Medicines and Independent Prescribing
Practice guidance for advanced paramedic independent prescribers in the safe use of medicines
This is the first edition of the College of Paramedics practice guidance, which is aimed at independent and supplementary prescribers. The information within the practice guidance will support prescribing activity and decision-making by prescribers in order to promote safe and effective patient care.
Independent prescribing by advanced paramedics comes into effect from 1 April 2018, pending changes to legislation and the provision of annotation to professional registration. Initially, this will be limited to medicines that are not controlled drugs, until the relevant legislation is also updated.
The following practice guidance provides information that should underpin the decision-making and actions of advanced paramedics who in future become annotated with the Health and Care Professions Council (HCPC) as independent and supplementary prescribers. Please note that independent prescribers are also supplementary prescribers, which, although uncommon in paramedic practice, is included in the practice guidance.
This document is published as guidance. ‘Guidance’ is defined as information which a paramedic has a duty to consider, and is expected to take into account as part of their decision-making process.
This document provides advice on the behaviours and conduct expected of paramedics who are annotated on the HCPC register as an independent prescriber. The practice guidance should be read in conjunction with the Implementation Guidance, and the Outline Curriculum Framework (published by the AHPF – see links section)
Practice Guidance for Paramedics for the Administration of Medicines under Exemptions
This is the first edition of the College of Paramedics practice guidance, which is aimed at administration of medicines under exemptions within the Human Medicines Regulations 2012.
This document provides information which should underpin the decision-making and actions of paramedics who are registered with the Health and Care Professions Council (HCPC) as having access to exemptions within the Human Medicines Regulations to be able to administer listed prescription only medicines (POMs) and pharmacy (P) medicines.
This document is guidance that a paramedic has a duty to consider and is expected to take into account as part of their decision-making process. This document provides advice on the behaviours and conduct expected of paramedics who are registered with the HCPC and are able to access exemptions.
The purpose of exemptions for paramedics is to support and enhance the delivery of care to patients by promoting safe and appropriate use of the current mechanisms by which paramedics deliver care. Accordingly, exemptions mean that paramedics; “can administer certain named medicines by injection on their own initiative for the immediate, necessary treatment of sick or injured people (i.e. in emergency situations).” (Human Medicines Regulations)
Paramedics must only work independently within their scope of practice and the same applies to the use of exemptions. If a paramedic extends their role to a new area of practice they will need to show they are competent in that area before they can access exemptions within that role.
Important definitions and terms
Throughout the guidance, the use of the word ‘must’ indicates a legal and/or regulatory requirement and describes a mandatory action and/or behaviour.
The use of the word ‘should’ indicates behaviours and/or actions that would be expected to occur in all normal circumstances.
If a paramedic deviates from the guidance in these documents, the clinical judgment for so doing should be carefully recorded.
You should comply with the practice guidance; other guidance issued by the College of Paramedics, and with any statutory requirements applicable to your practice involving medicines.
Failure to do so may put your HCPC registration at risk if concerns are raised about your fitness to practise.
Other key College of Paramedics Documents relating to Prescribing
- A Guide to Implementing Paramedic Prescribing within the NHS in the UK.
Key Documents, Resources and Further Reading relating to Prescribing
Allied Health Professional Federation. (2017). Outline Curriculum Framework for Education Programmes (Prescribing). Available: www.ahpf.org.uk/files/Online%20Curriculum%20Framework.pdf. Last accessed January 2018.
Department of Health. (2012). Human Medicines Regulations (2012). Available: www.legislation.gov.uk/uksi/2012/1916/contents/made. Last accessed January 2018.
Health & Care Professions Council. (2013). Standards for Prescribers. Available: www.hcpc-uk.org/assets/documents/10004160Standardsforprescribing.pdf. Last accessed January 2018.
NHS England. (2013). NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013. Available: www.legislation.gov.uk/uksi/2013/349/introduction/made. Last accessed January 2018.
NHS England. (2015). The National Health Service (General Medical Services Contracts) Regulations 2015. Available: www.legislation.gov.uk/uksi/2015/1862/contents/made. Last accessed January 2018.
NHS England. (2015). NHS (Personal Medical Services Agreement) Regulations 2015. Available: www.legislation.gov.uk/uksi/2015/1879/contents/made. Last accessed January 2018.
NHS England. (2015). NHS (Charges for Drugs and Appliances) Regulations 2015. Available: www.legislation.gov.uk/uksi/2015/570/contents/made. Last accessed January 2018.
The Royal Pharmaceutical Society. (2016). A Competency Framework for all Prescribers. Available: www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Professional%20standards/Prescribing%20competency%20framework/prescribing-competency-framework.pdf. Last accessed January 2018.