Researchers: Joodi Mourhli (co-PI), Dr Ben Bowers (co-PI), Dr Lina (Efthalia) Massou, Emily Ashwell, Nicola Zolnhofer, Claire McDonell, Maria Betts, Emma Clifford, Robyn Rendall, Tina Jarett, Prof. Stephen Barclay
Funders: Wellcome Trust and NIHR Applied Research Collaboration East of England
Partner institutions: NIHR Applied Research Collaboration East of England. Cambridgeshire and Peterborough NHS Foundation Trust. Engineering Department, University of Cambridge
Start date: 01/09/2026
End date: 31/08/2027
Project summary:
This national mixed-methods survey identifies how often independent nurse prescribers working in UK community settings prescribe end-of-life symptom management medications, and the factors that support or constrain this practice.
Project aims:
This study aims investigate the frequency of end-of-life symptom management medication prescribing by independent nurse prescribers, and to explore the perceived facilitators and barriers influencing this practice.
Objectives:
- To quantify the frequency of end-of-life symptom management medication prescribing by independent nurse prescribers.
- To describe variation in end-of-life prescribing patterns by prescriber characteristics and structural and cultural factors.
- To explore perceived barriers and facilitators influencing end-of-life prescribing among independent nurse prescribers.
Project impact:
This study will generate knowledge about the frequency of, and variation in, end-of-life prescribing by independent nurse prescribers, and the facilitators and barriers shaping this practice. Findings will be shared with a broad academic, clinical and policy audience to inform system-wide improvements and strengthen support for independent nurse prescribers.
Further information, references, publications and presentations:
1. Bowers, Ben, and Sarah A. Redsell. ‘A Qualitative Study of Community Nurses’ Decision‐making around the Anticipatory Prescribing of End‐of‐life Medications’. Journal of Advanced Nursing, vol. 73, no. 10, Oct. 2017, pp. 2385–94. DOI.org (Crossref), https://doi.org/10.1111/jan.13319.
2. Edwards, Judith, et al. ‘Barriers and Facilitators to Implementation of Non-Medical Independent Prescribing in Primary Care in the UK: A Qualitative Systematic Review’. BMJ Open, vol. 12, no. 6, Jun. 2022, p. e052227. DOI.org (Crossref), https://doi.org/10.1136/bmjopen-2021-052227.
3. Fennessy, Rosanna, et al. ‘Hidden Work and Blurred Boundaries: A Qualitative Study of How Community Nurses Navigate and Adapt Injectable Medication Processes to Provide Timely End-of-Life Symptom Control’. BMC Palliative Care, vol. 25, no. 1, May 2026, p. 222. DOI.org (Crossref), https://doi.org/10.1186/s12904-026-02159-0.
4. Noblet, Timothy, et al. ‘Barriers to and Facilitators of Independent Non-Medical Prescribing in Clinical Practice: A Mixed-Methods Systematic Review’. Journal of Physiotherapy, vol. 63, no. 4, Oct. 2017, pp. 221–34. DOI.org (Crossref), https://doi.org/10.1016/j.jphys.2017.09.001.