The development of nurse prescribing in mental health services: Outcomes from five national surveys 2004-2019

This study aimed to explore data from national surveys of nurse prescribing in England's National Health Service mental health services.

Nurse prescribing is increasing worldwide. Reports describing long-term developments after implementation are rare.

Five surveys were distributed to all mental health organisations between 2004 and 2019.

Response rates increased from 54% (n = 45/83) in 2004 to 79% (n = 42/53) in 2019. The estimated proportion of mental health nurses who were prescribers increased to 4.3% by 2019. Distribution between clinical practice areas did not change significantly over time, with the largest numbers in community mental health teams. The proportion of nurse prescribers actively prescribing increased from 76.4% in 2014 to 87.8% in 2019. Independent prescribing became the predominant approach, with supplementary prescribing rarely used as the sole model within organisations. The scale of implementation varied markedly between organisations.

Although nurse prescribing in mental health services has grown over time, growth has slowed and is variable at local level.

Organisations considering the introduction or growth of nurse prescribing should note the evidenced preference for an independent prescribing model to date and consider how to avoid unwarranted variation in nurse prescriber role distribution.