Prescribing in Physiotherapy for Pain

Prescribing in Physiotherapy for Pain: A Current and Emerging Role

Aim

With changing demographics, higher expectations and an increase in long term conditions (Department of Health, 2012) there is an heightened pressure and demand on the NHS. To meet these demands the roles within the NHS have had to change and expand.

As recently as 2013, physiotherapists in England have been granted the right to independently prescribe, giving them the ability to prescribe drugs, including some controlled drugs. These prescriptions must be used “within the overarching framework of human movement, performance and function” (NHS England Publications, 2013)

With these new responsibilities that are becoming a part of a physiotherapist’s remit, this page looks to explore prescribing as a physiotherapist. It also looks to provide information around their scope and responsibilities for prescribing for pain that impacts specialist musculoskeletal physiotherapist’s areas of expertise.

Audience: The resource was produced for use by Band 5 physiotherapists to understand the role the profession plays in prescribing medicines. It may be of benefit to other health professionals seeking knowledge. A case study and questions will be included, which can be used to check understanding after each section''

Abbreviations

Learning Outcomes

LO1. – The learner will able to complete the case study questions to demonstrate an understanding of prescribing within physiotherapy.

LO2. – the learner will be able to distinguish the scope of practice for non-prescribers, supplementary prescribers and independent prescribers within physiotherapy.

LO3. - The learner will be able to comprehend the process of how to become an independent and supplementary prescriber.

LO4. – The learner will be able to describe the effects & side effects of common groups of pain medication, and the role they have to play in patient centred care. Also, they should be able to provide general advice at a band 5 level for pain.

LO5. - The learner will be able to evaluate the effect of prescribing on the current and future role of physiotherapists.

Key Definitions

• Pain - The ISAP define pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” http://www.iasp-pain.org/Taxonomy#Pain
• Extended Scope Practitioner - A clinician who applies and expands their expert knowledge and skills to areas of healthcare traditionally performed by another healthcare profession, which is currently seen as outside the scope of practice of the majority of their profession (Crane and Delany 2013).
• Drug Classes - A drug is put into a class based on the penalty it would have if there was any offence involving the drug. 
• Non-prescribers - Physiotherapists without further training within the prescribing field, newly qualified Band 5’s fit within this areas.
• Supplementary prescriber- Those who have had some further training and have an agreed working relationship with a doctor or a dentist to implement treatment plans, any prescriptions that are written by this group must be signed off by the medical practitioner.
• Independent prescribers - Without consultation are able to either from their own diagnosis or a previous diagnosis prescribe treatment including prescribing and are fully responsible and accountable for the treatment. This should be done within the physiotherapists area of expertise.
• Non-Medical Prescriber - Any healthcare professional other than doctors or dentists who can independently prescribe medicine to a patient this includes physiotherapists nurses, podiatrists, pharmacists, chiropodists and optometrists.