2023/24 Taught Postgraduate Module Catalogue

HECS5321M Independent and Supplementary Prescribing for Allied Health Professionals

30 creditsClass Size: 25

If you are applying for a stand-alone Masters level module please note you must meet either the general University entry criteria or the specific module pre-requisite for this level of study.

Module manager: Martin Walsh
Email: m.p.walsh@leeds.ac.uk

Taught: 1 Jan to 30 Sep, 1 Sep to 30 Jun (adv year), Semesters 1 & 2 (Sep to Jun) View Timetable

Year running 2023/24

Pre-requisite qualifications

- Applicants are registered with the Health and Care Professions Council (HCPC) as a physiotherapist, paramedic or podiatrist

- Applicants are in good standing with the HCPC and any other healthcare regulator with which they are registered

- Applicants have normally at least 3 years relevant post-qualification experience and must be working at an advanced practitioner or equivalent level

- Applicants must be professionally practising in an environment where there is an identified need for the individual to regularly use independent and/or supplementary prescribing.

- Applicants have an identified an area of clinical or therapeutic practice in which to develop independent prescribing practice


- Applicants have a valid Disclosure and Barring Service (DBS) certificate

- Applicants have completed level 1 safeguarding adults training

- Applicants have completed level 3 safeguarding children training if their role involves contact with children

- English language requirement: IELTS 7.0 overall

- Applicants must have a Practice Educator (PE) who has agreed to supervise their learning in practice. The applicant’s PE must be a registered healthcare professional in Great Britain or Northern Ireland with legal independent prescribing rights, who is suitably experienced and qualified to carry out this supervisory role, and who has demonstrated CPD or revalidation relevant to this role.


- Where the applicant has not undertaken or will not be undertaking a module in physical assessment and diagnostics alongside the Independent and Supplementary Prescribing module, then the employer's Non-medical Prescribing Lead is responsible for confirming that the applicant has been assessed as competent to take a history, undertake clinical assessments, and diagnose the patients' problems

- Applicants must have a bachelor degree with a 2:1 (hons) in a health science from a recognised higher education institution or certified evidence of an ability to study at level 5 (Master's level)

Please direct any application enquiries to admissions@healthcare.leeds.ac.uk

This module is mutually exclusive with

HECS5322M	Independent and Supplementary Prescribing for Nurses and Mid
HECS5323M	Independent Prescribing for Pharmacists

Module replaces

N/A

This module is not approved as an Elective

Module summary

This module prepares allied healthcare professionals (podiatrists, paramedics and physiotherapists) for the advanced role of Independent and Supplementary Prescribing. It is taught interprofessionally with pharmacists, nurses and midwives and this is the most frequently mentioned ‘positive’ element mentioned in the module evaluations. The module is 38 days in length over a period of up to 26 weeks including 12 days of clinical practice. The University taught element is completed within the first 13 weeks for all students. A multidisciplinary approach has been used in the development of this module with lecturers drawn from a range of academic, research and clinical backgrounds.Please direct any application enquiries to admissions@healthcare.leeds.ac.uk

Objectives

This module is designed for physiotherapists or paramedics registered with the HCPC and who wish to obtain the necessary knowledge and skills to become Independent and Supplementary Prescribers.

The module includes taught compulsory days along with blended learning and practice hours supervised by a Practice Educator (PE). On successful completion of the module, physiotherapists/paramedics must apply to be annotated on the HCPC register as independent prescribers, in order to prescribe in their area of clinical practice.

The module aims to develop the competence of the individual as an independent and supplementary prescriber by focusing on the four key learning outcomes (please below). These learning outcomes together with the course content has been mapped to the Royal Pharmaceutical Society's Competency Framework for All Prescribers (2016).

Learning outcomes
The HCPC requires that the learning outcomes for the module are mapped to the RPS Competency Framework for all Prescribers (2016). The RPS Framework is composed of 76 competencies across 10 domains.
The domains are as follows Competency 1: Assess the patient; Competency 2: Identify evidence-based treatment options available for clinical decision making; Competency 3: Present options and reach a shared decision; Competency 4: Prescribe; Competency 5: Provide Information; Competency 6: Monitor and Review; Competency 7: Prescribe Safely; Competency 8: Prescribe Professionally; Competency 9: Improve Prescribing Practice; Competency 10: Prescribe as Part of a Team.


• Learning outcome 1 (LO1): Synthesise knowledge and skills from a wide range of appropriate sources (e.g. bio-psycho- social theories of human biology and development, pharmacology and applied therapeutics, pharmacy calculation, social influences, academic reviews, national and local policies and guidelines), to enable an in depth consultation with a patient in a structured, systematic manner. The consultation includes evidence based history-taking techniques, effective communication with patients/carers as well as implementing a plan for assessment and review of the patient where appropriate (Competency 1: Assess the patient; Competency 2: Identify evidence-based treatment options available for clinical decision making; Competency 3: Reach a Shared Decision; Competency 4: Prescribe: Competency 6: Monitor and Review).

