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To prescribe or not to prescribe – the question for occupational therapy

Karin Orman, Professional Practice Manager at the College of Occupational Therapists, discusses the question of whether occupational therapists should now be considered for Supplementary Prescribing, Independent Prescribing or Medicines Act Exemption. Follow Karin

Please have your full say in our survey https://www.surveymonkey.co.uk/r/OT-Prescribing closes 22nd February 2016.

NHS England has embarked on a scoping project to invite AHP professional bodies to consider whether their profession should be put forward to potentially increase their prescribing medicine responsibilities. Currently occupational therapists can, with appropriate training, administer medication under a Patient Specific Direction (PSD) or Patient Group Direction (PGD). A PSD is a written instruction from a prescriber for medicines to be supplied or administered to a specific person. A PGD is a written instruction for the supply or administration of a licensed medicine in an identified clinical situation. It is drawn up locally by doctors and pharmacists and must be approved by the organisation in which it is to be used. Individual practitioners must be authorised to practice under each PGD when assessed as competent to do so.

The question is whether occupational therapists should now be considered for Supplementary Prescribing, Independent Prescribing or Medicines Act Exemption. Supplementary Prescribing would allow occupational therapists to enter a prescribing partnership with an independent prescriber, and the patient to implement an agreed patient specific clinical management plan. As the Supplementary Prescriber, the occupational therapist prescribes any medicine agreed in the plan. Independent prescribing would allow occupational therapists to assess patients and agree a clinical management plan that would include prescribing. Medicines Act Exemption would give the profession specific exemptions in medicine legislation to supply and administer medicines that are essential to clinical practice, such as pain relief.

The argument for extending our prescribing mechanisms has to be clearly focused on the benefits to the person. Would the ability to prescribe enhance the person’s experience of care, improve timeliness of interventions and minimise distress? Patient safety comes first and any evidence has to illustrate how a wider range of prescribing mechanisms will keep a person safe and minimise risk of distress, pain and discomfort.

The College has already done some scoping with members and identified 4 areas of potential benefit:

  1. Administering medication to carry out assessments and interventions in a timely and safe way. This would be applicable in a rapid response service or clinics, such as hand therapy.
  2. Adjusting and administering medication when the occupational therapist is the most knowledgeable in the team in regards to the person, their history and symptoms, for example: in a service for people with long term conditions.
  3. The team has a single point of access and the occupational therapist needs to administer medication to provide timely intervention and to reduce multiple staff involvement.
  4. Occupational therapists working in a coordinator/ generic role, for example: in a community mental health service.

We have to be clear that this is not about professional recognition and standing – keeping up with other professions that have already extended their prescribing abilities. The focus has to be on the enhancing patient care and meeting patient need. The College is very keen to hear members’ views and to collect evidence of need. Please send any evidence to Ashleigh.Watkins@cot.co.uk stating where you are currently working and how increased prescribing responsibilities would be beneficial.

If you would like to find out more about prescribing there is a briefing on Medicines Management and Administration Duties available to BAOT members. Visit https://www.cot.co.uk/docs/briefings/professional-practice

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