Prescribing Rights

Here is an overview of what each of the following prescribers can prescribe depending on the prescribing rights given to each profession.

Table of contents:

Jump to the individual prescriber prescribing rights for the following prescribers.

1. Prescribing rights of doctors
2. Prescribing rights of dentists
3. Prescribing rights of pharmacist independent prescribers
4. Prescribing rights of optometrist independent prescribers
5. Prescribing rights of community practitioner nurse prescribers
6. Prescribing rights of nurse independent prescribers
7. Prescribing rights of physiotherapists independent prescribers
8. Prescribing rights of chiropodists/podiatrists independent prescribers
9. Prescribing rights of paramedic independent prescribers
10. Prescribing rights of therapeutic radiographer independent prescribers
11. Prescribing rights of supplementary prescribers

Some medicines, appliances, dressings and chemical reagents cannot be prescribed on an NHS prescription (see part Part XVIIIA); however, they can be prescribed on a private prescription as long as the prescriber has the prescribing rights to do so and it is within their competence.

In addition to this, some medicines can be prescribed on an NHS prescription in certain circumstances—for more information, please refer to the ACBS (see part XV) and the SLS (see part XVIIIB); however, they can be prescribed on a private prescription as long as the prescriber has the prescribing rights to do so and it is within their competence.

Prescribing rights of doctors

A doctor can prescribe:

• licensed medicines
• unlicensed medicines
• off-label or off-license medicines
• appliances, dressings and chemical reagents
• controlled drugs in Schedules 2-5 (only doctors who possess a license issued by the Home Office are authorized to prescribe diamorphine, dipipanone and cocaine for the treatment of addiction)

Doctors are registered with the General Medical Council. To find out if a doctor is registered, search the General Medical Council’s register.

Prescribing rights of dentists

A dentist can prescribe:

• licensed medicines
• unlicensed medicines
• off-label or off-license medicines
• appliances
• controlled drugs in Schedules 2-5 (excluding diamorphine, dipipanone and cocaine for the treatment of addiction)

A dentist can prescribe anything (e.g. medicines, appliances) listed in the British National Formulary (BNF) and British National Formulary for Children (BNFC) on a private prescription, but they must only prescribe to address the specific dental requirements of their patients and should only prescribe within their competence.^1,2

With regards to NHS prescriptions, dentists can only prescribe certain medicines and appliances that are listed in the Drug Tariff for England, Wales, Scotland and Northern Ireland, as well as in the List of Dental Preparations in the British National Formulary.

A dentist is registered with the General Dental Council. To find out if a dentist is registered, search the General Dental Council’s register.

Further Reading: When and how can dentists supply medicines?

Prescribing rights of pharmacist independent prescribers

A pharmacist independent prescriber can prescribe the following, but they must work within their level of professional competence and expertise:

• licensed medicines
• controlled drugs in Schedules 2-5 (excluding diamorphine, dipipanone and cocaine for the treatment of addiction)
• unlicensed medicines
• off-label or off-license medicines
• appliances, dressings and chemical reagents

Pharmacist independent prescribers can write private prescriptions (in addition to NHS prescriptions).

To find out if a pharmacist is registered and also holds the independent prescriber’s qualification to be able to prescribe, go to the General Pharmaceutical Council’s register.

Prescribing rights of optometrist independent prescribers

An optometrist independent prescriber can prescribe any licensed medicine (except for controlled drugs or medicines for parenteral administration) for conditions affecting the eye, and the tissues surrounding the eye, within their recognised area of expertise and competence.³

They can also prescribe:

• off-label or off-license medicines; however, the General Optical Council discourages optometrists from prescribing off-label or off-license medicines.⁴
• appliances (only allowed to prescribe these to treat conditions that are specific to their area of professional practice).⁴

Optometrist independent prescribers cannot prescribe unlicensed medicines.

Optometrist independent prescribers can write private prescriptions (in addition to NHS prescriptions).

An optometrist is registered with the General Optical Council. To confirm an optometrist’s registration and independent prescriber qualification, search the General Optical Council’s register.

Prescribing rights of community practitioner nurse prescribers

A community practitioner nurse prescriber can prescribe anything listed in the Nurse Prescribers Formulary (NPF) for Community Practitioners.

A community practitioner nurse prescriber is registered with the Nursing and Midwifery Council. Search the Nursing and Midwifery Council’s register to confirm whether a nurse is a community practitioner nurse prescriber.

