Prescriptions for Controlled Drugs by Non - Medical Prescribers

The ICB Medicines Optimisation (MO) team has detected some issuing of Controlled Drugs (CDs) by Healthcare Professionals outside their legal prescribing authority.

Paramedics, radiographers, physiotherapists, and podiatrists cannot prescribe any class of CD, except for those medicines listed in the Misuse of Drugs regulations:

• Paramedics and Radiographers: as per The Misuse of Drugs (England and Wales and Scotland) (Amendment) (No. 2) Regulations 2023
• Physiotherapist and Podiatrists: as per The Misuse of Drugs (Amendment) (No. 2) (England, Wales and Scotland) Regulations 2015

What is being done?

• The MO team is working to see if clinical systems can restrict the list of CDs that these professionals can issue.
• Relevant practices are being notified so they can provide more rigorous training to their Paramedics, Physiotherapists and Podiatrists, as necessary.

What you need to do

Check all prescriptions for CDs for the prescriber. If you receive a CD prescription from a paramedic, radiographer, or podiatrist that falls outside their legal prescribing authority, do not dispense it.

Any identified prescriptions must be returned to the prescriber/ surgery for a suitable professional to authorise.

You can identify prescriptions by checking the prescriber codes, as shown in the example image.

 What paramedic independent prescribers can prescribe:

• Morphine sulphate by oral administration or injection
• Diazepam by oral administration or injection
• Midazolam by oromucosal administration or injection
• Lorazepam by injection