Prescriptions soon to be available from some Allied Health Professionals

A number of the Allied Health Professionals (AHP), Therapeutic Radiographers, Dietitians and Orthoptists, in England will soon be able to prescribe medication directly to patients.  This follows an announcement by George Freeman MP (Parliamentary Under Secretary of State for Life Sciences, Department of Health) on 26 February 2016.  The announcement came after the conclusion of a multi-disciplinary review, led by NHS England, which has been on-going since October 2013.

The relevant Allied Health Professionals (AHPs), who are regulated by the Health and Care Professions Council (HCPC), are:

• Therapeutic radiographers  - who will be able to prescribe independently using written instructions  from  a doctor, dentist or other prescriber for the supply, sale or administration of medicines to either named patients or a group of patients who may not be identified individually prior to treatment; 
• Dietitians - who will be able to carry out supplementary prescribing. This will mean that  medicines to be prescribed must be defined in writing within a patient-specific clinical management plan, which names the patient and the medicine(s), that have been agreed with a doctor; and
• Orthoptists – who will be able to prescribe pursuant to exemptions within the Human Medicines Regulations 2012. This will mean that they can prescribe general sale, pharmacy and some prescription-only medicines.

Those who wish to have the new prescribing responsibilities will be required to complete a Health and Care Professions Council (HCPC) approved training programme. It is envisaged that the training programmes will be approved by the HCPC in the next 18 months. 

Of course, patient safety must be guaranteed throughout the changes, which is why only advanced level practitioners will be eligible for the training. The HCPC Register will include a section to confirm whether the AHP has been granted the ability to prescribe.  

Further amendments to the legislation on prescribing were proposed for independent prescribing by diagnostic radiographers and paramedics at this time, but were not adopted by this review. However, it is proposed that NHS England will continue working with the Medicines and Healthcare products Regulatory Agency (MHRA), the Department of Health and regulatory bodies to ensure that these proposals continue to be progressed.

At present, patients who are under the care of AHP’s often have to wait for medications as a result of the inability of these AHPs to prescribe.  It is anticipated that patients’ will have to attend less appointments as they will be able to obtain necessary medication from their AHP. Additionally, the reforms should increase the speed with which patients can obtain their medication. 
The reforms will mean that the service patients receive from the above listed AHPs will become more holistic.  Prior to this new law, patients had to attend an appointment with their doctor subsequent to consulting with their AHP to obtain medication. 

Commentary

This certainly feels like a step in the right direction towards patient-centred care.  The requirements for a specific level of experience and completion of an HCPC approved training course before practitioners are eligible to take advantage of the new powers reflect the responsibility involved.  Patients are entitled to have more choice and easier access to the medications they require, balanced with appropriate safety measures to ensure that they are never put at risk.