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2 Comments 26th July 2010

Currently podiatrists with suitable annotation with the health professions council have access to list of precription only medicines (POM) for sale, supply and adminsitartion to patients. While this list is useful in allowing seemelss patient care, this list has not been updated since 2006, and the list has not kept apace with change in drug licencing which means that patients may often purchase from a pharmacy certain medicines in a lrager quantity than can be supplied by a podiatrist. This is leading to a disjoined care pathway and can be dangerous.

For example a podiatrist can supply ibuprofen at a dose of 400mg Three times a day to a maximum of 3 days supply, however a phamracist may reatil a quantity up to 96 tablets!


Looking at the MHRA website, midwives and optmetrists may supply ANY P medicines to patients in the course of their professional practice but podiatrist have a limited list of P mediciens, does the Deprtment of Helath think a podiatrist is any less qualifies or responsible than an optometrist?


All groups may supply any GSL medicines but as these are available from outlets such as garages this is a mute point.


In addition the list of POM is restrictive while it allows the issuing of analagesia in the form of co-dydramol up to 3 days supply, this causes problems if analagesia is required over a longer period e.g. a bank holiday weekend, in additoon to the fact that phamracist do not like having to pack down from the smallest pack size of 30 tablets.


The range of drugs is now too limited to allow safe and effective practice. Theior is only one topical steriod on the list at very low strength, the range of antibitoics wihiel useful for a sabustantial majority of infection does cause problems when a swab result from the lab. states a resistant organism requiring another antibiotic e.g. co-amoxiclav.


Theire is only one injectable corticosteriod on the list while being effective is relatively short in duration and the steriod of choice in orthopadecis and by GP collegaues is triamcinolone (kenalog)


The list could go and on!


In addition currently podiatrist have to obatin these items wholesale and supply the drug directly to the patient. optomrtrists also perform this function, however optomterist also have an additional benefit they may issue a 'signed order' to a patient allowing the patient to take this to the phamracy and have the item dispensed by the pharmacist irectly to them, this means that if an optmetrist is out of stock of the drug or it is for an expensive item or short dated itme, the patient is not overly inconveneienced they simply take the signed order to the phamracy and have it dispensed in the same way as private prescription, when I enquired to the MHRA why podiatrists cannot do the same, I was informed podiatrist have never asked fro this valuable serice and contact the minister!


I am aware that there is a scope exercise to allow podiatrists and physiotherpaist full independent presctibing rights which is long over due, however it is likley to take several years before this becomes a reality given the process involved, as an interim measure the government should ask the MHRA to consult on an extension to the exepmtion list for podiatrists and add in the provision of issuing signed orders directly to patients, in order to ensure a safe, effective and seamless patient hourny. If the profession is being considered for prescribing rights then surely there can e no objection to an extension of the exepmtion list which can be achieved by secondary legislation in a matter of months following consultation?


I have already met with my MP and she is lobbying the DOH minister on this very issue, I would urge other podiatrists with POM annotation to do the same forwith, as I am informed the more lobbying by MPs that occurs the more likely to minister will take this forward

Why does this matter?

This will improve patient journey, patient safety, patient satisfaction, reduce costs to the health economy, recuce pressure on valubale appointments with medical colleagues.

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  1. c thorp says:

    you need to check this article for typing errors – it contains many and this gives an unprofessional impression.

  2. J Levin says:

    Extremely poor article. Comparing pharmacists to podiatrists is like comparing apples to pears. Pharmacists know the contraindications and interactions of a medicine far better than any other profession and certainly better than a podiatrist would. Pharmacists are not experts on feet so would always feel more than comfortable referring to a podiatrist – why does the reverse sit so poorly with you? Nobody knows everything and it is only the extremely arrogant or insecure (or both) that think otherwise… I’d also run a spellcheck next time I wrote an article

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