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.

Nurse and pharmacist independent prescribers are able to prescribe any medicine for any medical condition within their competence, including any controlled drug in Schedule 2,3,4 or 5 of the MDR 2002 Regulations, as amended.
Optometrist Independent Prescribers can prescribe any licensed medicine for ocular conditions affecting the eye and surrounding tissue, but cannot prescribe any controlled drugs.
Changes to legislation are planned during 2012/13 which will enable Physiotherapists and Podiatrists to qualify as independent prescribers. See below.

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:

Controlled Drugs

Amendments to the Misuse of Drugs Regulations (Northern Ireland) 2002 introduced on 10 May 2012 allow a nurse independent prescriber and a pharmacist independent prescriber to prescribe controlled drugs. The following Department letter and circular refer.

Independent Prescribing by Physiotherapists and Podiatrists

Changes to legislation to enable the introduction of independent prescribing by physiotherapists and podiatrists were announced by the Department of Health

on 24 July 2012. For further information please refer to:

Introduction of Independent Prescribing for Physiotherapists and Podiatrists - FAQs – Northern Ireland (PDF 54KB)

Information about Training as a Non-Medical Prescriber

A Single Competency Framework for all Prescribers

In May 2012 the NPC published 'A Single Competency Framework for all Prescribers' (PDF 696KB)

Having previously published prescribing competency frameworks for each of the non-medical prescribing professions, it is now clear that a common set of competencies underpin good prescribing regardless of professional background.

This framework consolidates the existing profession specific prescribing frameworks and updates the competencies in order to provide a single common framework that is relevant to doctors, dentists and non-medical prescribers.

The framework can be used to help healthcare professionals prepare to prescribe and help prescribers to identify strengths and areas for development through self-assessment. It is a generic framework which may be contextualised for application to specific clinical and professional settings