Hygienists And Therapists To Be Given Enhanced Prescribing Powers
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- Published: Monday, 08 April 2024 09:24
- Written by Guy Tuggle
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Dental Hygienists and Therapists who possess the necessary training are set to enjoy new freedoms to use medicines previously only available to them via the use of a patient specific direction (PSD) or patient group direction (PGD). They will be permitted to use previously regulated medicines under ’exemptions’.
There are 9733 hygienists and 6198 therapists on the GDC registers and the government’s NHS Long Term Workforce Plan (LTWP) and Dental Reform Plan (DRP) aim to grow this number. Both plans wish to see hygienists and therapists take some of the burden of treating patients off dentists so their time can be freed up to deliver treatments only they have the training to do. This will, it is hoped, help to improve the dental access crisis.
Hygienists and therapists currently deliver just 5% of dental activity but the LTWP aims to increase this to 15%.
Hygienists and therapists will soon be authorised to use local anaesthetics and apply fluoride varnishes without sign off from a dentist. In changes that will affect England, Scotland, Wales and Northern Ireland, they will also be permitted to prescribe Nystatin Oral Suspension and Minocycline 2% periodontal gel. Sodium Fluoride dental pastes (2800 and 5000 ppm) are also included on the list.
Concerns had initially been raised about the antimicrobial medicines but after consideration it has been agreed to include them on the proposed list of exemptions. Summarising its latest Consultation, the government briefing stated "Health benefits to certain groups of patients were identified and it was made clear that there will be training associated with these medicines that will further provide patient safety for this and the other medicines".
Although the profession was consulted about making changes back in 2020, the Medicines and Medical Devices Act 2021 brought in new requirements for consulting on proposed changes to the Human Medicines Regulations 2012 which necessitated the Department of Health and Social Care having to consult again*.
The latest consultation asked 2 key policy questions to seek views on the proposal itself and the way the policy is to be regulated.
Majority feedback confirmed a view that this proposal would be beneficial for patients, the professions and the NHS. This included a clear belief that the patient journey would be improved because the treatment process would become more efficient, reducing delays and freeing up dentist appointment time.
The pre-registration training that dental hygienists and dental therapists must undertake was mentioned frequently by respondents in a supportive manner for both questions. It was stated that professional qualifications would give the practitioners a good grounding in the use of exemptions and the medicines being proposed.
To the specific question asking respondents "Do you agree or disagree with the proposal to amend the Human Medicines Regulations 2012 to enable dental hygienists and dental therapists to supply and administer specific medicines under exemptions?" 2651 (97%) of the 2743 respondents signalled their agreement.
Regulation will be down to individual practices to ensure that the hygienist and therapists who prescribe have the necessary training. The GDC will not be keeping an annotated list.
The Specialist Pharmacy Service said "As with all professionals working under exemptions, it is essential that dental hygienist/therapists only do so within their scope of practice and where they have the appropriate underpinning knowledge.
Dental hygienists / therapists working under exemptions are accountable to both their employing organisation and professional body for their decisions to supply/administer medicines."
Commenting on the changes, Chair of The British Association of Dental Therapists, Dr Fiona Sandom issued an enthusiastic statement saying "The British Association of Dental Therapists is delighted that dental therapists and dental hygienists will soon be able to supply and administer certain prescription only medicines to patients without a need for a patient specific direction (PSD) or a patient group direction (PGD).
This will allow dental therapists and dental hygienists to use their full scope of practice and deliver the care they have been trained and educated to deliver".
For the government, Andrea Leadson MP, the Minister responsible for Primary Care said "We want to give patients faster, simpler and fairer access to the care they need, when they need it - and giving these powers to pharmacy technicians, dental therapists and hygienists will do just that".
*The Consultation took place between August and September 2023. A total of 2,743 responses were received, all through the GOV.UK page, and one which came via email. 73% of responses were from individuals sharing their professional views, 24% from individuals sharing their personal views and experiences, and 3% were on behalf of organisations.
48% of respondents stated that they were responding as a dental hygienist or dental therapist. 25% stated that they were responding as a patient and 15% as a dentist.
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