Prescribing rights of nurse independent prescribers

A nurse independent prescriber can prescribe the following, but they must work within their level of professional competence and expertise:

• medicines and products listed in the BNF⁵
• controlled drugs in Schedules 2-5 (excluding diamorphine, dipipanone and cocaine for the treatment of addiction)
• unlicensed medicines
• off-label or off-license medicines

A nurse is registered with the Nursing and Midwifery Council. Search the Nursing and Midwifery Council’s register to confirm a nurse’s registration and independent prescriber qualification.

Prescribing rights of physiotherapist independent prescribers

A physiotherapist independent prescriber can prescribe any licensed medicines from the British National Formulary, within national and local guidelines, for any condition within their area of competence within the overarching framework of human movement, performance and function.^6,7 Furthermore, they can also prescribe:

• the following seven controlled drugs—temazepam (oral), lorazepam (oral), diazepam (oral), dihydrocodeine (oral), morphine (oral and injectable), fentanyl ( transdermal) and oxycodone (oral)⁷
• off-label or off-license medicines⁷
• appliances and dressings (only allowed to prescribe these to treat conditions that are specific to their area of professional practice).⁴

Physiotherapist independent prescribers cannot prescribe unlicensed medicines.

Physiotherapist independent prescribers can write private prescriptions (in addition to NHS prescriptions).

A physiotherapist independent prescriber is registered with the Health and Care Professions Council. To confirm a physiotherapist’s independent prescriber’s registration and independent prescriber qualification, search the Health and Care Professions Council’s register.

Prescribing rights of chiropodist/podiatrist independent prescribers

A chiropodist/podiatrist independent prescriber can prescribe any licensed medicine from the British National Formulary, within national and local guidelines, for any condition within their area of competence in the management of conditions of the foot and related structures.⁸ They can also prescribe:

• the following controlled drugs for the treatment of organic disease or injury—temazepam (oral), lorazepam (oral), diazepam (oral) and dihydrocodeine (oral)^9,10
• appliances and dressings (only allowed to prescribe these for the purpose of treating conditions that are specific to their area of professional practice).⁴

Chiropodist/podiatrist independent prescribers cannot prescribe unlicensed medicines.

Chiropodist/podiatrist independent prescribers can write private prescriptions (in addition to NHS prescriptions).

A chiropodist/podiatrist independent prescriber is registered with the Health and Care Professions Council. Search the Health and Care Professions Council’s register to confirm a chiropodist/podiatrist’s registration and independent prescriber qualification.

Prescribing rights of paramedic independent prescribers

A paramedic independent prescriber can prescribe any licensed medicine, for any medical condition within their scope of practice competence and level of experience. Furthermore, they can also prescribe the following:

• off-label or off-license medicines
• the following controlled drugs for the treatment of organic disease or injury—morphine sulphate by oral administration or by injection, diazepam by oral administration or by injection, midazolam by oromucosal administration or by injection, lorazepam by injection and codeine phosphate by oral administration ^11,12
• appliances, dressings and chemical reagents

A paramedic independent prescriber cannot prescribe unlicensed medicines.

A paramedic independent prescriber is registered with the Health and Care Professions Council. Search the Health and Care Professions Council’s register to confirm a paramedic’s registration and independent prescriber qualification.

Prescribing rights of therapeutic radiographer independent prescribers

Therapeutic radiographer independent prescribers can prescribe most licensed medicines, within national and local guidelines, for any condition within the practitioner’s area of expertise and competence, and within the overarching framework of the radiography scope of practice including treatment of cancer and the overarching framework of imaging and diagnosis.¹³ In addition to this, they can also prescribe the following:

• off-label or off-license medicines
• appliance/dressings¹³
• the following controlled drugs for the treatment of organic disease or injury—tramadol by oral administration, lorazepam by oral administration, diazepam by oral administration, morphine by oral administration or by injection, oxycodone by oral administration and codeine by oral administration^13,14

Therapeutic radiographer independent prescribers cannot prescribe unlicensed medicines.

Therapeutic radiographer independent prescribers can write private prescriptions, as well as NHS prescriptions.

A Therapeutic radiographer independent prescriber is registered with the Health and Care Professions Council. Search the Health and Care Professions Council’s register to confirm a therapeutic radiographer’s registration and independent prescriber qualification.

Prescribing rights of supplementary prescribers

A supplementary prescriber has the authority to prescribe any medicine, including unlicensed medicines, off-label or off-license medicines and controlled drugs in Schedule 2 to 5 (excluding diamorphine, dipipanone and cocaine for the treatment of addiction). This authority is granted as long as the medicine is specified in the clinical management plan (CMP) and falls within the prescriber’s clinical competence.

