BAMAN Calls for Urgent Reform of Human Medicines Regulations 2012

Nurses Demand Patient Safety and Equality in Aesthetic Medicine

Independent nurse prescribers across England, Wales, and Northern Ireland are calling for urgent reform of the Human Medicines Regulations 2012, arguing that the current legislation is outdated, because it places patients and practitioners at risk. Unlike nurses in Scotland, independent nurse prescribers in other parts of the UK are not legally permitted to hold prescription-only medicines (POMs) as stock. This severely impacts the reasonable standard of care in emergency situations and limits the ability of nurses to provide safe, efficient, and effective care at the point of delivery, when patients need it most.

A Flawed System is Putting Patients at Risk

In Northern Ireland, independent nurse prescribers are prohibited from holding emergency stock, despite the fact that medicines are considered mandatory in the management of serious complications in order to ensure patient safety and in some instances, in order to save life. Instead, nurse prescribers are forced to rely on an unacceptable system, where they must secure prescriptions for each individual patient on a named patient basis when required. These nurses cannot own, hold, or store medicines, which is likely to result in unacceptable and avoidable delays in treatment. This significantly raises the risks to patients in time-critical emergencies and it cannot be allowed to continue due to the known risks.  Of particular note, is the risk of vascular occlusions, which can lead to blindness and the risk of sepsis, which can lead to death.  The risk of sepsis is the most serious complication of an infection. Without quick treatment, sepsis can progress quickly, leading to organ failure and the risk of death increases by 7.6% for every hour that passes without treatment, causing death in as little as 12 hours. Currently, in England, Wales, and Northern Ireland, this risk is being ignored by the government’s failure to address the absence of an amendment to current legislation, which nurses insist must now be addressed.

Inequality & Targeting of Nurses in Private Practice

This legislative barrier for nurses unquestionably discriminates against nurses working in private practice, restricting their ability to operate independently, whilst doctors and dentists face no such impositions or restrictions on independent practice. The lack of regulatory consistency raises serious questions about bias in the absence of fairness in the case of nurses and the government’s failure to support highly trained, competent nurse prescribers is evidence of discrimination against nurses who are responsible for and experts in the care of patients.

Recent actions by the medicines regulatory bodies in Northern Ireland have highlighted the fact that they have specifically targeted and raided nurse-led medical aesthetic practices, further compounding the discrimination and intimidation that has led to fear and anxiety amongst nurses. Following a series of raids on practices and clinics, nurses are suffering unnecessary financial and legal expenses by having to defend themselves in criminal and regulatory cases, despite the fact that they are upstanding and following best practices in their delivery of patient care. The situation in Northern Ireland raises serious concerns about the abuse of nurses and particularly, the misuse of Department of Health (DoH) resources because public money is being wasted by targeting nurses who have experienced heavy-handed policing of nurse-led clinics in the absence of addressing the critical fact that the HUMAN MEDICINES REGULATIONS 2012 is biased towards independent nurse prescribers and it is putting patients at risk.

The DoH has brought Crown Court criminal proceedings against an independent prescribing nurse, Nichola Hawes, for fraud and alleged breaches of the Human Medicines Regulations. The DoH has not accused Nichola of causing harm to any of her patients but has accused her of holding and supplying stock POMs. Similar criminal proceedings could be taken against any nurse that the DoH suspects to be holding stock mof edicine, including emergency medicines. Nichola’s solicitor, Michael Madden of Madden & Finucane Solicitors said:

“Ms Hawes vehemently denies all charges and has entered not guilty pleas with the court. She has made it clear throughout the process that she denies any criminality, and that at no time was any member of the public put at risk of harm. Ms Hawes looks forward to contesting the allegations at trial, and trusts that the process will result in her good name and reputation being upheld.”

Time for Change – A Fair, Safe Future for Nursing Practice

Scotland recognised the need for reform of the law by allowing independent nurse prescribers to hold medicines stock within regulated clinical governance frameworks. The time is well overdue therefore for the rest of the UK to follow suit.  UK nurses are now calling on the government and regulatory bodies to:

• Amend the Human Medicines Regulations 2012 to allow independent nurse prescribers to hold stock within strict professional guidelines that can be set out
• Ensure patient safety by allowing nurses to hold stock and thus reduce delays in emergency treatment, such as vascular occlusion reversal and critical care which is crucial to prevent sepsis
• End the discrimination against nurses in independent practice by removing the impositions placed upon them that is preventing nurses from supporting patients, operating safely and efficiently, and fulfilling their mandatory duty to nurse their patients in accordance with the reasonable standard of care, as their counterparts in Scotland can do.

The UK government must act now to protect the public, limit patients suffering unnecessarily and prevent avoidable harm due to an outdated and inequitable system.