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Hello Nick,
In answer to your rhetorical question - podiatrists in the UK can't prescribe. You might be able to supply or sell certain medications under our exemptions but you can't prescribe (apart from supplementary prescribing if you have done the course?).

If you would like to have independent prescribing rights for all of the drugs you really need to effectively treat your patient caseload, I would urge you and everyone else reading this to see the following link and email your views to the DOH:
http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_129981
Thanks,
Bob

 

Re: Obtaining Adrenalin in the UK

You pipped me to the post! I was going to write a similar plea and urge EVERYONE IN THE UK to look at the attached document and complete it on line (or post it to the DH) with the addition of your own words in the response sections, prior to the closing date of 8 December 2011.

It would be advantageous for us ALL to promote this document to our colleagues, Doctors, Patients and other health professionals to help support our quest for Independent Prescribing for Podiatrists.

Cheers,
Bel

 

All,

I`d like to urge EVERYONE IN THE UK to look at the attached document and complete it on line (or post it to the DH), if you haven`t already done so, with the addition (or substitution, if you don`t wish to utilise the suggested wording helpfully supplied by Dr Alan Borthwick), of your own words in the response sections prior to the closing date of 8 December 2011.

It would be advantageous for us ALL to promote this document to our colleagues, Doctors, Patients and other health professionals to help support our quest for Independent Prescribing for Podiatrists.

If anyone has any questions regarding this process, Dr Borthwick is happy for any questions to be sent direct to him on one of the following email addresses; ab12@soton.ac.uk or meds@scpod.org.

Further info found here;
http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_129981


Cheers,
Bel

 

Re: Obtaining Adrenalin in the UK

Hi Bob,

I can prescribe antibiotics (3 types) under my qualification and supply them. This qualification came in as standard for students who passed their degree from 2005 in the UK.

Nick

 

Re: Obtaining Adrenalin in the UK

Well done you !!!!

 

Re: Obtaining Adrenalin in the UK

Nick, I think you are slightly mistaken. Bob is correct, you cannot prescribe the 3 abx's, as in you don't have a script pad that a patient can take to a pharmacy and have dispensed.

You are right that you can supply the abx but you are not prescribing them, sounds confusing I know, but true. However just to make it more confusing you can now write a pharmacist order for the drugs to be dispensed, but this is still not prescribing.

EVERYBODY
http://www.dh.gov.uk/en/Consultation...ions/DH_129981


George

 

Re: Obtaining Adrenalin in the UK

Yep, what he says. :good:

George, that link isn`t working for me?

 

Re: Obtaining Adrenalin in the UK

Dear all,

This is a really important issue to get right especially in light of the current PUBLIC CONSULTATION on Independent Prescribing.


http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_129981

PLEASE PLEASE READ THIS AND RESPOND AND GET AS MANY PEOPLE AS POSSIBLE TO RESPOND THIS IS A PIVITOL TIME FOR THE PROFESSION

I cannot stress enough to all at this time as podiatrists we CANNOT prescribe (unless you are a supplementary prescriber / undertaken a specific course - usually over 6 months) and have been involved in a clinical management plan with a medical prescriber - usually a doctor and this is only in the NHS setting - no other !! Therefore any private application of this is not legal.

You are able to

Sell, Supply or administer a range of drugs which feature on the Prescription Only Medicines Exemption List

See at the end of this post a copy of the article from PODIATRY NOW recently that further highlights the recent positive gains we have made. One being the use of SIGNED ORDER PROVISION (which is not a PRESRIPTION at all !!!)

This is a common issue that is confused by colleagues but is one we need to have correct otherwise it will reflect badly on us in the future as we need to show we are well versed and experienced in the correct procedures we are able to access and those we are not.

We are asking for a big thing with FULL INDEPENDENT PRESCRIBING but this is not done lightly.

As the MEDICINES OFFICER for the Society of Chiropodists and Podiatrists for the past 18 months I have been working to help develop the necessary paper work for submission to the stage we are at. This has not been alone by any stretch.

PLEASE PLEASE READ THE FULL DOCUMENTS ON THE Dept of health WEBSITE !!!


