Non-Medical Prescribing

It is the Department's policy to extend prescribing responsibilities to a range of non-medical professions to:

Improve patient care without compromising patient safety
Make it easier and quicker for patients to get the medicines they need
Increase patient choice in accessing medicines
Make better use of the skills of health professionals
Contribute to the introduction of more flexible team working across the Health Service

The development of non-medical prescribing within the Health Service enables suitably trained healthcare professionals to enhance their roles and effectively use their skills and competencies to improve patient care in a range of settings involving:

management of long term conditions
medicines management / medication review
emergency/urgent care/unscheduled care
mental health services
services for non-registered patients e.g. homeless
palliative care

Currently nurses, pharmacists, optometrists, physiotherapists, chiropodists or podiatrists, radiographers and community practitioners may undertake further professional training to qualify as non-medical prescribers.

In 2011 over 500 nurses and midwives and over 120 pharmacists had trained as Independent or Supplementary Prescribers in Northern Ireland.

There are three types of non-medical prescribing:

1. Independent prescribing.

Independent prescribers are responsible and accountable for the assessment of patients with undiagnosed and diagnosed conditions and for decisions about the clinical management required, including prescribing.

From May 2006, Nurse Independent Prescribers, formerly known as Extended Formulary Nurse Prescribers, are able to prescribe any medicine for any medical condition within their competence, including some controlled drugs.
Pharmacist Independent Prescribers can prescribe similarly, with the exception of all controlled drugs.
Optometrist Independent Prescribers can prescribe any licensed medicine for ocular conditions affecting the eye and surrounding tissue, but cannot prescribe any controlled drugs.

2. Supplementary prescribing

Supplementary prescribers may prescribe any medicine (including controlled drugs), within the framework of a patient-specific clinical management plan, which has been agreed with a doctor.
Nurses, pharmacists, physiotherapists, chiropodists or podiatrists, radiographers and optometrists may train and register as a supplementary prescriber.

3. Prescribing by Community Practitioners from the Nurse Prescribers' Formulary for Community Practitioners

Community Practitioners, formerly known as District Nurses and Health Visitors, are able to prescribe independently from a limited formulary comprising a limited range of medicines, dressings and appliances suitable for use in community settings.

What can Non-Medical Prescribers Prescribe?

Information about what non-medical prescribers can prescribe is detailed in the BNF, Nurse Prescribers' Formulary and the FAQ section of the National Prescribing Centre

website. Refer also to the following advice issued by DHSSPS:

Public Consultations

Two public consultations on proposals to extend independent prescribing to physiotherapists and podiatrists in England were conducted between September and December 2011. The consultations concerned proposals for physiotherapists and podiatrists to become independent prescribers of medicines. They also propose that physiotherapist and podiatrist independent prescribers are allowed to mix licensed medicines prior to administration and direct others to mix, and to be able to prescribe independently from a limited list of controlled drugs.

Consultation to extend independent prescribing to physiotherapists

http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_129983

Consultation to extend independent prescribing to podiatrists

http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_129981