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Senior NHS paramedics could soon be able to prescribe drugs

Hundreds of the UK National Health Service’s (NHS’s) most senior paramedics will soon be able to give drugs to sick patients thanks to a change in the law that NHS chiefs hope will take the pressure off overcrowded hospitals.

The Guardian reports that 700 advanced paramedics across the UK will gain the right to prescribe medication when an amendment to the human medicines regulations (2012) comes into effect. The move is expected to lead to a reduction both in the number of people being taken to A&E by ambulance and also those being admitted to hospital.

The report says people with asthma would be able to receive doses of steroids to improve their breathing more quickly at home than if they had to be taken to hospital. Similarly, advanced paramedics would be able to give painkillers on the spot to those suffering chronic back pain and antibiotics to older people who have a urinary tract infection.

It will mean that the NHS’s most experienced paramedics will be able to carry out some of the functions usually performed by doctors, once they have been trained how to prescribe. Those who complete their training will become “independent prescribers” and be allowed to give patients drugs in the same way that doctors, dentists, pharmacists and some senior nurses and therapeutic radiographers already can.

“This is good news for patients. It will make it easier for them to receive treatment at home, eliminate the need to see a second professional in many cases, and reduce the need for transportation into hospital that isn’t clinically necessary. Rather, they will be able to start treatment without delay, which for some will be critical,” said Rachel Power, the CEO of the Patients Association.

The report says the change is part of NHS England’s transformation of how care is delivered, with more patients being treated in or near their homes in an effort to reduce unnecessary stays in hospital, as part of the NHS Five Year Forward View blueprint to help the service cope with growing demand.

“Increasing the range of treatments offered by paramedics closer to people’s homes is another significant step in transforming emergency care as ambulance clinicians increasingly become part of community urgent treatment services,” said Simon Stevens, NHS England’s CEO.

“In the NHS’s 70th year, home visits by advanced paramedics and increasing use of clinical pharmacists and mental health therapists are among the practical ways the health service continues to innovate and adapt to the changing needs of patients and the population.”

Dr Fenella Wrigley, the medical director of the London ambulance service, said: “Our advanced paramedic practitioners (APPs) are all highly skilled paramedics. We have 16 urgent care APPs who treat less critically ill patients who may have complex needs but can often be managed at home, and 30 critical care APPs who attend patients with life-threatening conditions – often cardiac arrest or major trauma patients.

“Specialist paramedics being able to prescribe medication to patients in their own home will mean we are better able to meet the patient’s needs and it will mean fewer unnecessary trips to the GP or to the hospital. It will also mean our ambulances are free to respond to other very sick and injured patients.”

Dr Ron Daniels, CEO of the UK Sepsis Trust, is quoted in the report as saying that paramedics prescribing antibiotics could help reduce the annual toll of 44,000 deaths from sepsis, the potentially fatal blood-borne infection. “Timely identification and treatment of sepsis can mean the difference between life and death, so better access to healthcare professionals who can make accurate diagnoses and prescribe antibiotics where appropriate is an important provision,” he said.

[link url="https://www.theguardian.com/society/2018/mar/31/nhs-englands-top-paramedics-gain-right-to-prescribe-medicines"]The Guardian report[/link]

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