I am not wanting to be antagonistic to any colleagues but am passionate that we get this right and get it right now

with regards


Matt Fitzpatrick


=======================================================
Amendments to the Medicines Exemptions for Podiatrists: 2011

On March 10th 2011, the Commission on Human Medicines considered and approved the submission made by the Society of Chiropodists & Podiatrists to amend key provisions of the existing exemptions relating to the sale, supply and administration of medicines by podiatrists.
Earlier, in October 2010, the MHRA undertook a public consultation, known as MLX 372, on the proposal for amendment to the existing exemption lists, which sought four specific changes. Each of these proposals was accepted by the Commission on Human Medicines; the Statutory Instrument has now been laid, and came into force on 1st July 2011.
The changes to the existing legislation relate to the following issues that are known to exist in practice, and which reflect the current provisions:

1. At present the relevant Statutory Instruments only permit podiatrists the right to the sale and supply of co-dydramol tablets (10/500) to an amount sufficient for 3 days, to a maximum of 24 tablets. It also restricts the sale and supply of ibuprofen tablets to an amount sufficient for 3 days, where the maximum dose is 400mgs, the maximum daily dose 1, 200mgs and the maximum pack size of 3,600mgs. Recently, manufacturers have changed pack sizes for these medicines, which has meant that podiatrists have not been able to access these medicines, as current pack sizes are larger than those permitted for podiatrists to access and supply.

2. In some NHS Trusts, the analgesics of choice include codeine phosphate and co-codamol, in preference to co-dydramol and ibuprofen.

3. At present podiatrists in possession of the ‘local anaesthetic’ annotation on the Health Professions Council register are entitled to access and administer certain local anaesthetic agents, such as lidocaine hydrochloride, and also the corticosteroid agent methylprednisolone. However, they are not permitted to administer the commercially available pre-mixed solutions of these medicines without recourse to a Patient Group Direction (PGD). As a result, they have been compelled to give two separate injections when treating patients with both medicines.

4. At present podiatrists often hold stocks of medicines in their clinics, but may choose not to hold stocks of certain medicines which are used infrequently or irregularly, and which therefore might lose shelf life. An example might be stocks of erythromycin. Wholesale suppliers may also be reluctant to supply small quantities of these types of medicines to practitioners.
These difficulties in practice gave impetus to the recent submission to the CHM to amend existing legislation. The following 4 key proposed amendments have been accepted by the CHM:

Amendment 1.
The CHM has agreed to the removal of the restriction on pack size and, therefore, a legal specification of the limitation of 3 days and a maximum number of tablets/mgs, providing that the Society of Chiropodists & Podiatrists makes clear in its professional guidance to members that these analgesics should only be supplied for a 3 day course of treatment prior to re-review of the patient.
This will mean that any subsequent change to pack sizes will not affect access to supplies of these medicines.

Amendment 2.
The CHM has agreed to the addition of codeine phosphate and co-codamol to the podiatrists’ exemption list. Whilst it will not specify limitations on pack size or number of tablets/mgs, it requires the Society of Chiropodists & Podiatrists to issue clear guidelines recommending a limitation to a 3 day course prior to patient re-review.

Amendment 3.
The CHM has agreed to the removal of the current restriction on the administration of commercially available pre-mix solutions of medicines already on the podiatrists’ exemptions list. This will allow podiatrists access and administration rights to medicines such as ‘depo-medrone and lidocaine’ for parenteral administration. It may also allow the use of other commercially available premix solutions of agents that become available in future, providing the individual medicines are on the podiatrists’ exemptions list.

Amendment 4.
The CHM agreed that podiatrists would benefit from access to a ‘signed order provision’. This is a means by which podiatrists can supply medicines to their patients via a pharmacist. For example, rather than holding a stock of medicines in clinic, and supplying medicines directly to patients, a ‘signed order provision’ will allow the podiatrist to issue a ‘signed order’ to a pharmacist requesting the patient be supplied with medicines on the order of the podiatrist. It is important to stress that this is not a form of prescribing, and neither is it a prescription. It will not involve the use of an FP10 or any prescribing equivalent. But it does mean that the podiatrist can choose to either keep the medicines within their surgery premises or use the 'signed order' arrangement with the pharmacist allowing medicines to be supplied to patients without the concern of shelf life. It allows the podiatrist to supply medicines only from the podiatrists’ exemption list, and the issuing podiatrist must be in possession of the ‘POM’ annotation on the Health Professions Council register. In addition, the Society of Chiropodists & Podiatrists will recommend in its professional guidance that all analgesic medicines on the exemption list (including codeine phosphate, co-codamol and co-dydramol) are supplied to the patient via signed order where relevant, as it ensures good clinical governance and permits a second check of the supply decision by a registered pharmacist.

Further details will be made available on the Medicines section of the Society’s website, and the Society will issue professional guidance on the use of medicines in support of these changes.


