The developing role of the paramedic prescriber

Following several years of project work by the College of Paramedics, in 2018 the law was changed to allow paramedics to train and practice as non-medical prescribers for the first time (gov.uk, 2018). This represents a large step forward for the profession, and will likely only serve to help paramedics cross traditional boundaries, making an already attractive and sought-after professional group even more valuable. With paramedics already working in a diverse range of settings, far beyond the traditional ambulance work they are best known for, the addition of non-medical prescribing (NMP) as a skill can only help to increase the career options for paramedics, in a time where healthcare services are an under unprecedented demand to help patients access medication in a more timely manner.

In order to provide some additional contextualisation, I will describe my own clinical practice and how prescribing fits this. I studied full time for an FdSc in Paramedic Science, followed by part time completion of a BSc (hons) in Emergency Care and then an MSc in Advanced Practice. This led me from ambulance practice to my current job where I work primarily in primary care, providing with a nurse practitioner colleague, around half of the same day appointments available at the practice, along with home visits and telephone triage as required. This role is one I developed into having spent time training in primary care as part of the progression into a specialist paramedic role within the ambulance service. When I moved into primary care full time, I found I was very much limited by not being able to prescribe medication, I was encouraged and empowered by the doctors to decide what was needed, using local formularies to guide me, but would always need to get someone else to produce the prescription, which was time consuming and frustrating at times. Upon completion of the course and annotation as a prescriber I could then take responsibility for most of my prescribing, making my consultations slicker and faster (Dixon, 2019), being able to provide, in most cases, a complete episode of care without senior input (although this always remains available should I need it). While being unable to prescribe controlled drugs (CDs) myself does present a limitation I have found that at least in my practice I can largely avoid prescribing CDs, and where they are needed it is infrequent enough that getting a prescription from an appropriate prescriber isn’t a significant issue. The ability for a paramedic in my position to prescribe allows me to work largely autonomously, this takes pressure away from the doctors and allows them to focus on the work that better utilises a GPs expertise, while my colleague and I deal with the generally less complex acute issues. This is very much in keeping with national objectives to support multi-professionalism within primary care (Primary Care Workforce Commission, 2015).