Physios to bypass GPs in prescribing overhaul

Physiotherapists and podiatrists are set to prescribe medicines for patients without their GP's approval under a 'landmark' shake-up of prescribing rules.

Lord Howe: prescribing powers for physios and podiatrists
Lord Howe: prescribing powers for physios and podiatrists

Health minister Lord Howe announced on Tuesday that the government will seek to grant specialist physiotherapists and podiatrists powers to independently prescribe licensed medicines without the need for GPs to authorise the decision.

The powers would be similar to those already given to nurses and pharmacists. It would see physiotherapists and podiatrists prescribe drugs for pain relief and inflammation, as well as diseases such as asthma and neurological disorders.

Supporters claimed the move will reduce pressure on GPs and speed up patients' access to treatment.

GPC prescribing lead Dr Bill Beeby said the BMA had worked to try to make sure the new arrangements were ‘doctor-friendly’.

‘They are pretty much identical to nurse and pharmacist prescribing,’ he told GP magazine. ‘In that light, there isn’t much of an issue.

‘The evidence from nurse prescribing is that they do it well and fully understand their responsibilities,’ he added. ‘So it is entirely appropriate that properly trained physiotherapists will be able to prescribe within their area of expertise.’

But Dr Beeby said he didn’t think there’d be a ‘huge rush’ of physiotherapists wanting to take on prescribing rights.  Any physiotherapists wanting to become prescribers would need to be sponsored, and there may be limited appetite in the current climate to fund large numbers to undertake such work, he pointed out.

Move 'will improve care'
The government will now seek to alter the medicines legislation in parliament to allow the changes.

Health minister Lord Howe said: 'Physiotherapists and podiatrists are highly trained clinicians who play a vital role in ensuring patients receive integrated care that helps them recover after treatment or manage a long-term condition successfully. By introducing these changes, we aim to make the best use of their skills and allow patients to benefit from a faster and more effective service.'

Dr Helena Johnson, chair of the Chartered Society of Physiotherapists (CSP), said the move would speed up patient access to treatment. 'Giving physiotherapists the opportunity to prescribe independently will hugely improve the care we can provide in the future,' she said.

She added that it would remove a layer of bureaucracy and reduce 'unnecessary burden' on doctors. The CSP insisted physiotherapists would take full responsibility and accountability for the prescribing decisions they make.

Alison Wishart, chair of the society of chiropodists and podiatrists, said: 'Independent prescribing provides podiatrists with the opportunity to deliver more flexible services for patients - ensuring timely access to medicines, care closer to home and enabling innovation.'

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Extra training needed
Physiotherapists are expected to begin prescribing from 2014, subject to parliamentary approval of the plans. Many physiotherapists will require extra training before they are allowed to prescribe.

Since 2005, some physiotherapists can be granted supplementary prescribing status, whereby they can prescribe only in agreement with the patient's GP or other independent prescribers.

But under the new rules many physiotherapists will be able to prescribe medicines relevant to their scope of practice for a wide range of illnesses. These include respiratory diseases like asthma, neurological disorders, rheumatological conditions, women’s health issues, chronic pain and mobility problems.

Podiatrists treating conditions such as diabetic foot ulcers and arthritic disorders in the foot and ankle would also be granted prescribing powers.

Only physiotherapists in advanced practitioner roles will be allowed to prescribe, and many will need to undergo training before they are able to prescribe.

The move followed a public consultation run by the DH from September to December 2011. The government will now seek to change the medicines legislation to allow the changes.

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