• Learning Outcome 2 (LO2): Demonstrate ability to critically appraise the roles and responsibilities of an independent and supplementary prescriber with knowledge of the legal, ethical and professional framework for accountability and responsibility in relation to prescribing (Competency 4: Prescribe, Competency 8: Prescribe professionally)

Learning Outcome 3 (LO3): Demonstrate ability to question and interpret evidence to enable appropriate, safe and cost-effective prescribing decisions taking into account evidence-based practice and national/local guidelines where they exist (Competency 5: Provide information, Competency 7: Prescribe safely, Competency 8: Prescribe professionally)

Learning Outcome 4 (LO4): Communicate and collaborate effectively with healthcare professionals to ensure the safe and effective management of the patient (Competency 9: Improve prescribing practice, Competency 10: Prescribe as part of a team)

Skills outcomes
Skills and knowledge introduced/strengthened and assessed during the module build on the professional skills and knowledge of a qualified podiatrist/physiotherapist/paramedic and include: effective history taking and consultation skills, rational clinical decision making, critical appraisal of the evidence base, theory and legislation underpinning safe and cost-effective independent prescribing including deprescribing.

Syllabus

To satisfy each of these learning outcomes, the module will focus on a range of topics of importance to prescribers under the themes of:

• Assessing the patient and Identify evidence-based treatment options available for clinical decision making
• Reaching a Shared Decision and Providing Information
• Prescribing professionally and prescribing as part of a team
• Monitoring and reviewing the patient, prescribing safely, improving prescribing practice


Teaching sessions delivered as part of the module fit under these themes. Please see Appendix 1 for mapping of teaching sessions to RPS Competency Framework for All Prescribers (2021).

Assessing the patient and Identify evidence-based treatment options available for clinical decision making
Face-to-face Sessions
Consultation, diagnosis and decision making and treatment planning
Introduction to Pharmacology and Pharmacokinetics
Getting familiar with the BNF and other information sources
Pharmaceutical Calculations
Pharmacodynamics
Interpretation of numerical results
Critical appraisal of the literature
Introduction to patient Assessment and Physical Examination
Treatment of anxiety, depression and related conditions
Antimicrobial Stewardship

Online Learning Materials
Prescribing in Cardiovascular Disease
Prescribing for older people
Deprescribing
Managing acute and chronic pain conditions
Prescribing for Gastrointestinal Conditions
Health Economics for Prescribers

Reaching a Shared Decision and Providing Information
Face-to-face Sessions
Informed consent, autonomy and competence

Online Learning Materials
Introduction to Medicine Optimisation
Information Sources and supporting individuals to make informed choices
Patient partnerships: Understanding medicines taking from the patient’s perspective


Prescribing professionally and prescribing as part of a team
Face-to-face/ Teaching Sessions
The law that governs the use of medicines in the UK
Independent Prescribing: legal requirements, medical records, prescription writing and prescription safety
Professional Framework: Responsibility, accountability, vicarious liability and duty of care
Ethics in prescribing
Reflective practice & reflective writing
Respecting equality, diversity and cultural differences
Roles and responsibilities in safeguarding with children and vulnerable adults

Online Learning Materials
Prescribing in the context of the NHS, the team and the individual
Clinical management plans and supplementary prescribing
Prescribing of controlled drugs

Monitoring and reviewing the patient, prescribing safely, improving prescribing practice
Face-to-face Teaching Sessions
Investigation and interpretation of results for prescribing practice
Medication errors and safe independent prescribing

Online Learning Materials
Drug Interactions
Adverse Drug Reactions
Safer prescribing: policies and processes
Exercises related to investigation and interpretation of results for prescribing practice

Teaching methods

Delivery type	Number	Length hours	Student hours
e-Lecture	28	2.50	70.00
Supervised Practice	90	1.00	90.00
Lecture	26	2.50	65.00
Practical	4	3.00	12.00
Tutorial	3	2.00	6.00
Independent online learning hours			5.00
Private study hours			70.00
Total Contact hours			243.00
Total hours (100hr per 10 credits)			318.00

Private study

There is a minimum of 70 hours at Level M included for private study. Students are expected to spend private study time in preparation for lectures, tutorials, practicals, the portfolio and assessment. 5 hours are timetabled for students to complete e-learning pharmacology workbooks. Students are also required to spend 90 hours with the Practice Educator.

Opportunities for Formative Feedback

Formative assessment is provided throughout the module. Formative OSCEs are provided during a 1.5 hour session which takes place two weeks prior to summative assessment. The marking schemes for each of these formative OSCE stations are provided to students during these sessions to compare their answers to the correct/appropriate answers for the station. This gives students the opportunity to identify any outstanding knowledge or competency gaps prior to undertaking to the summative assessment. A formative exam (1.5hrs) is also provided to students at least two weeks prior to the summative assessment. In addition, case-based scenarios and questions are used within the lectures and seminars for students to work on. There are also workbooks and online learning opportunities available for students to complete which have formative assessments within them.

Feedback is also provided by the PE via observation of practice, discussions about patient cases and achievement of competencies throughout preparation of the portfolio. We also require students to meet with the PE at the outset of the course; during this meeting the student drafts a learning plan in conjunction with the PE. The PE will also meet with the student midway through the module to review the learning plan and discuss progress. This midway point meeting is an opportunity to receive written and verbal formative feedback.

