Non-Medical Prescribing

Over the last decade there has been an increase in the number of healthcare professionals who are able to prescribe. Traditionally, this has been a role for medical personnel; however, increasingly this is being extended to include other professions. The development of non-medical prescribing was designed to give patients quicker access to medicines and improve access to services, at the same time making better use of health professionals’ skills. 

Supplementary prescribing 

Supplementary prescribing describes ‘a voluntary prescribing partnership’ between an independent prescriber (who must be a doctor or dentist) and a qualified supplementary prescriber, to implement an agreed patient-specific Clinical Management Plan (CMP) with the patient’s agreement.

 

A supplementary prescriber, who may be a nurse, pharmacist, physiotherapist, chiropodist/podiatrist, radiographer or optometrist who has undertaken an approved course, may prescribe and administer any Controlled Drug (excluding Schedule 1 Controlled Drugs) as long as it is contained within a specific CMP for that patient and there is agreement between the patient, independent prescriber and supplementary prescriber.
 

Independent prescribing 

Independent prescribing is undertaken by a practitioner who is responsible and accountable for the assessment of patients with undiagnosed conditions and for decisions about the clinical management required, including prescribing. Currently, nurses, pharmacists, physiotherapists, chiropodist/podiatrists, and optometrists are the only non-medical prescribers able to use independent prescribing, although optometrists are able to prescribe from a limited formulary for eye conditions. 

 

Some independent prescribers (nurses and pharmacists) who has undertaken an approved course, may prescribe and administer any Controlled Drug (excluding Schedule 1 Controlled Drugs) with the exception of except cocaine, dipipanone and diamorphine for the treatment of addiction. From June 2015, physiotherapist independent prescribers are only able to prescribe a restricted number of controlled drugs. 

 


Further Reading
 

  • Charted Society of Physiotherapists. Practice guidance for physiotherapist supplementary and/or independent-prescribers in the safe use of medicines. (3rd edition) 2016.
  • Department of Health. Improving patients’ access to medicines: a guide to implementing nurse and pharmacist independent prescribing within the NHS in England. 2006.
  • Latter S, Blenkinsopp A, Smith A, et al. Evaluation of nurse and pharmacist prescribing. Department of Health Policy Research Programme Project 016 0108. 2010.
  • Stenner K, Carey N, Courtenay M. Prescribing for pain - how do nurses contribute? A national questionnaire survey. Journal of Clinical Nursing 2012; 21: 3335–3345. 
  • Stenner KL, Courtenay M, Cannons K. Nurse prescribing for inpatient pain in the United Kingdom: a national questionnaire survey. International Journal for Nursing Studies 2011; 48: 847-855.