Impact, challenges and support needs of non-medical prescribers across the UK: a cross-sectional survey

Objectives To explore the experiences and perceptions of non-medical prescribers (NMPs) across the UK, including their perceived contribution to patient care, barriers to effective practice and priorities for workforce development. Design Cross-sectional mixed-methods survey. Participants A total of 1191 qualified NMPs, including nurses, pharmacists and allied health professionals, working across a range of clinical specialties and healthcare settings in all four UK nations. Methods An online survey comprising closed-ended and free-text questions explored prescribing activity, preparedness, organisational support, governance, perceived impact, enablers and barriers to practice and development needs. Quantitative data were analysed descriptively. Qualitative responses were analysed using inductive qualitative content analysis informed by thematic analysis. Quantitative and qualitative findings were integrated. Results Prescribing was routinely embedded in practice, with 52% of respondents prescribing daily and 28% several times per week. Most respondents (82%) reported being able to fully use their prescribing qualification, although 18% reported under-utilisation. Lower utilisation was reported more frequently among respondents reporting limited organisational support, supervision and access to prescribing-specific continuing professional development (CPD). Respondents rated the perceived impact of prescribing positively for patient care (96% good/very good), team efficiency (93%) and professional development (89%). Qualitative findings highlighted improved access to treatment, enhanced service efficiency, holistic care, medication optimisation and workforce capacity as key perceived benefits. Reported barriers included workload pressures, limited protected time, fragmented digital infrastructure, inconsistent access to supervision and CPD, variable governance arrangements and insufficient professional recognition. Conclusions Respondents perceived NMPs to make a substantial contribution to patient care and service delivery. However, qualification alone does not guarantee utilisation of prescribing capability. Respondents reporting under-utilisation more frequently reported limited organisational support, supervision, protected time, prescribing-specific CPD, professional recognition and governance and digital infrastructure challenges. These findings highlight priorities for implementation and sustainability of prescribing roles.