The presence of difficulties with timely contact with the doctor leads to the fact that the prescribed medications are used ineffectively or the patient refuses treatment altogether. Meanwhile, in the vast majority of cases, the patient needs relatively uncomplicated, non-specific advice, recommendations, control measures, for which the competence of a clinically trained pharmacist or even a junior pharmacist is sufficient. Can I see a pharmacist instead of my GP?
Pharmacist instead of my GP
Non-pharmacist prescribing has been permitted in the United Kingdom since 1992, until spring 2006, only nurses and only within a limited nomenclature – the so-called dependent or “additional prescribing”. In November 2005, a decision was made to allow nurses and pharmacists to prescribe any medication for any condition except controlled conditions (nurses immediately, and pharmacists later were also allowed to prescribe certain controlled drugs used for certain medical conditions). More recently, physical therapists, orthopedists, and optometrists were added to the number of specialists allowed additional prescribing within their purview. In 2016, legal regulations were passed in England allowing independent prescribing by therapeutic radiologists and additional prescribing by dietitians.
The authority of pharmacists to independently prescribe became a key point for their participation in multidisciplinary teams (MDT), which began to be created as part of pilot projects. The Royal Pharmaceutical Society of Great Britain (RPS) published a competency framework for all prescribers (Picton C., 2016).
Independent prescribing is performed by a healthcare professional who is responsible for assessing patients and making decisions about the necessary clinical management, including prescribing. Specifically:
- An independent prescriber may be a specially trained nurse, pharmacist, optometrist, physical therapist, radiologist, or podiatrist who may prescribe marketing-approved medications within their clinical competence; however, nurses and pharmacists may prescribe unlicensed drugs and controlled substances.
- A community practitioner nurse prescriber (CPNP), such as a district, nursing or school nurse, may self-prescribe from a limited Nurse Prescribers’ Formulary for Community Practitioners (Nurse Prescribers’ Formulary), which can be found in the British National Formulary (BNF).
Supplemental prescribing is a voluntary partnership between a physician or dentist and a prescriber as part of an agreed-upon individualized clinical management plan (CMP). Nurses, optometrists, pharmacists, physical therapists, orthopedists, radiologists, and dietitians, once qualified, can prescribe any medication within their clinical competence under the CMP.