AHP Prescribing Rights

Your Prescribing rights are linked to your scope of practice

To be a prescriber means to have the legal authority to issue prescriptions. In practice, prescribing is a complex clinical skill. Only some of our registered professions can train to become prescribers.

Eligible professionals can study the V300 course Independent and Supplementary Prescribing. This should be within the professional's scope of practice. This means they may focus their study in their traditional role, or within aesthetics, provided that suitable training in aesthetics has been obtained. Some universities will require students to have completed a Level 7 qualification in aesthetics prior to starting the V300 course.

HCPC Medicines and Prescribing rights

Independent Prescribers

Paramedics
Physiotherapists
Podiatrists
Therapeutic Radiographers

Supplementary Prescribers

Paramedics
Physiotherapists
Podiatrists
Therapeutic Radiographers
Diagnostic Radiographers
Dietitians

Prescribing unlicensed medicines

HCPC Registrants who are independent prescribers cannot prescribe unlicensed medicines. Only doctors, dentists, nurses and pharmacists are able to independently prescribe unlicensed medicines.

Registrants who are supplementary prescribers can prescribe unlicensed medicines, but only in accordance with the patient's clinical management plan.

HCPC Registrants who are supplementary and independent prescribers, are permitted to prescribe off-licence.

For more information, please contact the MHRA – the UK medicines regulator.

Let's establish a common confusion between off-licence, off- label and un-licensed medicines.

Off-label/ Off-license

"Off-label" and "off-licence" are often used interchangeably, and refer to using a medicine in a way not specified by its product license. For example in aesthetics Hyaluronidase is used Off-license/off-label to aid in the dissolution of hyaluronic acid filler.

Licensed use: Hyaluronidase is licensed in the BNF for increasing the absorption and dispersion of other injected drugs (like local anaesthetics), aiding subcutaneous fluid administration, and promoting the reabsorption of excess fluids or blood in tissues.

HCPC independent and supplementary prescribers are permitted to prescribe off-licence, and therefore are permitted to prescribe hyaluronidase for the dissolution of hyalauronic acid.

The key distinction is that "off-license" applies when a medicine, that is licensed for some uses but not the intended one, while a truly "unlicensed" medicine has no UK product license at all.

The British National Formulary states that HCPC registered professionals are able to prescribe off-license/ off-label. Here is an example from their website:

"Paramedic Independent Prescribers can prescribe any medicine for any medical condition. This includes “off-label” medicines subject to accepted clinical good practice. Prescribing of Controlled Drugs is subject to legislative changes."

Unlicensed medicines:

HCPC registrants cannot prescribe unlicensed medicines. An example would be TORBAC or Bacteriostatic saline.
TORBAC has no UK license for use. This means that whilst nurses and doctors can prescribe this as a diluent for botulinum toxin, HCPC registrants are not permitted to do so.

HCPC independent prescribers are not permitted to prescribe unlicensed medicines, therefore are not permitted to prescribe TORBAC or bacteriostatic saline. Supplementary prescribers are permitted to prescribe unlicensed medicines, but these must be included on the Clinical Management Plan (CMP) for the individual patient.

The AHPA would advise independent prescribing AHPs to use either:

normal 9% sodium chloride (saline)
A pre-mixed botulinum toxin, for example Alluzience or Relfydess by Galderma