The Dawning of the Patient Group Directive

refers to changes in legislation brought about by need for patient safety and public service. While dentistry achieved a greater mandate than any other profession podiatry led the way for other professions such as physiotherapy to expand their use of medications formally only available by medical qualifications. The state of play has altered with Independent Prescribing. Where did it all start?
This month I came across an old paper on steroid injections from 1996 that I had written and the introduction to that paper became this June’s Podiatric Reflective Practice article. No doubt it will be a few years before we see all podiatrists with pharmacy wide access but at least it is worth recording some of the earlier actions that took place.

Patient Group Directives were the method of supporting patients with medicines usually reserved for medical prescribing. In 1996 Podiatry started to increase access by this method to maintain legal provision and yet continued to fight until 2006 to obtain basic access to support patients with pain management, infection control under the two main sub divisions; Podiatric Surgery and High risk foot health care. Podiatric surgery was established in 1974 with the Podiatry Association and amalgamated with The Society of Chiropodists in 1998 to become The Society of Chiropodists & Podiatrists. Nail surgery has been established in schools by the mid-seventies and now offered by most podiatrists with local anaesthetic.

Independent Prescribing

By 2014 Independent Prescribing became available to podiatrists needing to extend their provision of prescription medicines and is recognised after additional academic study and annotated on a register held by the Health Care Professions Council. This was an immediate importance to some groups more than others. Nursing has led the way in many ways and has produced more written material on the subject. It is early to establish the effects of the increased activity of non-medical prescribing but training is so intense that the comparison of risk to patients may in fact be shown to be more dangerous in medical hands as legislation allows medical doctors greater latitude.

Next month I will publish the steroid paper in e-format although this can be found in the old J. British Podiatric Medicine 1996 but not accessible to most people. This publication will be available for any reader.
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Opinions stated in this article are those of the author and are not necessarily the same as the professional body – The College of Podiatry.

First issued July 2018