Prescribing for physiotherapists

There are two types of prescribing for physiotherapists:

1. Supplementary prescribing is the use of a written clinical management plan (CMP) to prescribe agreed medicines in partnership with a doctor. The CMP can include any licensed or unlicensed medicines and all controlled drugs.
2. Independent prescribing is the use of your own clinical reasoning and professional judgment to determine the nature and extent of any medicines to be used in the management of diagnosed and undiagnosed conditions. Independent prescribers may prescribe any licensed medicine from the British National Formulary, within national and local guidelines, for any condition within their area of competence within the overarching framework of human movement, performance and function. Independent prescribers may also mix medicines prior to administration and prescribe from a restricted list of seven controlled drugs.

Key facts on prescribing by physiotherapists

• Supplementary and independent prescribing by physiotherapists is legal in all parts of the UK.
• Prescribing by UK physiotherapists is not allowed overseas.
• Physiotherapists cannot prescribe medicines for purely cosmetic purposes.
• Prescribing courses for physiotherapists are validated and approved by the HCPC.
• The HCPC sets separate prescribing standards for those annotated as prescribers.
• Courses validated for independent prescribing will automatically provide you with a supplementary prescribing qualification as well.
• You must not prescribe until your prescribing qualifications are added to your HCPC registration.

Further information

• The Health and Care Professions Council sets the proficiency standards for prescribing and lists all the approved prescribing courses available to physiotherapists in the UK.
• The Allied Health Professions Federation hosts the curriculum framework for non-medical prescribing educational programmes.
• The Royal Pharmaceutical Society publishes the competency framework for all prescribers. We have contributed to the creation of this framework and endorse its publication. We expect all our prescribers to follow it.
• The Medicines and Healthcare Products Regulatory Agency is the UK-wide statutory regulator for medicines and advises on all aspects of compliance with UK medicines law.

Controlled drug prescribing

Updated 14th Dec 2023:  In July 2021, the Commission on Human Medicines (CHM) recommended adding codeine, tramadol, gabapentin and pregabalin to the physiotherapist independent prescriber controlled drug formulary. You can read the minutes of the CHM meeting. We have no indication of when any ministerial decision will be forthcoming. The  Advisory Council on the Misuse of Drugs (ACMD), which makes recommendations to ministers within the Home Office regarding changes to the Misuse of Drugs Regulations (MODRs) must also approve any changes. We have no indication when this might occur.

The recent Misuse of Drugs Regulations (England, Wales & Scotland) (Amendment) (No2) Regulations 2023 affect paramedic and therapeutic radiographer prescribing rights only and do not amend the existing list of controlled drugs that may be prescribed by physiotherapist independent prescribers, and the physiotherapist list currently remains at seven controlled drugs as set out in existing Regulations. 

Other changes to MODRs[1],[2],[3] mean that Nitrous Oxide has now been made a Schedule 5 controlled drug throughout the UK.  However, updates to MODRs mean that physiotherapists  can continue to lawfully supply, possess and administer nitrous oxide for medical purposes including medical care and treatment, subject to the wider requirements of MODRs.