Understanding the Role of Prescription-Only Medicines in Podiatry

In the field of podiatry, the ability to manage and treat various foot-related conditions often necessitates the use of medicines that are regulated under specific guidelines. For HCPC (Health and Care Professions Council) registered podiatrists, understanding the legal framework around the supply, sale, and administration of these medicines is crucial to ensuring safe and effective patient care.

All HCPC-registered podiatrists are permitted to sell or supply General Sales List (GSL) and Pharmacy (P) licensed products to their patients, provided they stay within their professional scope of practice. However, only those podiatrists who hold the specific annotations of POM-S (Prescription Only Medicines – Sale/Supply) and POM-A (Prescription Only Medicines – Administration) have additional privileges. These annotations grant them an exemption under the Human Medicines Regulations 2012, allowing them to sell, supply, and administer certain prescription-only medicines (POMs) within the limits of their practice. This legal provision supports the supply of critical medications such as anaesthetics, antibiotics, and injectable steroids, which are essential for certain podiatric procedures.

Podiatrists can legally supply and administer medicines to patients through various routes, each with its specific legal and professional requirements:

·         POM-A (Prescription Only Medicines – Administration): Podiatrists with this annotation can administer certain prescription-only medicines, including specific anaesthetics and adrenaline, as part of their professional practice. This enables them to perform procedures that require these medications, ensuring patient safety and comfort.

·         Patient Specific Direction (PSD): A PSD involves written instruction from an independent prescriber, which could be an independent prescribing podiatrist. The prescriber assesses the patient and then authorises the supply or administration of a specific medicine. This method is commonly used in settings like immunisation clinics for flu or COVID-19 vaccinations.

·         Patient Group Direction (PGD): PGDs are often used within NHS podiatry practices and allow the supply of medicines to groups of patients with specific conditions. A PGD is a signed agreement between a doctor, a pharmacist, and an authorising authority, and it typically covers anaesthetics and antibiotics. This approach allows podiatrists, even those without the POM-S annotation, to supply these medicines under the agreed-upon protocol.

·         POM-S (Prescription Only Medicines – Sale/Supply): Podiatrists with the POM-S annotation can supply and sell a predefined list of prescription-only medicines through different avenues, such as writing a signed order for a pharmacist to supply medicines directly to a patient, or by purchasing these medicines for sale or supply directly from their practice.

Podiatrists who supply or sell medicines must adhere to stringent standards to ensure patient safety and legal compliance:

·         Expertise and Knowledge: Podiatrists must demonstrate a thorough understanding of the medicines they intend to supply, including their therapeutic effects, correct dosage, potential side effects, and contraindications.

·         Patient Communication: It is essential that podiatrists effectively communicate with their patients, explaining any side effects or potential adverse reactions, and providing the appropriate patient information leaflet.

·         Qualification and Continuous Professional Development (CPD): Podiatrists must hold the POM-S annotation on the HCPC register and regularly update their knowledge and skills as part of their CPD requirements.

·         Medicine Handling and Record Keeping: Medicines must be pre-packed, stored securely in a locked metal drugs cabinet, and records must be meticulously maintained. These records should include details such as the source of the medicine, patient information, product details, and any adverse reactions observed. These records must be kept for at least five years and be available for inspection by licensing authorities.

The ability to supply and administer prescription-only medicines significantly enhances the scope of practice for podiatrists, allowing them to provide comprehensive care. However, this privilege comes with considerable responsibility. Podiatrists must remain diligent in maintaining their qualifications, adhering to legal requirements, and ensuring that they operate within the bounds of their professional scope. This commitment to excellence not only protects the patient but also upholds the integrity of the profession.