Midwives have long been recognised as clinical practitioners with medicinal supply and administrative rights. Under the Human Medicines Legislation 2012 (amendment 2016) registered midwives may supply and/or administer on their own initiative, the 23 Prescription Only Medicines specified within Schedule 17 of the legislation.
Additionally, the Medicines Pharmacy (P) and General Sales List Exemption (GSL) Order 1980 permits midwives to supply and/or administer P or GSL medicines in the course of their professional practice, without the need for a prescription or patient specific direction.
Information overload
Midwives need to familiarise themselves with 30 or more medicines to support their everyday practice. For a new midwife, this can be quite overwhelming.
Many Trusts have local policies supporting midwives, such as midwives exemption formularies or patient group directions. These are updated bi- or triennially, requiring midwives to update themselves periodically. This requires staff to check printed or electronic documents but on a busy shift this may not always be practical or feasible as limited access to laptops and PCs delays the sourcing of information.
Conversations with midwives highlighted that some medicines were not being supplied as staff were unfamiliar with them, resulting in reliance on doctors to prescribe.
Using technology to support practice
With advances in technology, many people today carry smart phones. Search engines and apps on these devices allow timely access to information, whether staff are at a hospital bedside or at a home birth. With this in mind, we developed an app which provides the necessary information that midwives require to support their practice, consisting of locally agreed PGDs and midwives exemption drug monographs.
Midwives need to familiarise themselves with 30 or more medicines to support their everyday practice. For a new midwife, this can be quite overwhelming.
The platform used, known as MicroGuide, is owned by Horizon Strategic Partners Ltd and was first developed and trialled at University Hospital Southampton (UHS) NHS Foundation Trust. The platform may be purchased by any Trust, Health Board or CCG, giving them access to 22 different guides that have so far been developed. Once purchased, organisations may add their own guides or adapt an existing guide for their own needs.
Development took approximately three months. One pharmacist populated the information into the templates, which was checked for accuracy by another pharmacist and a midwife. The app was subsequently trialled by two preceptorship groups and a feedback survey carried out to review receptivity.
Determining the actual impact of the app is difficult to quantify as reliance on feedback surveys provides limited responses. Nevertheless, the general response following discussion with midwives has been extremely favourable. The UHS Midwives Formulary app is now available for use as it stands or for adaptation by other organisations for their own purposes. We hope that the app will support midwives across the UK in supplying and administering medicines in their daily practice.
The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.
Competing interest statement:
The author declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
