Legal aspects of prescribing

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).