Unit 1 - Foundations of Prescribing Practice

Legal and Clinical Liability

Liability is defined in the Concise Oxford Dictionary (Fowler et al, Eds, 2004) as 'responsible by law; legally answerable'.

The liability of the employer

Where a nurse or midwife is appropriately trained and qualified, and prescribes as part of their professional duties with the consent of the employer, the employer is held vicariously liable for their actions. In addition, nurse prescribers are individually and professionally accountable to the NMC for this aspect of their practice, as they are for other aspects, and must act at all times in accordance with the NMC code of professional conduct: standards for conduct, performance and ethics (2004).

Professional indemnity

As a result of a consultation on indemnity insurance in September 2002, the NMC recommended the inclusion of an indemnity clause in its Code of Professional Conduct that would require all nurses, midwives and health visitors to have professional indemnity insurance for professional activities that are not provided for under an employer's vicarious liability scheme. The clause states:

'The NMC recommends that a registered nurse or midwife or health visitor, in advising, treating and caring for patients/clients, has professional indemnity insurance. This is in the interests of clients, patients and registrants in the event of claims of professional negligence.

'Some employers accept vicarious liability for the negligent acts and/or omissions of their employees. Such cover does not normally extend to activities undertaken outside the registrant's employment. Independent practice would not normally be covered by vicarious liability, while agency work may not. It is the individual registrant’s responsibility to establish their insurance status and take appropriate action.

'In situations where employers do not accept vicarious liability, the NMC recommends that registrants obtain adequate professional indemnity insurance. If unable to secure professional indemnity insurance, a registrant will need to demonstrate that all their clients/patients are fully informed of this fact and of the implications this might have in the event of a claim for professional negligence.'

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