Proposals to expand medicines paramedics administer and CDs physiotherapists & podiatrists prescribe
NHS England, in collaboration with the Scottish, Welsh and Northern Ireland governments, is consulting on proposed changes to add to the list of medicines that registered paramedics are currently able to administer directly to patients under exemptions within the Human Medicines Regulations 2012. There are six additional medicines being proposed; the controlled drugs lorazepam (by injection) and midazolam (by injection); and the prescription only medicines dexamethasone, magnesium sulfate, tranexamic acid and Flumazenil.
The way that paramedics work has changed considerably since 2011 when the list of medicines that paramedics can currently administer under exemptions was last updated. In response to changes to the ways that urgent and emergency care is being given, guidelines relating to paramedic practice have been updated and new guidance published. This means that some of the medicines that paramedics need to administer to patients are not on their current list of exemptions. As a result, paramedics must either ask a prescriber to prescribe the medicine or ask for a PGD to be written by the organisation in which they work. This can lead to differences across the UK in the way that the medicines are administered to patients by paramedics. If the proposed medicines were to be included in the list of exemptions then all paramedics can administer the medicines wherever they treat patients.
Physiotherapist and Podiatrist Independent Prescribers:
In collaboration with the Scottish, Welsh and Northern Ireland governments, we are consulting on proposed changes to enable
- physiotherapist independent prescribers to prescribe four more controlled drugs for their patients; codeine phosphate, tramadol hydrochloride, pregabalin, and gabapentin; all by oral administration. This would be in addition to the seven they can already prescribe; and,
- podiatrist independent prescribers to prescribe four more controlled drugs for their patients tramadol hydrochloride, morphine sulfate, pregabalin, and gabapentin; all by oral administration. This would be in addition to the four they can already prescribe.
Although, current ways of prescribing, supplying and administering medicines have improved patient care there could be greater benefit to patients if physiotherapist, and podistrist independent prescribers were able to prescribe an extended range of controlled drugs as proposed. This would be of benefit to patients as they will be able to receive these additional medicines without having to see another prescriber, such as a GP.
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