Prescribing Rights in the UK

This page has been created as part of the Queen Margaret University project on current and emerging roles in contemporary physiotherapy practice

Present

Current Prescribing Rights

Supplementary Prescribing

Definition

"Voluntary prescribing partnership between an independent prescriber (doctor) and supplementary prescriber (pharmacist, nurse, physiotherapist, etc) to implement an agreed patient-specific Clinical Management Plan with the patient's agreement" 

Classes Offered

Supplementary prescribing classes involve at least 26 days in the classroom, and 12 days in practice with a designated medical practitioner 

Limitations of Current Prescribing Rights

Do current Prescribing Rights' allow for a Patient-Centred Approach to Physiotherapy Practice?

Although current prescribing mechanisms available to physiotherapists serve in providing some patients with increased access to medications, it is clear they are limited in their capacity to optimize patient-centred practice. The degree of which current measures fail to meet the needs of patients is illustrated by a recent scoping project undertaken by the Department of Health into the provision of medicines by allied health professionals (AHPs) (Department of Health, 2009).
   Supplementary Prescribing, Patient Specific Directions (PSDs) and Patient Group Directions (PGDs) all require direct input from an independent prescriber such as a doctor in order for physiotherapists to provide patients with the medicines they need (Department of Health, 2009). However, such professionals are often unavailable for consultation in many clinical working environments, such as outpatient departments. Therefore, ensuing delays' in communication within the multi-disciplinary team relating to the patient's clinical management plan (CMP) unfortunate result in the needs of many patients failing to be met Interestingly, doctor availability has been previously identified as posing "the greatest challenge" for physiotherapists implementing such treatments (Department of Health, 2009).

With specific reference to PGDs, physiotherapists are unable to modify the provision of medication - such as modifying a patient’s prescription in order to supply a more suitable drug (Department of Health, 2009). Furthermore, many departments require different medications to be detailed on separate PGDs, with some clinical settings requiring numerous PGDs in order to manage a single pathology. It is clear that this system poses a practical barrier to meeting the needs of patients suffering from certain health conditions (Department of Health, 2009).
   Physiotherapists are often unable to prescribe or administer drugs promptly enough in order to optimize the management of a patient's health condition, such as when they respond to a treatment provided (Department of Health, 2009). Furthermore, although such AHPs are able to asses and identify deterioration or regression of a patient’s condition, they are currently unable to appropriately alter or reduce dosage without consulting an independent prescriber. Not only does this represent avoidable delays for patients, but clinicians often take unnecessary preventative measures in order to minimise risk, such as advising patients to contact their GP, or in some cases calling an ambulance (Department of Health, 2009).

Do current mechanisms reflect the Autonomy of modern day Physiotherapists'?

How do current prescribing rights influence the Effectiveness of Physiotherapy Practice?

Future

Independent Prescribing

Classes Offered

Likewise, Independent prescribing classes involve at least 26 days in the classroom, and about 12 days in practice with a designated medical practitioner