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Dietitians to be given greater prescribing powers to reduce demand on GPs



NHS England has set out proposals to reduce the need of patients to book GP appointments by giving greater prescribing powers to dietitians, radiographers, paramedics and orthoptists.

The proposals – set out in four separate consultation documents – have been designed to provide a more ‘efficient and convenient service’ for patients, while ‘reducing demand on other services’.

Under the proposals, radiographers and paramedics would be able to independently prescribe, and dietitians would be able to subscribe following agreement with GPs or other independent prescribers.

NHE England says that for many patients, an associated health professional is their lead clinician, but the patient may have to ‘make an additional appointment with their GP or doctor to get the medicines they need’.

Suzanne Rastrick, chief allied health professions officer at NHS England, said: ‘Our proposals will allow patients to get the medicines they need without delay, instead of having to make separate appointments to see their doctor or GP.

‘Breaking down barriers in how care is provided between different parts of the NHS is key to the vision set out in the NHS Five Year Forward View.

‘Extension of prescribing and supply mechanisms for these four professions creates a more flexible workforce, able to innovate to provide services that are more responsive to the needs of patients, and reduce demand in other parts of the healthcare system.’

The consultation on dietitians gave the example of CKD treatment, and said: ‘The frustration amongst doctors and patients alike is that the current system requires the patient’s consultant or GP to initiate and adjust medicines as advised by the dietitian in a separate additional appointment/consultation. As such, there can be several days delay between the dietitian’s appointment, and obtaining the prescription from the consultant or GP.’

Dr Andrew Green, chair of the GPC clinical and prescribing subcommittee, said: ‘In general we would be supportive of these groups being empowered to prescribe within their areas of expertise, it is always frustrating when GPs find their time being used to ‘rubber stamp’ clinical decisions which have quite appropriately been made by our colleagues.’