Here is a list of the types of supplementary prescribers:

• Pharmacist supplementary prescriber
• Nurse supplementary prescriber
• Midwife supplementary prescriber
• Chiropodist/podiatrist supplementary prescriber
• Physiotherapist supplementary prescriber
• Optometrist supplementary prescriber
• Paramedic supplementary prescriber
• Diagnostic radiographer supplementary prescriber
• Therapeutic radiographer supplementary prescriber
• Dietetic supplementary prescriber

References

1. General Dental Council. Guidance on prescribing medicines. Accessed via https://www.gdc-uk.org/docs/default-source/guidance-documents/guidance-on-prescribing-medicines.pdf?sfvrsn=2e82e39c_2 on 13/02/2024.
2. Scottish Dental Clinical Effectiveness Programme. Drug Prescribing For Dentistry. Accessed via https://www.sdcep.org.uk/published-guidance/drug-prescribing/ on 13/02/2024.
3. The College of Optometrists. Independent prescribing. Accessed via https://www.college-optometrists.org/professional-development/further-qualifications/independent-prescribing-ip-qualification on 30/01/2024.
4. Drug tariff. Part XVIIB(ii) – Non-Medical Independent Prescribing (Nurses, Pharmacists, Optometrists, Physiotherapists and Chiropodists/Podiatrists). Accessed via https://www.drugtariff.nhsbsa.nhs.uk/#/00782291-DD/DD00781684/Part%20XVIIB(ii)%20-%20Non-Medical%20Independent%20Prescribing%20(Nurses,%20Pharmacists,%20Optometrists,%20Physiotherapists%20and%20Chiropodists%20Podiatrists) on 30/01/2024.
5. Royal College of Nursing. Types of nurse prescriber. Accessed via https://www.rcn.org.uk/Get-Help/RCN-advice/non-medical-prescribers on 30/01/2024.
6. Chartered Society of Physiotherapy. Professional guidance: Prescribing for physiotherapists. Accessed via https://www.csp.org.uk/professional-clinical/professional-guidance/medicines-prescribing-injection-therapy/prescribing on 30/01/2024.
7. Chartered Society of Physiotherapy. Practice guidance for physiotherapist supplementary and/or independent prescribers in the safe use of medicines (4th edition). Accessed via https://www.csp.org.uk/publications/practice-guidance-physiotherapist-supplementary-andor-independent-prescribers-safe-use on 30/01/2024.
8. Royal College of Podiatry. Royal College of Podiatry Policy: Medicines: prescribing, sale, supply and administration of medicines by podiatrists. Accessed via https://rcpod.org.uk/the-college/medicines on 12/02/2024.
9. Royal College of Podiatry. Royal College of Podiatry Guidance: Good Practice in Prescribing and Medicines Management for Podiatrists. Accessed via https://rcpod.org.uk/api/documentlibrary/download?documentId=665 on 19/02/2024.
10. Health and Care Professions Council. Controlled drugs. Accessed via https://www.hcpc-uk.org/standards/meeting-our-standards/scope-of-practice/medicines-and-prescribing-rights/controlled-drugs/ on 12/02/2024.
11. Home Office. Circular 007/2023: The Misuse of Drugs (England and Wales and Scotland) (Amendment) (No.2) Regulations 2023. Accessed via https://www.gov.uk/government/publications/circular-0072023-the-misuse-of-drugs-no2-regulations-2023/circular-0072023-the-misuse-of-drugs-england-and-wales-and-scotland-amendment-no2-regulations-2023 on 30/01/2024.
12. The Misuse of Drugs (England and Wales and Scotland) (Amendment) (No. 2) Regulations 2023. Accessed via https://www.legislation.gov.uk/uksi/2023/1345/regulation/5/made on 30/01/2024.
13. The Society and College of Radiographers. The Society and College of Radiographers Practice Guidance for Radiographer Independent and/or Supplementary Prescribers. Accessed via https://www.sor.org/learning-advice/professional-body-guidance-and-publications/documents-and-publications/policy-guidance-document-library/practice-guidance-for-radiographer-prescribers on 12/02/2024.
14. Home Office. Circular 007/2023: The Misuse of Drugs (England and Wales and Scotland) (Amendment) (No.2) Regulations 2023. Accessed via https://www.gov.uk/government/publications/circular-0072023-the-misuse-of-drugs-no2-regulations-2023/circular-0072023-the-misuse-of-drugs-england-and-wales-and-scotland-amendment-no2-regulations-2023 on 30/01/2024.