Good Medicines Management – Guidance
Medicines Committee – College of Podiatrists 2011

The Medicine and Healthcare products Regulatory Agency (MHRA) has been taking action to ensure there is a consistent approach to the supply without prescription, of medicines containing codeine and di-hydrocodeine for the treatment of acute / moderate pain. In 2009, the Agency introduced new restrictions on the sale of these medicines because of concerns about the risk of addiction from deliberate or inadvertent overuse.

These included restricting the pack size and strengthening warnings on the label and patient leaflet about the risk of addiction. The Agency has therefore sought assurance from the College of Podiatrists that, where relevant, our professional practice guidance will reflect these restrictions.

In this respect the following should be taken into consideration.

• Limiting the use of such analgesic provision to the short term treatment of acute / moderate pain which is not relieved by paracetamol, ibuprofen or aspirin alone

• Limiting length of supply of analgesia, before a direct review of the patient, to 3 days

• Strengthening warnings about addiction on label and leaflets.

With this in mind the Medicines Committee, College of Podiatrists, strongly recommends that the supply, sale or use of signed order provision for analgesics of this type be limited to a maximum of 3 days’ supply. The supply may, due to pack size, exceed this but would still recommend review after this period of time.
The Royal Pharmaceutical Society has also issued guidance to their members around the changes in legislation and how these will affect those podiatrists who are able to access the medicines on the exemption list.

The use of Signed Order Provision will further facilitate good practice and secondary checks as highlighted earlier. Following discussion with colleagues in the Royal Pharmaceutical Society the need for clear advice to patients is recognised as paramount. As this is not a prescription, the usual labelling of the medicines is not required, although advice is generally given by all pharmacists when supplying a medicine.

The Signed Order is retained by the pharmacist for audit and record keeping, therefore any advice / guidance written on the order is not available to the patient. It is, therefore, the Medicines Committee’s advice that additional written information is provided as part of the consultation.


Recommendation is also made to liaise with the local pharmacist around the currently available pack size of the medicines being requested. This is important when considering differing dosages as certain strengths of codeine are not available in smaller sizes and, for example, may be better made up from lower strengths with increased doses to meet the desired level of analgesia.


Extract from the Royal Pharmaceutical Society guidance to its members on the subject of legislative changes to the exemptions for chiropodists/podiatrists:
From the 1st July 2011, podiatrists are allowed to sell/supply codeine phosphate and co-codamol to patients under their care, therefore registered pharmacies are able to wholesale these medicines to HPC registered podiatrists. You can also supply these medicines directly to a patient who presents a signed order written by the podiatrist.

In order to minimise the risk of overuse and addiction to these medicines, the RPS strongly recommends pharmacists to wholesale to the podiatrist closest pack sizes commercially available to a maximum of three days treatment. For example, if the podiatrist requests 100 co-codamol tablets and the smallest pack size available at the time of request is 32. The pharmacist should supply 3 packs of 32 tablets.

NB.Only whole packs in original manufacturers container can be supplied, broken packs cannot be supplied. For supplies made directly to the patient from a signed order, the closest pack commercially available for three days treatment should be supplied. Pharmacists can advise the podiatrist on appropriate strength and pack sizes.

This professional recommendation of selling or supplying the closest pack size commercially available to a maximum of three days treatment is in line with advice from the College of Podiatrists, Medicines Committee.

Addendum
As part of the ongoing activities of the Medicines Committee in relation to changes to the exemptions lists and the Department of Health project on independent prescribing for podiatrists, Matthew Fitzpatrick was asked to continue in the role as Medicines Officer for the College of Podiatrists for another year. There were a number of important factors which informed this decision:

1) The need for ongoing support of the Independent Prescribing Project at the Department of Health
2) Representation on the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection
3) Professional body representative on the European Antibiotic Governance Group
4) Continued preparation and support around extending current exemptions to members.

The demands on the College of Podiatrists to continue to support these developments meant that, following a recommendation from The Faculty of Podiatric Medicine and General Practice & the College of Podiatrists Board of College Governors, Council agreed to extend funding for this post for a further specified period.

As a result, although recently elected to Council, Matthew Fitzpatrick was consequently unable to take his place on Council. As a Society officer, he would not be permitted to act simultaneously as a member of Council and an employee of the Society, under the terms of the Articles of Association. Matthew hopes to be able to stand again in future, but believes it necessary to prioritise the important work of the independent prescribing project. The Medicines Committee is grateful to Matthew for his commitment to this work, and to Council for its decision to support the continuance of the role for a further period of time.

