It is helpful to know who can prescribe your medicines. There are ongoing developments in whom we train to be able to prescribe, so it might not always be a doctor. There are also local arrangements about which services can, or should, prescribe specific medicines.
In a few specific instances medicines can be provided or administered without a prescription. This involves the use of a 'Patient Group Direction'. One example is the administration of an influenza (flu) vaccination.
Non-Medical Prescriber
In recent years the number of healthcare professionals who are trained and allowed to prescribe has increased. In addition to doctors and dentists you might now receive prescriptions from a “non-medical prescriber” such as a nurse or pharmacist who has completed extra prescribing qualifications and who is highly skilled in their particular specialism. These professionals are also trained to assess and diagnose illness and to complete physical examinations of patients to be sure that they prescribe safely. Non-medical prescribers are supervised by doctors and other highly experienced healthcare professionals throughout their practice.
The development of non-medical prescribing is happening throughout the NHS and you are likely to meet non-medical prescribers in your GP surgery, in clinics and in hospitals. This benefits patients by making services more accessible and more efficient. When a medicine needs to be prescribed or adjusted, this can be done without the need to refer the patient to a doctor and without the patient needing to attend another appointment or wait for a prescription to be written.
The following websites offer information about the development of non-medical prescribing:
Prescribing restrictions
As well as the question of who is qualified to prescribe, some medicines have restrictions on who is allowed to prescribe them.
In Derbyshire these restrictions are specified in the “traffic-light” system.
Most medicines can be prescribed by your GP, or non-medical prescribers in their practice, and these are described as “Green” in the traffic light list.
Some medicines must be started by a specialist and the GP practice will then prescribe once everything has settled down. These are described as “Amber” in the traffic light system. In some cases, amber medicines require additional monitoring. To keep treatment safe we have “Shared Care Guidelines” for these medicines that tell us what the specialist’s responsibilities are and what the GP’s responsibilities are. If the GP does not agree to prescribe the medicine for you, then you will continue to get prescriptions for the medicine from your specialist.
A few medicines can only ever be prescribed by a specialist. These are described as “Red” in the traffic light list. In Derbyshire the mental health medicines that are red include clozapine and antipsychotic depot injections.
In some cases it is agreed that a medicine should not be prescribed by anyone working for the NHS in Derbyshire and these are described as “Black”. Medicines might be classified as black if they lack evidence that they are as good as other treatments.
A very few medicines are in the “Brown” category. These are medicines that are not normally used, but in specific circumstances they might be helpful and prescribing is allowed.
Patient Group Directions
Patient Group Directions (PGDs) provide a legal framework that allows some registered health professionals to supply and/or administer specified medicines to a pre-defined group of patients, without them having to see a prescriber (such as a doctor or nurse prescriber). Supplying and/or administering medicines under PGDs is reserved for situations in which this offers an advantage for patient care, without compromising patient safety.