenesis.

    This would demonstrate a real commitment to the Duty of Candour.

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