Independent and supplementary prescribers are professional healthcare practitioners who have completed approved medication-prescribing educational programmes. Independent prescribers have an annotation mark (IP) on their record on the Register. 

Independent prescribing (IP) is prescribing by a healthcare practitioner who is responsible for the assessment of patients with undiagnosed or diagnosed conditions and decisions about their clinical management.

As an independent prescriber, you can prescribe the appropriate medication for patients within your scope of practice relevant to current regulations.

Supplementary prescribers

A supplementary prescriber is a healthcare professional that works in a voluntary partnership with a doctor or dentist. You could prescribe medication within an agreed service user-specific clinical management plan as a supplementary prescriber.

A clinical management plan is a written and agreed action plan between a doctor or dentist and a supplementary prescriber for treating a patient or service user. The plan is drawn up with the knowledge and agreement of the patient/service user or their carer. 

The supplementary prescriber will work within the conditions of the plan to prescribe and administer the types of medicines they are allowed to prescribe, plus any limits to the strength or dose of medications they can prescribe.

You can learn more about independent and supplementary prescribing and the recommended PDUK course to fulfil your requirement for NMPs to demonstrate ongoing CPD by updating your qualification annually in our main article.

Legal aspects of being a prescriber 

On 23 April 2012, changes were made to The Misuse of Drugs Regulations that covers all of the UK except Northern Ireland. This legislation divides controlled drugs into schedules according to their therapeutic usefulness and misuse potential.

The regulations allow qualified independent prescribers to prescribe all controlled drugs listed in schedules 2 to 5 where it is clinically appropriate and within their professional competence, except for the treatment of addiction with cocaine, diamorphine and dipipanone.

The 2012 legislation changes also allowed qualified independent prescribers to mix any controlled drugs listed in schedules 2 to 5 before administration with another medicine for patients needing intravenous drugs. 

Generally speaking, an independent prescriber can prescribe any medicine for a health condition within their own clinical competence. A supplementary prescriber can prescribe any medication within their clinical competence that is included in the individual patient’s specific clinical management plan.

This basic table gives a simple summary of what independent prescribers and supplementary prescribers can prescribe:

Food is essential for human beings. It is good for the palate but also for the health. Eating healthy food can nourish the body and the mind. Getting regular health screening is another way to maintain a healthy body. Do you know that 4 out of 10 adults in the world suffer from digestive system problems? This shows that there are many people who experience digestive disorders or gastrointestinal disorders of varying severity. This article highlights one of the disorders known as colitis.

Colitis is characterised by inflammation of the large intestine (colon). There are many causes leading to colitis. This includes infection, autoimmunity, immune deficiency, toxin exposure, radiation exposure and drugs. Colitis may occur to people of all ages.

There are many types of colitis. Below are examples of common one:

1)  Ulcerative colitis- Often refers to inflammatory bowel disease (IBD). It is part of an autoimmune condition that affects the inner lining of the colon.

2)  Pseudomembranous colitis- Inflammation of the colon caused by bacteria. Common bacteria such as Clostridium difficile is the most common cause for this type of colitis. The bacteria are actually normal in the human guts but often grows abundantly when a person takes a strong course of antibiotic therapy. Such therapy kills other bacteria that should keep the Clostridium difficile under control and maintain balanced bacteria in the bowel.

3)  Ischemic colitis- This colitis is the result of the limited or obstructed blood flow to the colon. It is common in people with cardiovascular disease, previous surgery of the aorta or blood clotting problems. Other causes include twisted colon (volvulus). Hernia and colon cancer.

4)  Microscopic colitis- Colitis that causes persistent watery diarrhoea especially in the elderly. It is associated with autoimmune disorders such as type 1 diabetes, celiac diseases, thyroid dysfunction and psoriasis. As the name suggests, it is considered as microscopic as the need of a microscope to identify it and tissue findings are typically normal after a colonoscopy or sigmoidoscopy procedure.

5)  Tuberculous colitis- Often mimics IBD but is caused by bacteria causing lung tuberculosis.

6)  Drug-induced colitis- Most commonly reported are from usage of anti-inflammatory drugs (NSAIDs). Other drugs include antihypertensive drugs.

7)  Radiation colitis- Secondary to radiotherapy in gynaecological and urological.

Symptoms of colitis may slightly differ to the types of colitis. Common symptoms include abdominal pain, bloating, diarrhoea, constipation, fatigue, loss of appetite, bowel movement urgencies, bloody stools and fever. Since symptoms of colitis are difficult to know its exact type, it is best to get medical care for proper diagnosis and treatment.

You probably wonder, out of all types of colitis, which are the worst type? The answer is ulcerative colon. Although ulcerative colon itself is not fatal, the complications it brings can shorten a person’s lifespan. This is because it is associated with progression into colon cancer due to cells constantly repairing the damages and mutating. In addition to the dangerous colon cancer, ulcerative colitis may lead to perforated bowels that increase chances for life-threatening infections. Another serious complication of ulcerative colitis is the ability to spread into deeper layers of the colon resulting in swelling of the colon known as toxic megacolon.

In essence, there are numerous types of colitis and symptoms may seem similar to one type and another. It is best to seek a doctor if you spot yourself with any of the symptoms related to colitis especially when watery diarrhoea lasts more than a few days, a heavy and ongoing diarrhoea, signs of dehydration such as dark colour urine or little urine, high fever or pain that does not resolve. Treatments will depend on how severe the colitis is.