We refer to the letter by Mr Cheng Choon Fei (Nurses, pharmacists prescribing medicine raises concerns; July 9).

In collaborative prescribing, experienced and qualified advanced practice nurses and senior pharmacists prescribe medicines to and order tests for patients, under the supervision of doctors.

This way of organising care in teams aims to improve patients' accessibility to quality care, and reduce delays in treatment.

Patient welfare is of utmost importance to us. The Ministry of Health has put in place two levels of safeguards to ensure the prescribing services of these nurses and pharmacists are safe and effective.

First, healthcare institutions offering collaborative prescribing services are required to set up:

•A Credentialing Committee, which will verify and approve the participating nurses, pharmacists and their collaborative prescribing services; and

•A Service Review Committee, which will monitor, audit and review these prescribing services to ensure that quality and safety are upheld.

Second, only suitably qualified and trained nurses and senior pharmacists who have completed the National Collaborative Prescribing Programme, a three-month course by the National University of Singapore, will qualify to prescribe.

The supervising doctor and these collaborative prescribing practitioners will jointly draw up a collaborative practice agreement (CPA), which describes their scope of practice under the doctor's responsibilities and oversight. As long as they are prescribing within their CPA with their collaborating doctors, the team will hold accountability for the patients' care.

Doctors will continue to oversee and manage the patients, adjusting treatment plans where necessary. At determined intervals, the patient will return to this attending doctor for review. Care will be escalated to the doctor if the patient's condition evolves outside of the treatment plan. Doctors, nurses and pharmacists are also regulated by their respective councils. This ensures we uphold high standards of care provided by the team.

Lim Siok Peng (Ms)
Director, Corporate Communications
Ministry of Health