When preparing the portfolio, students are encouraged to send in samples of their work from the portfolio, these are reviewed by a member of the module team and returned to the student. There is a timetabled session on preparing the portfolio and students can bring samples of their work to this session and receive feedback from the tutor. There are also three additional tutorial sessions scheduled in the months following completion of the OSCE, when the students are undertaking their practice placement hours. Students are encouraged to attend one of these three tutorial sessions to receive feedback from one of the module team on drafts relating to their portfolio work. We are also happy to meet with students throughout the module to discuss any aspect of teaching or assessment as appropriate.

Methods of assessment

Coursework

Assessment type	Notes	% of formal assessment
Portfolio	Pass/Fail: The portfolio forms the main framework for recording supervised learning in practice and independent study. It includes a prescribing log, supervised practice time log and evidence of prescribing competency in various forms such as: - case studies - reflective accounts - witness testimonies - records of meetings, visits, discussion - protocol or guideline development and use	0.00
In-course Assessment	FORMATIVE: Standard Exam (1.5 hours)	0.00
In-course Assessment	FORMATIVE: OSCE (1.5 hours)	0.00
Total percentage (Assessment Coursework)		0.00

The portfolio is marked as a pass or fail by the PE who signs to verify the student’s achievement of each RPS competency. The portfolio is the marked by a member of the module team to assess it from a clinical and academic viewpoint. Students must demonstrate all specified competencies based on the RPS Competency Framework for All Prescribers (2021). The portfolio is a robust assessment tool as it allows the module team to consider the development of the student as a competent and reflective independent and supplementary prescriber. Although an applicant may be supervised by more than one person, only one prescriber must be the PE. The PE is the person who will certify that successful podiatrist/physiotherapist/paramedic are competent to practise as independent and supplementary prescribers in their area of clinical practice Additionally the portfolio must include a numerical assessment. This will take the form of a drug calculation constructed by the student’s PE related to the context of the student’s practice. A prescription linked to this calculation is necessary to demonstrate competence in this area. Students must achieve 100% in both the calculation and the prescription to pass, which is assessed and verified by the PE and by the academic marker. This means that the calculation has to be entirely correct (i.e. all workings are included and are correct) and that the prescription satisfies all legal requirements. The calculation and prescription are required components of the portfolio, therefore if either of these components are awarded <100%, the overall portfolio fails. All elements (demonstration of competencies, supervised practice time, numerical assessment, prescription assessment, ‘sign-off’ from PE of the portfolio have to be satisfactory, otherwise the portfolio will be deemed a fail.

Exams

Exam type	Exam duration	% of formal assessment
Standard exam (closed essays, MCQs etc) (S1)	2 hr 30 mins	50.00
OSCE (Objective Structured Clinical Exam)	0 hr 40 mins	50.00
Total percentage (Assessment Exams)		100.00

The pharmacology examination is a MCQs examination with automated marking which ensures the impartiality of the prescribing programme team. The examination will consist of Extended Matching Questions (EMQs); each question will consist of an option list, a lead-in statement which tells the student clearly what to do, and then a list of between one and five options. The examination will also consist of Single Best Answer (SBAs) questions. This operates similarly to the first, but with just five options to choose the best single answer from. Each question will consist of a clinical scenario followed by a lead-in question, and then a list of 5 options. In the marking scheme incorrect answers will not be penalised. The NMC require that nurses and midwives pass the pharmacology exam at 80%. As these allied healthcare professionals (podiatrists, paramedics and physiotherapists) will be completing the same pharmacology exam as the nurses and midwives, it is equitable that the same passmark is set for all groups of students undertaking the exam. OSCE stations will assess performance and competence in a range of skills, knowledge and behaviours covered within the teaching sessions of the module. Stations will examine several topics including knowledge of legislation related to prescribing, pharmacology and therapeutics, and communication skills. The OSCE will last for no longer than 40 minutes with each station lasting 10 minutes. Compensation is permitted between OSCE stations. Each OSCE station will be standard set individually and then the total score or the equivalent total percentage based on the modified Angoff method will be calculated. All scores of the standard set stations are added together to get a final pass mark. We will then model the addition of a standard error of measurement (SEM) which is approximately 2-3% addition to the pass mark. This is to ensure that false positive decisions are not made and that we are confident that all who ‘pass’ should have done. However, a major failure to identify a serious problem or an answer which would cause the patient harm (moderate, severe or death outcomes as defined by WHO 2018 guidance) will result in overall failure of the OSCE (Cooper et al., 2018). The student will be required to complete a second attempt at the OSCE. Currently the summative OSCEs are recorded for internal moderation and are uploaded to Grademark for external examining purposes and deleted after the appeals process deadline has expired. There is no compensation allowed between assessment elements. The summative coursework assessments and examinations associated with the module all need to be a passed independently for the student to pass the module.

Reading list

The reading list is available from the Library website

Last updated: 09/06/2023

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