Non-medical prescribing

What is non-medical prescribing?

-prescribing by specially trained nurses, optometrists, pharmacists, physiotherapists, podiatrists and radiographers, working within their clinical competence as either independent or supplementary prescribers.

What are the 2 different types of prescribers? Explain them

-the supplementary prescriber can’t diagnose and prescribe on their own. It is a group effort

Can medicines be given by NMPs in any other situations?

-Medicines can be given by a HP with the instructions of an independent prescriber or via local arrangements

What is the difference between a patient specific direction (PSD) and patient group direction (PGD)?

-A patient specific direction (PSD) is an instruction given by an independent prescriber to another professional to administer a medicine to a specific patient

-A Patient Group Direction (PGD) is a written instruction for the supply and/or administration of specific medicines by named, authorised health professionals, to a welldefined group of patients requiring treatment for a specific condition

Give examples of HCP’s that can administer and supply a medication under PGD

-not any HCP can do it, only certain

Give 5 HCP’s that have an exemption  on supplying medication without a prescription

1. Podiatrists/chiropodists

2. Midwives (and student midwives) e.g. antifungals. Vitamin K injections

3. Occupational health

4. Optometrists e.g. medications for eye without needing a prescription

5. Paramedics e.g. adrenaline in life-threatening conditions

What is the rule for HCP’s supplying medicinein case of emergencies without prescription?

-if it’s in an emergency i.e. life-threatening event, HCP allowed to give pt a life-saving medication without needing to prescribe it. Example meds shown in image

Who can prescribe products included in the Dental Prescribing Formulary (Part XVIIA of the Drug Tariff) and on what form?

-Dentists can only prescribe products in the Dental Prescribing Formulary on an FP10D prescription.

Who can prescribe items listed in the Nurse Prescribers’ Formulary for Community Practitioners (Part XVIIIB(i) of the Drug Tariff)?

-Community practitioner nurse prescribers can only prescribe products included in that formulary.

Which prescribers can prescribe any medicine for any medical condition within their competence, including most Controlled Drugs?

-Nurse independent prescribers and pharmacist independent prescribers can prescribe any medicine for any medical condition within their level of experience and competence.

-They can prescribe Schedule 2, 3, 4, or 5 Controlled Drugs, except diamorphine, dipipanone, or cocaine for the treatment of addiction.

Which independent prescribers are limited to ocular conditions and cannot prescribe Controlled Drugs?

-Optometrist independent prescribers can prescribe any licensed medicine for ocular conditions affecting the eye and surrounding tissue but are not authorised to prescribe Controlled Drugs.

Which prescribers can issue licensed medicines within their professional scope and are permitted to prescribe some Controlled Drugs?

-Physiotherapist independent prescribers and podiatrist/chiropodist independent prescribers can prescribe any licensed medicine within their competence and scope of practice as independent prescribers, and can prescribe some Controlled Drugs.

Which prescribers can prescribe medicines for off-label use under cancer frameworks but cannot prescribe Controlled Drugs?

-Independent therapeutic radiographers can prescribe any licensed medicine for any medical condition within their experience and competence and within the overarching framework for cancer.

-They may prescribe for off-label use but cannot prescribe Controlled Drugs.

Which prescribers can prescribe medicines agreed with a doctor in a clinical management plan, including most Controlled Drugs except those for addiction?

-Supplementary prescribers can prescribe any medicine (except products listed in Part XVIIIA of the Drug Tariff) as agreed with the patient and doctor in a clinical management plan.

-They may prescribe Schedule 2, 3, 4, or 5 Controlled Drugs, except diamorphine, dipipanone, or cocaine for the treatment of addiction.

What is a green, blue, purple and yellow prescription used by?

-BUT, for example, if dentist is writing on a private prescription, they can prescribe a medication that isn’t on the dental formulary. Same for the other HCP’s

A schedule 2 or 3 CD can only be prescribed…

-privately on a pink private prescription form, FP10PCD

What MUST all private prescribers include inFP10PCD?

-GMC number NOT required. What IS required is an allocated a 6 digit prescriber identification number (issued by the relevant NHS agency)

-just because the prescription looks like an NHS, it is NOT. It is a private, so even if pt is elderly or usually exempt according to NHS, they are not when it comes to private prescriptions

Which CDs can doctors prescribe? What about dentists? What about nurse IP and pharmacist IP?

Which CD’s can physiotherapist IP prescribe? What about podiatrist/chiropodist IP?

-’’morphine for injectable adm.’’ means can’t administer any other route e.g. oral

Which CD’s can community practitioner nurse prescribers and optometrist IP prescribe? What about supplementary prescribers?

-’’not authorised’’ means never!!

Can therapeutic radiographer IP prescribe schedule 2 and 5 CD’s?

-only certain meds in certain formulations

Can therapeutic radiographer IP prescribe off-label and/or unlicensed meds?

-only off-label

Can therapeutic radiographer IP prescribe emergency supply?

-yes but not schedule 1,2, or 3 CDs

Can a paramedic IP prescribe schedule 2-5 CDs?

-only certain CDs in certain formulations

What are the 6 benefits of non-medical prescribing?

-Better and quicker access to services

-Time-saving

-Promotes integrated care

-Makes better use of clinical workforce skills, by optimising the use of the available skill mix

-Gives organisations the flexibility to innovate when designing cost-effective quality services

-Increased choice of services

Give 6 similarities between a pharmacist and pharmacist IP? What is the main difference between a pharmacist and pharmacist IP?

How can a pharmacist become an IP?

-Integrated prescribing training:

• Prescribing skills are built into the MPharm degree and foundation training year.

• The GPhC standards now require prescribing competence to be achieved at the point of registration

-Supervised practice included earlier:

• Foundation trainees are supported by Designated Prescribing Practitioners (DPPs) and clinical supervisors during training, rather than years later.

-Registration outcome:

• From 2026, all newly qualified pharmacists will be independent prescribers at the point of registration.

-No extra course after qualification:

• The separate IP course is phased out for new entrants.

• Prescribing is core to the pharmacist role, not an optional add-on.

How do pharmacists practice safely as independent prescribers?

-Independent prescribers have a responsibility to remain up-to-date with the knowledge and skills that enable them to prescribe competently and safely. This means that they must complete appropriate continuous professional development and this can effectively be achieved by working in a multi-disciplinary team. In community, this may mean NMPs must be affiliated with a GP practice or another multidisciplinary forum for support and professional development.