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
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
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.
Supplementary prescribers may prescribe any medicine (including controlled
drugs), within the framework of a patient-specific clinical management plan, which has been agreed with
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
website. Refer also to the following advice issued by DHSSPS:
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.
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:
about Training as a Non-Medical Prescriber
A Single Competency Framework for all Prescribers
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
Key Publications, Guidance Documents and Communications