Controlled drugs and independent prescribers

Physiotherapist independent prescribers can currently prescribe from a restricted list of seven controlled drugs (CDs).

The CSP recognises that many members feel the current CD restrictions impact on patient experience, outcomes and service delivery and we have been seeking to extend the list of CDs that physiotherapists can independently prescribe.

The CSP is part of the NHS England Chief Professions Officers’ Medicines Mechanisms (CPOMM) programme. A public consultation sought to add four CDs – codeine, tramadol, gabapentin and pregabalin – to the physiotherapist independent prescriber CD formulary. The outcome of the consultation was strongly supportive of these additions.

The proposed changes to medicines legislation and findings of the public consultation were presented by CPOMM and the CSP to the Commission on Human Medicines (CHM) on 1-2 July 2021.

The CHM recommended accepting the proposal to increase the number of medicines within the physiotherapist independent prescriber controlled drug formulary. This has now been passed to the Department for Health and Social Care for a decision regarding changes to the Human Medicines Regulations.

Changes to the Misuse of Drugs Regulations will also be required, meaning the proposals will also have to go to the Advisory Council on the Misuse of Drugs. The council makes recommendations to ministers within the Home Office regarding changes to the Misuse of Drugs Regulations.

The CSP has had no indication when these latter two stages of the process will occur. However, legislative change can only occur following decisions from both the Department of Health and Social Care and the Home Office; it is a long legal process with several stages which the CSP can input to but cannot control. We understand and share members’ frustration with the length of time this process is taking but rest assured we are continuing to work as part of the CPOMM project to ensure completion of this work.