Medicines and Prescribing

This page explains more about the medicines and prescribing rights of the professionals that we register.

The Medicines Act 1968 and Prescription Only Medicines (Human Use) Order 1997 are two important pieces of legislation which cover the sale, use and production of medicines. This includes prescribing rights.

The Medicines and healthcare products regulatory agency (MHRA) is responsible for regulating medicines in the UK. This includes ensuring that medicines and medical devices are safe and bringing prosecutions when medicines legislation has been broken.

There are three main classes of medicines:

Prescription only medicines (POMs) can only be sold and/or supplied with a prescription from an appropriate practitioner (e.g. a doctor, dentist, pharmacist and in certain circumstances, a nurse prescriber or supplementary prescriber).

Pharmacy only medicines can only be sold or supplied at registered pharmacy premises or under the supervision of a pharmacist.

Medicines on the General Sales List (GSL) can be sold at a wider range of outlets (such as supermarkets).

Prescribing
The law says who can and cannot prescribe medicines. It also allows local arrangements to be developed to administer medicines to certain types of patients, in certain circumstances.

There are two different types of prescriber:

An independent prescriber is someone who is able to prescribe medicines on their own initiative from the British National Formulary (BNF). Examples of independent prescribers are Doctors and Extended Formulary Nurse Prescribers (subject to certain conditions).

A supplementary prescriber is able to prescribe medicines in accordance with a clinical management plan. The plan is agreed between the supplementary prescriber, a Doctor and the patient.

Medicines can also be given by another professional with the instructions of an independent prescriber or via local arrangements.

A patient specific direction 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 or administration of medicines to certain groups of patients. The instruction is agreed and signed by a senior doctor and pharmacist and includes the following information:

1. The health professional who can supply or administer the medicine;
2. The condition(s) included;
3. A description of those patients who should not be treated under the direction;
4. A description of circumstances where referral to another professional should be made; and
5. The drugs included and method of administration.

The legislation currently permits the following professionals on our register to administer or supply medicines under a patient group direction:

Chiropodists and podiatrists, dietitians, occupational therapists, orthoptists, paramedics, physiotherapists, prosthetists and orthotists, radiographers, speech and language therapists.

Specific entitlements

The law allows certain professions on our register to administer or supply certain drugs on their own initiative when that would normally be restricted to independent prescribers.

Paramedics can administer certain named drugs on their own initiative in emergency situations. The legislation is regularly amended to extend or amend the list of drugs which paramedics can administer.

Chiropodists and podiatrists who are appropriately qualified can administer certain local anaesthetics and supply certain prescription only medicines in the course of their practice.

In order to have these entitlements they must have successfully completed training in these areas and have the entitlement marked (“annotated”) on our register. The online register indicates where a chiropodist or podiatrist can administer local anesthetic or supply prescription only medicines.

All pre-registration programmes currently on our approved course list include these entitlements. We also approve a number of post-registration programmes which allow chiropodists and podiatrists without these entitlements to gain them.

Supplementary prescribing – chiropodists and podiatrists, radiographers, physiotherapists

Registered chiropodists and podiatrists, radiographers and physiotherapists can become supplementary prescribers.

We approve post-registration programmes which allow registrants from these professions to qualify as a supplementary prescriber. We then annotate the register to indicate that they are able to practise as s supplementary prescriber. You can find a list of the supplementary prescribing courses we approve by clicking here.

Further information

The following are suggestions of sources of further information:

The website of the Medicines and Healthcare Products Regulatory Agency (MHRA) provides information about medicines regulation.

The National prescribing centre provides information about prescribing and patient group directions.

The Department of Health produces a helpful publication 'Medicines Matters'.

The relevant legislation is available from the Office of Public Sector Information’s website.

If you any questions about this page, please contact the Policy and Standards team by e-mail to policy@hpc-uk.org.