Advice line - a pointed reminder

Pip White looks at the importance of understanding injection therapy.

Injection therapy is part of physiotherapy practice, provided it is used for therapeutic, but not cosmetic, purposes.

Since April 2011 the CSP has set the educational expectations for injection therapy courses.

You must be able to prove that you have undertaken training that meets these standards even if you trained before 2011. Injection therapy should be listed in your job description.  

Injection therapy requires the use of prescription only medicines (POMs).

The Human Medicines Regulations 2012 state that these can only be used in accordance with a written, or electronic, prescription from an appropriate practitioner or in accordance with a written patient group direction (PGD).

You must not accept verbal instructions to use POMs in routine settings such as injection therapy clinics.

A prescription for an individual patient, known as a patient specific direction (PSD), must include the name and address of the patient and cannot be drawn up in advance.

A PGD is a document that can be drawn up in advance and specifies the groups of patients for which certain medicines may be used without the need for an individual patient prescription.

If you want to use a patient group direction, you must be registered with the Health and Care Professions Council (HCPC) and individually named on the patient group direction document.

Sometimes it may be necessary to mix medicines.

You can only do this under a PSD or if you are a supplementary prescriber, and, in due course, an independent prescriber.

The law does not permit medicines to be mixed if you are using a PGD.

There are no generic policies that can be locally created that would allow you to mix under a PGD.

If you work for an NHS employer, you cannot take medicines from your hospital and use them to treat private patients.

This may be theft from NHS services and fraud, and could result in dismissal and referral to the HCPC.

If you work in both the NHS and private practice remember the polices of the NHS do not always transfer into private practice governance requirements.

Injection therapy performed by physiotherapists in private practice does not require Care Quality Commission registration.

Pip White is a CSP professional advice with specialist knowledge in medicines law

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Pip White

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