Time to change gear?

An update and overview on the current situation of physiotherapists independently prescribing controlled drugs 

Time to change gear? Medicines and prescribing

Medicines and prescribing

The introduction of UK-wide physiotherapy independent prescribing (IP) in 2013 has transformed the profession. However, we understand the frustration of our members with the current controlled drug (CD) formulary, particularly in light of recent advances for paramedics and therapeutic radiographers in December 2023.

In 2021 the Commission for Human Medicines (CHM) recommended adding a further four medicines to physiotherapists’ independent prescriber CD formulary. We have been waiting for progress at government level since then.

What is the CSP doing? 

The CSP is in regular communication with NHS England’s chief allied health professions officer’s (CAHPO) office and understand that currently there are no plans between the Department of Health and Social Care and the Home Office to further develop the UK-wide physiotherapists’ CD formulary.

This means that the CSP is now re-evaluating how it approaches progressing this issue. As medicines legislation is not devolved, we will continue to work with the NHSE CAHPO office to ensure we have understood the current position and, if correct, understand its reasons for pausing work on this issue.

We are considering a parliamentary question directly to a minister for Health and Social Care regarding the timetable for implementing CHM recommendations.  We continue to directly inform and influence other non-AHP regulators and professional bodies when we are aware they are working on prescribing issues, to ensure that prescribing by physiotherapists is not overlooked as part of wider developments in advanced practice and workforce policy.

We are using and building links with CSP professional networks to understand how prescribing in specific specialities can be maximised, together with encouraging more physiotherapists to become prescribers. We have regular conversations with members who need support with local prescribing issues and system challenges, and this allows us to give real time feedback to key national stakeholders. 

Left behind? 

It is correct to say that doctors, nurses and pharmacists have the widest prescribing rights of all regulated healthcare professions. However, within the AHP groups, physiotherapists still have the widest prescribing formulary available. 

We know that members complete higher educational institutions prescribing programmes that are approved by a number of regulators to enable multi-professional learning within the same programme content. However, the law still restricts what any individual professional group can prescribe, and we understand how frustrating this is. 

Individual action  

What can you do to help the prescribing agenda? Members of parliament act on constituents’ concerns, so contacting your local MP to support the legislative change required is one thing. 

Write to your MP or visit their clinic to raise your concerns. The more members that do this alongside our own work, the more pressure is put on the government. Similarly, the more members who can provide data to demonstrate both the impact of, and barriers with, physiotherapist IP, the more we can shine a spotlight on the change needed to fully optimise the benefits of physiotherapist prescribing within the workforce. 

The CSP is developing its new plan to address ongoing issues, in line with our corporate strategy, so look out for more updates throughout the year. 

Professional advice team

The CSP’s Professional Advice Service gives advice and support to members on complex and specialist enquiries about physiotherapy practice, including professional practice issues, standards, values and behaviours, international working, service design and commissioning, and policy in practice.

Pip White and Rachael Wadlow are professional advisers who lead the CSP’s work on medicines and prescribing


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