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Legal aspects of prescribing

02 October 2021
Volume 13 · Issue 10


Paramedic independent prescribing is in its infancy and there are limitations to the range of medicines that can be prescribed when compared with other professions undertaking independent prescribing. Medication and prescribing errors are common events within the NHS in England, resulting in a substantial number of litigation and fitness-to-practise proceedings against other professions in relation to prescribing and medicines management. It is foreseeable that paramedic independent prescribers could also find themselves subject to legal action. This article considers a fictitious scenario where a patient suffers harm as a result of a prescribing decision and the legal implications for the prescriber.

The scope of paramedic practice is wider than ever before—in part, thanks to the addition of paramedics to the growing list of professions eligible to become independent prescribers in 2018 (College of Paramedics (CoP), 2021a). Independent prescribing is far removed from the narrow range of medicines which paramedics can administer by exemption under Schedules 17 and 19 of the Human Medicines Regulations (HMR) 2012. In an ambulance setting, the immediacy of administration and proximity to the patient ensures efficacy and adverse effects can usually be monitored and acted on. In contrast paramedic independent prescribers working in primary or secondary care settings may initiate longer term treatments in patients with complex medical and drug histories, and with variable clinical supervision. Early adopters of paramedic prescribing have identified concerns in relation to inadvertent patient harm, litigation and possible resulting harm to the profession (Stenner et al, 2021).

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