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RCCP Guidance on Prescribing

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.
There are three main classes of medicines:
  1. 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).
  2. Pharmacy only medicines can only be sold or supplied at registered pharmacy premises or under the supervision of a pharmacist.
  3. Medicines on the General Sales List (GSL) can be sold at a wider range of outlets (such as supermarkets).
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:
  1. An Independent Prescriber is someone who is able to prescribe medicines on their own initiative from the British National Formulary (BNF) – for example independent prescribers are doctors, independent nurse prescribers and independent pharmacist prescribers.
  2. 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 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.
A Patient Specific Direction is an instruction given by an independent prescriber to another professional to administer a medicine to a specific patient.  Please see this e-learning resource for more information. 

Clinical Physiologists can only LEGALLY be involved in prescribing via a Patient Specific Direction - follow this link for more information from the CQC.
RCCP advises very strongly that you obtain approval from your Local Medicines Management Committee and check your local Trust policies which may have a non-registered practitioners’ administration policy before you become involved in any prescribing activities. 
The website of the Medicines & Healthcare Regulatory Products Agency (MHRA) provides information about medicines regulation.

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