Non-medical prescribing

Non-medical prescribing (NMP) refers to any prescribing provided by healthcare professionals other than doctors or dentists. A range of professionals can qualify to be a non-medical prescriber (NMP) although there may be restrictions on what they can prescribe and the terms under which a prescription can be provided.

The following professional groups can become NMPs

Nurses / Midwives
Pharmacists
Physiotherapists
Podiatrists
Paramedics
Optometrists
Therapeutic radiographers
Diagnostic radiographers
Dietitians

Supplementary prescribing
Supplementary prescribing is defined as “A voluntary partnership between a doctor or dentist and supplementary prescriber, to prescribe within an agreed patient-specific clinical management plan (CMP) with the patient's agreement”. Currently, nurses, midwives, optometrists, pharmacists, physiotherapists, podiatrists, radiographers, paramedics, and dietitians may become supplementary prescribers. Once qualified, they may prescribe any medicine (including Schedule 2-5 controlled drugs but excluding diamorphine, cocaine and dipipanone for treatment of substance misuse) within their clinical competence and according to the CMP.

Supplementary prescribing

Supplementary prescribing is defined as “A voluntary partnership between a doctor or dentist and supplementary prescriber, to prescribe within an agreed patient-specific clinical management plan (CMP) with the patient's agreement”. Currently, nurses, midwives, optometrists, pharmacists, physiotherapists, podiatrists, radiographers, paramedics, and dietitians may become supplementary prescribers. Once qualified, they may prescribe any medicine (including Schedule 2-5 controlled drugs but excluding diamorphine, cocaine and dipipanone for treatment of substance misuse) within their clinical competence and according to the CMP.

Independent prescribing
A prescribing healthcare professional who is responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing*. Medical doctors can prescribe any controlled drug to be administered via any route. Dentists can only prescribe controlled drugs included in the Dental Prescribing Formulary on an FP10D (England), GP14 (Scotland) or WP10D (Wales) Nurse and pharmacist independent prescribers (IPs) can prescribe and administer any controlled drug from Schedule 2-5, excluding cocaine, dipipanone and diamorphine for treatment of substance misuse. Physiotherapist IPs can prescribe only diazepam, dihydrocodeine, lorazepam, morphine, oxycodone and temazepam for oral administration. They can also prescribe morphine for injectable administration and fentanyl for transdermal administration. Chiropodists and podiatrist IPs are able to prescribe diazepam, dihydrocodeine, lorazepam and temazepam for oral administration only. Paramedic IPs are able to prescribe morphine sulphate, diazepam, midazolam by oral and by injection, lorazepam by injection only and codeine phosphate oral administration. Therapeutic radiographer IPs are able to prescribe tramadol, lorazepam, diazepam, oxycodone and codeine by oral and morphine by oral or by injection. Optometrist and Community Nurse IPs are not allowed to prescribe any controlled drugs.

Independent prescribing

A prescribing healthcare professional who is responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing*.
Medical doctors can prescribe any controlled drug to be administered via any route.
Dentists can only prescribe controlled drugs included in the Dental Prescribing Formulary on an FP10D (England), GP14 (Scotland) or WP10D (Wales)
Nurse and pharmacist independent prescribers (IPs) can prescribe and administer any controlled drug from Schedule 2-5, excluding cocaine, dipipanone and diamorphine for treatment of substance misuse.
Physiotherapist IPs can prescribe only diazepam, dihydrocodeine, lorazepam, morphine, oxycodone and temazepam for oral administration. They can also prescribe morphine for injectable administration and fentanyl for transdermal administration.
Chiropodists and podiatrist IPs are able to prescribe diazepam, dihydrocodeine, lorazepam and temazepam for oral administration only.
Paramedic IPs are able to prescribe morphine sulphate, diazepam, midazolam by oral and by injection, lorazepam by injection only and codeine phosphate oral administration.
Therapeutic radiographer IPs are able to prescribe tramadol, lorazepam, diazepam, oxycodone and codeine by oral and morphine by oral or by injection.
Optometrist and Community Nurse IPs are not allowed to prescribe any controlled drugs.

*Royal Pharmaceutical Society. A Competency Framework for all Prescribers. Effective: September 2022. https://www.rpharms.com/resources/frameworks/prescribing-competency-framework/competency-framework (Accessed: October 2023)

Other resources in this section

Best Professional Practice

Opioids Aware homepage

Non-medical prescribing

Further Reading

Other resources in this section