LAUSR

Health visitors are registered nurses or midwives who have completed further university training, usually at master's level, in community public health nursing. They provide a universal service by working with individuals, families and groups using a public health framework to reduce health inequalities, focusing on preschool children and their families. ‘Health visitor’ is a term used in the UK, Norway, Denmark and Finland, but similar models of nursing have other titles, such as Child Health Nurse in Sweden, Public Health Nurse in Ireland, the USA and Canada, Plunket Nurse in New Zealand and Social Nurse in Belgium [1]. The majority of health visitors have completed a prescribing qualification as part of their training, and this can be one of several different forms of prescribing qualification. In the UK, most health visitors will have the V100 qualification, also known as Community Practitioner Nurse Prescriber, which allows them to prescribe from only a small formulary of medications and medical appliances within the British National Formulary (BNF). These include medications for constipation, dry skin, anti-pyretics, anti-infestations and anti-fungals. Some health visitors have become qualified as independent prescribers, also known as V300, which allows them to prescribe from the whole BNF as long as it is within their sphere of competence, which is maternal and child health. Health visitors are ideally placed to prescribe for the common conditions inmaternal and child health. However, a growing body of research suggests that health visitors are not using these qualifications and skills to prescribe for their clients, but are askingGeneral Practitioners (GP) or Advanced Nurse Practitioners to prescribe for them. Coull et al. [2] discovered, in a review of nurse prescribing across Scotland, that a significant number of health visitor prescribers were not actively prescribing for clients, despite GPs supporting nurse prescribing, particularly in specialisms in which the nurse or health visitor was more knowledgeable than the GP. This would apply to conditions such as cow's milk protein allergy and ductal candida infection in breast-feeding mothers. Brooks [3], Bishop and Gilroy [4] and Rippon and Massey [5] identified several barriers to health visitors' prescribing, such as lack of time, continuing professional development sessions which were not relevant to health visiting practice and the formulary for V100 being too limited. Courtenay et al. [6] conducted a Delphi consensus study which identified conditions which health visitors might need to prescribe for, some of which can be prescribed for using the V100 formulary but not all.