Quite Clearcut Prescribing Protocols In UK
The protocols of prescribing drugs in the United Kingdom are very clear-cut and precise. Up until the early 1980's, the health professionals who were given a mandate to prescribe drugs were quite limited. These professionals would have included doctors, dentists and consultants.
Now there is a very a strict two tier system which works on the notion of Independent Prescribers and Supplementary Prescribers.
Independent Prescribers include doctors, who may prescribe whichever drug they deem necessary, although there are certain caveats. Your local doctor or GP may not always be able to prescribe certain medications without first having an initial approval from a consultant. A good example of this would be in my own case, where the combination of drugs I am taking had to be, in effect, "ok'd" by my consultant psychiatrist. Another example might be in the treatment of oncology, or other specialised fields. There are also certain drugs that can only be be prescribed initially by a consultant. Once the medication has been authorised it's tendering is automatically switched to one's own doctor.
Consultants and Professors in medicine may also prescribe (in the role of Independent Prescriber) and they are at the top of the tree in terms of latitude over what they may prescribe. However, consultants always work in a chosen field, so the medicines they sanction for prescribing tend to be niched.
Nurse Independent Prescribers can also prescribe but don't have as wide a remit on the types of drugs that they may prescribe under their own volition. They can prescribe some controlled drugs (unlike doctors or consultants who may prescribe any controlled drug), but certain controlled drugs, such as "serious" opiate medications, such as Morphine, have to be authorised by a doctor, although the Nurse may suggest the use of such a drug.
Pharmacist Independent Prescribers can prescribe any drug they with, so long as it is not a controlled substance. Another term for a Pharmacist Independent Prescriber is your local pharmacist, who can sell over the counter medications and a wide range of drugs that preclude controlled drugs and oral antibiotics, amongst others.
Dentists are also Independent Prescribers, and they have a surprisingly wide remit of what they may prescribe - including controlled drugs, such as opiate painkillers and benzodiazepines. Dentists scripts are often very desirable to thiefs, because they are almost always hand written in the UK, unlike doctor's scripts, and so they are easily forged.
Optometerists are also classed as Independent Prescribers, but they may only prescribe drugs directly related to the eyes, or eye conditions and have no licence to prescribe controlled medication.
Supplementary Prescribers work with a patient after an different prescriber has assessed your health or condition. They work concomitantly with the Indepent Prescriber to engage with and fulfil a health management plan, agreed between you and the prescriber.
Supplementary Prescribers include, but are not limited to -
A supplementary prescriber may prescribe any drug that had been agreed upon between yourself and your Independent Prescriber, which should be part of a pain/illness management plan. The drugs a supplementary prescriber can prescribe may be controlled, if that is what the Independent Prescriber has decided is best for your condition. There is an strong element of supervision from the Independent Prescriber to the Supplementary Prescriber.
An example of how this system works would be if you were to have Obstructive Lung Disease, and your Independent Prescriber (consultant) worked out a management plan that included physiotherapy and medication in the form of inhalers. The task of physiotherapy and the prescribing of the inhalers could then be passed to the Supplementary Carer.
Another example would be an individual suffering terminal cancer, when the Independent Prescriber arranges a home care management plan with nurses (who become the Supplementary Prescriber) who tend to the patient and also prescribe the controlled drugs, such as Diamorphine and Midazolam, necessary to keep a patient comfortable.
So, basically, whilst Supplementary Prescribers may prescribe controlled medications, they have to have been given an authorisation to do so by the Independent Prescriber, which, in most 99 out of 100 cases is a consultant or a doctor.
.....The most magical, Saggy old cloth cat in the whole wide world.