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Aims and Method  To describe the implementation of supplementary prescribing and nurse-led care in an acute in-patient unit. The issues of delegation and distribution of responsibility were explicitly addressed. Structures were developed for training and supervision, to ensure improved medicines management in the acute setting.    Results  We present our five-step model of nurse-led in-patient care and our experience of using a clinical management plan for 33 patients.    Clinical Implications  Implementation of supplementary prescribing provides a model for new ways of working, requiring engagement of both doctors and nurses, clear delegation and distribution of responsibilities, and well-developed governance structures.

Supplementary prescribing: a new way of working for psychiatrists and nurses