The Cumberlege Report (1986) or Neighbourhood nursing: a focus for care was the report of a Department of Health and Social Security (DHSS) committee advocating that community nurses in the

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be permitted to prescribe from a restricted list of treatments.

Context

A committee was created in 1985 by the DHSS to review the care provided by nurses and health visitors outside hospitals and report on how resources could be used more effectively. The committee focussed on

primary care Primary care is a model of health care that supports first-contact, accessible, continuous, comprehensive, and coordinated person-focused care. It aims to optimise population health and reduce disparities across the groups by ensuring equitable ...

nursing. Welsh and Scottish reviews also took place, on different timelines. Julia Cumberlege was appointed chair.

Report

The Cumberlege Report was published in 1986. The Report stated that patient care would be improved and resources used more effectively if nurses were able to prescribe items from a limited list. The Report also recommended that a neighbourhood nursing service be established, with eventual removal of differences between district nurses, health visitors and school nurses. It suggested a "

nurse practitioner A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications an ...

" role be created to designate more highly skilled nurses with prescribing powers and also that

general practice General practice is personal, family, and community-orientated comprehensive primary care that includes diagnosis, continues over time and is anticipatory as well as responsive. Definitions A general practitioner (GP) is a doctor who is a consu ...

s should not be subsidised to employ practice nurses.

Impact

The Cumberlege Report recommendations were included in ''Promoting Better Health'', a 1987

white paper A white paper is a report or guide that informs readers concisely about a complex issue and presents the issuing body's philosophy on the matter. It is meant to help readers understand an issue, solve a problem, or make a decision. Since the 199 ...

. A

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was told to review nurse pay. In 1989, the Department of Health created a committee with Dr June Crown as chair, to examine nurse prescribing. It issued the ''Report of the advisory group on nurse prescribing (Crown Report)'', which recommended which items nurses might prescribe and the circumstances in which they might prescribe them. The report stated that doctors often merely signed-off nurse prescribing decisions and that 'There is wide agreement that action is now needed to align prescribing powers with professional responsibility.' The Crown Report noted that patients particularly likely to benefit from changes were those with a

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

stoma In botany, a stoma (: stomata, from Greek language, Greek ''στόμα'', "mouth"), also called a stomate (: stomates), is a pore found in the Epidermis (botany), epidermis of leaves, stems, and other organs, that controls the rate of gas exc ...

, those with postoperative wounds, and

homeless people Homelessness, also known as houselessness or being unhoused or unsheltered, is the condition of lacking stable, safe, and functional housing. It includes living on the streets, moving between temporary accommodation with family or friends, liv ...

not registered with a

general practitioner A general practitioner (GP) is a doctor who is a Consultant (medicine), consultant in general practice. GPs have distinct expertise and experience in providing whole person medical care, whilst managing the complexity, uncertainty and risk ass ...

. In 1992, the ''Medicinal Products; Prescriptions by Nurses etc Act'' was enacted. A trial of community nurse prescribing took place and then the Secretary of State gave

district nurse District nurses work manage care within the community and lead teams of community nurses and support workers. In the United Kingdom, the role requires registered nurses to take a Nursing and Midwifery Council (NMC) approved specialist practitione ...

s and

health visitor Health visitors are professional individuals engaged in public health work within the domestic setting, predominantly found in countries with state-funded health systems. They are distinct from district nurses, who provide clinical healthcare, do ...

s prescribing powers from a Nuse Prescriber's Formulary in 1998. By the 2010s, there were approximately 54,000 nurse and midwife prescribers in the UK. In 1997, Crown again headed a review into prescribing and in 1999 recommended an extension to prescribing. The ''Review of Prescribing, Supply and Administration of Medicines (Crown II Report)'' led to nurses being able to prescribe from the Formulary, plus licensed pharmacy and general sales list medicines, and some prescription-only medicines, under a "dependent prescribing" or "supplementary prescribing" framework. In 2001, supplementary prescribing was extended to pharmacists and some other health professionals. From 2006, the Extended Formulary was eliminated and those who had permission to prescribe from it were able to independently prescribe any licensed medicine except

controlled drugs The prohibition of drugs through sumptuary legislation or religious law is a common means of attempting to prevent the recreational use of certain intoxicating substances. An area has a prohibition of drugs when its government uses the forc ...

References

{{reflist Health care reports of the United Kingdom government Nursing in the United Kingdom 1986 documents 1986 in the United Kingdom Welfare in the United Kingdom

Context

Report

Impact

See also

References