Department of Health and Social Care
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Nurses, midwives and pharmacists now able to provide faster and more effective pain relief

Changes to Misuse of Drugs Regulations mean that appropriately qualified nurses and pharmacists will now be able to prescribe controlled drugs like morphine, diamorphine and prescription-strength co-codamol, the Government announced today. This means that:

  • Up to 20,000 nurses and midwives, and 1,500 pharmacists who are qualified as ‘independent prescribers’ will now be able to prescribe controlled drugs where it is clinically appropriate and within their professional competence. This makes the best use of their skills and helps patients get faster and more effective care.
  • Nurses and pharmacists will also now be able to mix a controlled drug with another medicine for patients who need drugs intravenously. This will ensure faster treatment, especially for those who need urgent pain relief in A&E and palliative care settings.
  • They will also now be able to supply or administer morphine and diamorphine under Patient Group Directions, for urgent treatment of very sick or critically injured groups of patients.

Most prescriptions for controlled drugs will be to reduce pain and suffering of emergency patients in A&E, or those nearing the end of their life. These patients will now no longer have to wait for a doctor to sign a prescription, which means they will be able to receive urgent pain relief more quickly. Nurses and pharmacists will also now be able to prescribe controlled drugs in community pain clinics for patients with long-term conditions such as arthritis.

Chief Nursing Officer, Professor Dame Chris Beasley, said:

“These changes will help deliver faster and more effective care, making it easier for patients to get the medicines they need, without compromising safety.

“Enabling appropriately qualified nurses and pharmacists to prescribe and mix those controlled drugs they are competent to use, for example in palliative care, completes the changes made over recent years to ensure we make the best use of these highly trained professionals’ skills, for the benefit of patients.”

Only nurses, pharmacists and midwives who have the right experience and who have successfully completed additional post-registration training will be able to prescribe controlled drugs. This means that prescribing will only be carried out by appropriately trained health professionals working within their professional competence. These changes do not change the tighter controls that were introduced following the Shipman Inquiry, which protect patients from the misuse of controlled drugs.

Chief Pharmaceutical Officer Dr Keith Ridge, said:

“Patients are increasingly being treated by a broader range of health professionals. Whilst it remains important that all healthcare professionals work as a team to support patients, pharmacists, like nurses and midwives are increasingly taking on new roles to deliver more flexible, improved care, and better outcomes.

“These changes support our aim of making the best possible use of pharmacists’ knowledge and capability to deliver faster, more personalised and optimised patient care.”

Notes to editors

  • Nurses and pharmacists will now be able to prescribe controlled drugs in schedules 2-5. Schedule 1 drugs have no recognised medicinal use and include things like cannabis, coca leaf and lysergic acid diethylamide (LSD).
  • A Patient Group Direction is a legal mechanism that allows named registered healthcare professionals to supply and/or administer medicines to groups of patients that fit certain criteria. These are most often used in emergency situations, for example to provide urgent pain relief to large groups of patients after a major incident.
  • The changes relating to prescribing and mixing of controlled drugs by nurse and pharmacist independent prescribers also apply to midwives who are registered as nurse independent prescribers.
  • These changes are supported by The Commission on Human Medicines (CHM), an independent advisory body on medicines and the Home Office’s Advisory Council on the Misuse of Drugs (ACMD).