 

Re: Obtaining Adrenalin in the UK

Mark , any chance of merging threads on `independent prescribing rights`? This is a REALLY important issue, which the UK podiatric community cannort afford to miss.

Cheers,
Bel

 

Further to the above, Dr Alan Borthwick (Chair of the SCP Medicines Committee) has agreed to speak to pods and their colleagues at an open Branch meeting on Wednesday 9th November at Poole Hospital Post Graduate Centre. The meeting will commence at 7:30pm. Registration will be from 6:30 pm in the dining room at Poole Hospital (See attached flyer).

NB; if we are granted the option to become independent prescribers, members DO NOT NEED to take up this option (which will involve a period of further study) unless they choose to do so. However, it is important that we understand all the issues at stake. Dr Borthwick has stressed that we should invite other members of our health care teams, who may be affected by this issue. Please forward the attached flyer and also speak to your colleagues, inviting them to attend the meeting and/or encourage them to respond to the consultation. The support of other health care professionals could be critical in a positive outcome to this consultation.

As the DH doc states;
The development of independent prescribing by podiatrists is part of a drive to make better use of their skills and to make it easier for patients to get access to the medicines that they need. Independent prescribing can enable new roles and new ways of working to improve quality of services – delivering safe, effective services focussed on the patient experience. It facilitates partnership working across professional and organisational boundaries within commissioning/provider landscapes and with patients to redesign care pathways that are cost-effective and sustainable, e.g. improving the transition from acute to community care. It can enhance choice and competition, maximising the benefits for patients and the taxpayer.

Cheers,
Bel

 

Re: Obtaining Adrenalin in the UK

Hi Nick,
As others have said, it is worthwhile reading through Matthew's post and any other information you can get your hands on regarding what you are able/ endorsed to do to patients before you attempt to do it.
If you really want to be able to prescribe the appropriate drugs for your patients, make sure you read through all the info on the DoH website and put your response into them. This is a pivotal point in the future of podiatry in the UK and the more of us that contribute the greater chance that things will change for the positive. Matthew and his colleagues are to be applauded for their efforts so far, but it for all of us to help theirs and our future by contributing to the consultation. My form has already gone in and I am keen for us all to have full independent prescribing rights, I hope you are too.
All the best,
Bob

 

Re: Obtaining Adrenalin in the UK

Hi All,

As a supplementary prescriber and the prescribing lead for the Institute, serving with our other Institute representative; Judith Barbaro-Brown, on the same D of H committee as Matthew for the Society and Alan for the AHP federation can I just strongly endorse and repeat the points that have been made about confusing 'administration and supply' with 'prescribing'. It is vital to understand that a POM's certificate does NOT permit you to 'prescribe'.

You can administer or supply the medicines listed in the statutory exemption to the medicines act that applies to Podiatrists who have been appropriately trained. That is not prescribing which is very specifically defined in law.

It is very, very, important that we do not give the impression to other people involved in the prescribing project committee, who include; Pharmacists, MHRA members, D of H Civil Servants, Ministerial representatives, D of H lawyers, medical Doctors, H. Ed. reps etc that we DO NOT UNDERSTAND THE LAW AS IT APPLIES TO US AT THE MOMENT.

I make no apologies for shouting this in capital letters, because in the first round of professional consultations in 2010 it was sadly apparent that some of the answers that came back from Pods with POMs certificates showed just that. This was picked up at the highest level in the project (I can say no more than that due to confidentiality issues) and commented on to the substantial embarrassment of certain other senior individuals who had been a strong support to our profession up until that time.

As Bel' and other colleagues have exhorted, please do get involved (and get others involved) in the consultation. But PLEASE, PLEASE, get your facts right.

Rant (with the best of intentions for our profession) over,

Regards, Martin

 

Re: Obtaining Adrenalin in the UK

As a further member of the same DoH project committee and working groups, I can't stress enough the importance of martin et als comments. The closing date for the consultation is Dec 8th but please don't leave it that long before you respond. This chance will NOT come again.
Judith Barbaro-Brown.

 

I make no apology for bumping this thread back on to the homepage...D`you get the impression it`s quite an important opportunity? Good.

Anyway, thanks for the PM and showing your support, Betafeet. This is the thread in question.

Cheers,
Bel

 

Thank you Belinda will circulate to Bucks SCP Pods.

Jude

 

bttt

bumpety bump bump bump!

 

Think I wanna tell the world - probably aint listening.

