Independent Prescribers and Supplementary Prescribers Explained
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.
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:
|Independent Prescriber (IP)
(Nurses, Midwives and Pharmacists only)
|Supplementary Prescriber (SP)
(Nurses, Midwives and Pharmacists only
|Controlled Drugs (CDs)||Yes – CDs Schedule 2 to 5, except diamorphine, dipipanone
or cocaine for the treatment of addiction
|Yes – CDs Schedule 2 to 5, except diamorphine, dipipanone or cocaine for the treatment of addiction|
|Unlicensed medicines||Yes -provided they are competent and take responsibility for doing so.
(May vary for Nurse prescribers in Scotland)
|Yes – covered by the CMP|
|Off-label/off-licence prescribing||Yes – should only be prescribed where it is best practice to do so and
must take full clinical and professional responsibility for their prescribing
|Yes – covered by the CMP|
|Private prescribing||Yes – for any medicine within their competence||Yes – for any medication covered by the CMP|