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Paramedic Prescribing

pills by rodrigo senna, on Flickr

pills by rodrigo senna, on Flickr

[Update: The Department of Health have launched an engagement exercise on Paramedic Prescribing. See more info at the bottom of the article]

Not long ago I had an observer out with me for the day. Nick Crowther is working on Ambulance Policy for the Urgent and Emergency Care Branch of the Commissioning & System Management Directorate in the Department of Health. His intention for the day was to see the possible benefits and impact on patients that extending the responsibilities for prescribing for advanced paramedic practitioners may bring. Nick feels that it is important to get out from the office environment and get a feel for what is happening on the front line and how patients will benefit from having access to paramedics who can prescribe.

Nick said to me, “We intend to do for paramedics what we did for nurses and pharmacists back in 2002.  We want to see what the possible benefits may be for the patient; we need to know if there will be any added value in advanced paramedic practitioners being able to prescribe for certain groups of patients.”

Nick feels that it is paramedics working as ECPs in Urgent Care settings rather than in Emergency Care who may require the provision the most.

“Cutting red tape and obstacles around how medications are supplied to patients will mean that it is easier for commissioners to place practitioners where they are needed the most. They will have a workforce that is more flexible and mobile. Individual practitioners will benefit from being able to use their skill set in various work environments as and when the need or desire dictates.”

Nurses of course have been prescribing for some years now. The majority of these Nurses have over ten years nursing experience and have had to demonstrate that they have sufficient assessment and diagnostic skills in the specialist area they will be prescribing in. The training course is intensive and thorough and includes a calculations exam that must be passed at 100%. There are now nearly 40,000 nurses in the UK qualified to prescribe, and developments continue.

Taking Healthcare to the Patient suggested that Paramedic prescribing is an issue which should be examined more closely. The Department of Health and MHRA (Medicines and Healthcare products Regulatory Agency) are hoping to put out a consultation paper at the end of this year or beginning of next year. In addition they will target interested parties and organisations for their thoughts and opinions on the matter.

Processing the responses will take some time however and the Commission for Human Medicine will need to give the final sanction to prescribing for advanced paramedics. I will be watching with interest because not only will it provide professional development for paramedics but the aim is to improve the experience for the patient and that is what we all want to see.

Nick said to me that the Department of Health are always seeking to get feedback on developments such as this. If you have any thoughts feel free to leave them in the comments and I’ll pass them on.

Update 04/04/10:

The Department of Health have launched a stakeholder engagement exercise, designed to obtain the views and opinions of any interested parties on the introduction of Prescribing for Paramedics. The exercise will inform the development of a formal consultation later this year. There are only ten questions and you are strongly advised to have your say on this matter. Here’s the link:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_114355

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  1. stuckeyd says:

    hi lysa, i read your comments on paramedic prescribing with interest. i am a registered paramedic and qualified ECP and 3 yrs ago i started working at a walk in centre. I would love to get the opportunity to become a prescriber however my registration has held me back from doing this. The nurses i work with have all gone on to become independant prescribers and although i have PGD’s i often find them limiting. i still practice part time as an on the road paramedic where prescribing is not so much of an issue. The main reason i became an ECP was to lift the ceiling of career development that was taken as part of the paramedic role and i hope that the DOH consider allowing advanced paramedic practitioners to prescibe as i have now found that ceiling firmly back in place in comparison to my nursing colleagues.

    • Lysa says:

      Hi Dave,

      I guess the ability to prescribe wasn’t of any particular consequence for most paramedics prior to the Skills for Health document and the emergence of the new roles that followed; however those of us who have embraced the aspirations of the document and are trying to develop as independent practitioners are now finding our practise curbed in comparison to our nursing colleagues.

      At the moment we predominantly use PGDs in emergency situations and these are a very useful tool for administration of medicines. However, PGDs have their limitations, can be costly and time consuming to develop and are, on the whole, non-transferable between employers and work environments; therefore they don’t fit particularly well with a highly flexible workforce such as ECPs who may work across a variety of settings in primary, urgent and emergency care for more than one employer. Having the ability to prescribe however, is a skill that will thankfully follow the professional wherever they may be employed at the time, cutting down on the bureaucracy and red tape so common to the NHS and the prime beneficiary will be our patients as we increase the treatment options available to us.

  2. [...] Service decides they will no longer use Emergency Care Practitioners as part of their workforce and Paramedic Prescribing – both hot topics at the [...]

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