`Bump`

 

Mentioned again in this months DoH Allied Health Bulletin, for those who havent worked out what all the hype is about yet:

'The Department of Health, in conjunction with the Medicines and Healthcare products Regulatory Agency (MHRA), has launched two public consultations on proposals for independent prescribing: one for physiotherapists and one for podiatrists.
The development of independent prescribing by podiatrists and physiotherapists is part of a drive to make better use of the skills of allied health professionals (AHPs) and to make it easier for patients to access the medicines they need. Independent prescribing can also improve quality of services through the development of new roles and new ways of working to deliver safe, effective services focused on the patient experience.
An engagement exercise took place in autumn 2010 to gather information from a range of stakeholders on the key issues around independent prescribing by podiatrists and physiotherapists.
Professional bodies, royal colleges, individual practitioners and members of the public, who participated in the engagement exercise, welcomed the proposals. The responses confirmed that a public consultation would be an opportunity to clarify some queries, particularly about the content of education programmes and governance frameworks across regulatory, professional and prescribing bodies.
The public, patients and patient representative groups, carers, voluntary organisations, healthcare providers, commissioners, doctors, pharmacists, AHPs, nurses, regulators, non-medical prescribers, the royal colleges and other representative bodies are all encouraged to respond to these consultations, which closes on 8 December 2011.
The Commission on Human Medicines (CHM) will then be asked to consider the proposals together with a summary of comments received during the consultation process. The CHM will then advise ministers of its recommendations.'

Whilst it is important for as many pods to reply as possible, we need far more responses from other areas, patients, drs, friends, family so that they realise this is something that is needed and not just pods trying to get a script pad for the sake of it!

PLEASE SELECT OPTION 1!!

 

I shall be waiting for the decision with great excitement! Who knows maybe something good will come out of it. I shall certainly add my thoughts to the consultation document.

 

I've sent mine in!

Pehaps we should do a poll on the home page asking who has sent in their (positive!) response?

 

Bump de hump doop bodu
Hump de bump doop bop
Bump de hump doop bodu

Bump bump

http://www.youtube.com/watch?v=OM9uMJWtNww

 

Reminder that Dr Alan Borthwick (Chair of the SCP Medicines Committee) is speaking to pods and their colleagues at an open Branch meeting tonight at Poole Hospital Post Graduate Centre. The meeting will commence at 7:30pm. Registration will be from 6:30 pm in the dining room at Poole Hospital (See attached flyer).

 

I can't think of a more important current development in our profession. I've submitted my response and urge all colleagues to do the same

 

The response date has now been extended to 30th December 2011, but please respond a.s.a.p. Don`t not miss the deadline!

Cheers,
Bel

 

Finally got around to filling in the consultation document.

Attempted to fill the document in on the lap top. Gave up after it crashed the system 3 times. Transfered to the "big" computer and after 2 more crashes it failed to send. Saved to my documents and attached it to an email hoping that some kind soul at the DoH would include it in the consultation.

Some kind soul returned the document as 1 of the crucial answers hadn't saved. I noticed several ticked boxes had unticked themselves. Have reattached to email and returned to kind soul at DoH.

How many folks have given up responding at the first crash? Or is it just my computer systems?

GB

 

George....sorry you have had trouble...

I have had some people say the same but it usually the IE operating system.

I am pleased to say we are on 974 responses which is great (not perfect considering we have a UK (Society and Institute) Population of about 12,500 Pods - but hey is more than other consultations have got (may be one of the best the DH has ever done!)

keep the word spreading - tell one, tell all, even the milkman can respond !

thanks

Matt

http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_129981

 

....975...

No word from the DoH today so assume response has been accepted!

GB

 

Hi Guy's,

Is there any news regarding the outcome of the consultation yet?

Paul.

 

Dear all,

not yet - CHM submission has gone to ministers for their review and deliberations.
We await that - but hope to have heard by mid to end July as is then recess...

will keep you all posted

Matt

 

I am resurrecting this old thread in the hope that someone can update me on where independent prescribing for podiatrists is up to in the UK? Has anyone done the course? If so, what is it like? Are you qualified as an independent prescriber? How has it changed your working life?

If I enroll on any of the courses starting in September, will I have independent prescribing rights by next Easter?

Thanks,
Bob

 

Bob. No one will as yet
It goes before parliament in August. With first courses planned for jan 2014

Then all systems go

There was a delay due to parliamentary timetable and this was out of anyone's control

But there is no problem with it. Just due process