Medicines and Medicine Management

This is where guidance and resources linked to all aspects of medicines use by paramedics is collated. If you have other information which could be useful please let me know via enquiries@collegeofparamedics.co.uk

Following feedback from members I will try and update this page on a regular basis. 


David Rovardi MCPara, MRPharmS


To view all resources, join the College of Paramedics as a member and follow the link at the bottom of the page.

21st January 2025

Clarification now received regarding mixing of controlled drugs by paramedic prescribers. 

The College of Paramedics is pleased to announce that we have now received confirmation from The Home Office that the mixing of controlled drugs by paramedic prescribers is permitted.
 
We are sorry for the delay, however, due to the nature of legislation we needed to seek clarification from The Home Office due to the potential for criminal penalties under the Misuse of Drugs Act if the wrong information had been provided to members.
 
We would also like to remind members that all local policies and guidelines need to be followed including the appropriate disposal of excess controlled drugs.

Ref -
https://assets.publishing.service.gov.uk/media/5a7c7f92ed915d48c241025e/dh_116360.pdf 
https://www.legislation.gov.uk/uksi/2018/199/pdfs/uksiem_20180199_en.pdf

4th September 2024

The College continues to lobby for a change in legislation to allow paramedic prescribers full controlled drug prescribing rights. In order to support our case we require as much evidence as possible to present to interested parties and government officials. 

Please could I ask all paramedic prescribers to complete the form when they identify instances of when controlled drug prescribing of controlled drugs not on the limited list would benefit patient care and the impact on treatment time and other time implications of when they have been unable to prescribe. 

https://forms.office.com/e/YY7F7WPREt
 

3rd January 2024

Controlled Drugs; Legislation Changes Webinar
 
Andy Collen, Consultant Paramedic at SECAmb who on behalf of the College led the Medicines and Prescribing Projects, chaired this panel of College of Paramedics experts David Rovardi, Pharmacist, Independent Prescriber and Registered Paramedic and Specialist Medicines Advisor, College of Paramedics, Helen Beaumont-Waters, Head of Clinical Development (Primary and Urgent Care) College of Paramedics and Carl Smith, Head of Clinical Development Emergency and Critical Care, College of Paramedics, as they discussed Controlled Drugs; Legislation Changes.

This webinar was facilitated to provide information to our members following the recent announcement regarding regulatory changes to the Misuse of Drugs Regulations 2001 to allow paramedic independent prescribers to prescribe and administer, and direct others to administer, the following five controlled drugs:
• 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.
Please note no other controlled may be prescribed independently by paramedic prescribers. 

Topics of discussion were:
• The medicines selected
• Safe, responsible and legal use of these medicines
• Deprescribing
• Relevant guidelines and good practice
• Practical points
• The future

To watch the webinar please click the link below...
Controlled Drugs; Legislation Changes

Controlled Drugs; Legislation Changes Slides PDF

30th May 2023

Guidance for Purchasing and Administration of Medicines by Paramedics and Private Ambulance Providers.

Individual Paramedics
Individual paramedics may order any prescription only medicines (POM) from Schedule 17 of the Human Medicines Regulations. They may also order any P medicines for administration to a patient. They may not make a supply of any medicine.
Schedule 17 morphine will require a private requisition number which can be obtained from your local controlled drugs accountable officer.
 
Private Companies.  
Private companies will require a doctor’s requisition (also known as a doctors order or doctors authority) for ordering any medication. This is because any transaction between a wholesaler and company is classified as a company-to-company supply and is not covered by schedule 17 of the Human Medicines Regulations.
In addition, due to the above private companies who wish to obtain controlled drugs must have a Home Office Controlled Drugs License.
All other POMs including schedule 19 medicines require a doctor’s requisition.
 
The College is grateful and wishes to acknowledge the advice provided by Well’s Offshore Wholesaler dealers for the guidance above.

 

8th November 2022

Paramedics are reminded that as part of their registration they are entitled to privately requestion for use in private practice all medicines in Schedule 17 of the Humans Medicines Regulations 2012. 
 
This list includes morphine and diazepam which are schedule 2 and schedule 4 controlled drugs. 
 
In order for paramedics to requisition morphine they must:
• Register with their local controlled drugs accountable officer (CDOA), this will typically be through the medicines management team at their local clinical commission group / health board / integrated care system.
• Obtain a private Controlled drugs requisition / prescribing code.
• The CDAO may request standard operating procedures for the purchase, recording, safe storage and disposal of the controlled drugs. The college recommends that this good practice and should be followed by all paramedics even if not required. 
• Requisitions must be written on approved stationery only. 
• Paramedics must adhere to law regarding safe storage, recording and disposal of controlled drugs.
 

If you require any further help or clarification on this, matter please email enquires@collegeofparamedics.co.uk

28th September 2022

Controlled Drugs Independent Prescribing
 
Following recent changes in Government and within the Home Office, The College is working to build new relationships with the ministers who are involved with the legislative changes needed for paramedics to be able to prescribe controlled drugs. 
 
We continue to receive enquiries regarding prescribing controlled drugs, can I please remind all independent prescribers that they are unable to prescribe any controlled drugs on schedules 2 to 5 until the legislation is amended, this includes codeine and co-codamol.  It is imperative that prescribers work within their scope.  Please follow this link for the webinar which was held recently.

 

8th September 2022

Please find the link here to download the template to give examples of where independent prescribing of controlled drugs would benefit patient care. 

I have also included an example document here for guidance.

Please email completed examples to david.rovardi@collegeofparamedics.co.uk  
 

5th September 2022

Following the recent webinar to discuss controlled drugs and the changes to Fit Note legislation, we have now completed answering the questions which were put forward in the chat box.  You can read this document here .

If you missed the webinar, it is on the CPD hub and you can watch it here Discussing Controlled Drugs and Fit Notes (collegeofparamedics.co.uk).

Medicines and Independent Prescribing

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