23 October 2019

The Department of Health is looking at the benefits and risks of extending the prescribing rights for professions like speech and language therapy.

The legal options for prescribing, supplying and/or administrating medicines are; patient-specific directions (PSDs), patient group directions (PGDs), supplementary prescribing and independent prescribing. This is not restricted to medicines or topical applications, for example, reflux medications or topical anaesthesia.

However, it includes prescribed medical devices, such as the TheraBite, where the extension of SLT prescribing rights would produce efficiencies and benefits for patients.

Supply & Administration of medicines

Patient Group Directions (PGD)

This is a written instruction for the supply or administration of a licensed medicine (or medicines) in an identified clinical situation, where the patient may not be individually identified before presenting for treatment. This should not be interpreted as indicating that the patient must not be identified; patients may or may not be identified, depending on the circumstances.

More information can be found on PGDs on the NHS England website.

A Patient-Specific Direction (PSD)

This is the traditional written instruction from a doctor, dentist, nurse or pharmacist independent prescriber for medicines to be supplied or administered to a named patient. The majority of medicines are still supplied or administered using this process. Examples in secondary care include instructions on a patient’s ward drug chart. As a Patient Specific Direction is individually tailored to the needs of a single patient, it should be used in preference to a Patient Group Direction (PGD) wherever appropriate.

The future

In March 2017, the RCSLT were involved in an NHS England scoping exercise along with other professional bodies, to establish which mechanism (if any) is most suited to the needs of our profession, and NHS England recently updated us on the outcome.

The work to take forward the use of independent prescribing by the Speech and Language Therapists is not part of the current programme of work. Instead, it is identified as part of Phase B.

There is no commitment to Phase B and any proposals would have to go through NHS England business planning process, to secure resources for any future work. However, the process for approval is lengthy so even if approved it is likely to be a few years before this is practically possible.

In the meantime, Patient Group Directives (PGDs) are an alternate route that can be set up locally and can be a solution for specific medications.