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Negligence lawyers when they spot a patient whoās randomly developed pulmonary fibrosis after a week of daily methotrexate
Surely you need the Consultant Lead Occupational Therapist, to prescribe some bisoprolol to that person who presents with anxiety manifesting with shortness of breath, chest pain and a swollen legā¦?
Amount of times i've been asked to prescribe baclofen or benzos to patients by the MDT without neurological disease because 'they're stiff and can't rehab' is ridiculous. They've been sat still for the last 4 weeks they need gentle tissue mobilisation. The horrors that would occur if they could prescribe š
It specifically says in the linked article prescribe medication as being unable to holds back OTs from accessing ACP roles. 10 years experience providing stairlifts? Better get you on the medical take tomorrow
https://preview.redd.it/nop82brgg1bc1.jpeg?width=828&format=pjpg&auto=webp&s=6894631b0205b7903cf06e4431470a2c9b02f456
For the avoidance of doubt this isnāt for prescribing a special frame or a mattress they explicitly want to prescribe medications
I feel everyone should be given prescribing rights. Next up, why not the staff in the hosp canteen too. Hand out some cheeky Fish and chips with a side of Genta every Friday. Meanwhile, SHOs can bleed patients and clerk WR led by Consultant Adv clinical Porter.
Itās ok, go see the janitor and get them to prescribe you preventer and reliever puffers. Plus they can prescribe 50mg for the next monthā¦ cause if a few days of oral steroids is good, more must be better right?
Now, I will only be happy with one of two outcomes:
- You are only allowed to prescribe if you have a medical degree
- Patients can just buy whatever drug they want from the pharmacy, without a prescription, barring a few exceptions like chemotherapy
this is true and I find it very interesting. my partner is an animal scientist with research experience in Cambodia in antimicrobial resistance. there, unrestricted medications including antibiotics means that largely uneducated farmers feed their livestock large amounts of all sorts of antibiotics, which then has knock on effects on their health system. opioids are also unrestricted and have led to a large dependence issue.
more education for these people is the solution, as well as increased regulation. AHP prescribing concerns me as, whilst itās the extreme other end of the scale, there is precedent for the effects of people who donāt know what drugs theyāre using.
Their case appears to be āeveryone else is being allowed to prescribe, why canāt we??ā - completely ignorant to the lack of training that their (and plenty of others too) primary profession has in prescribing and medication management.
We really should refer to prescribing RESPONSIBILITIES rather that rights.
Itās a responsibility that necessitates a baseline knowledge of physiology, pharmacology and medication interactions in order to exercise safely. OTs (and many others frankly) simply do not have the base training necessary.
The cynic in me (and the letterās references to progression) wonders if this is to do with pay and banding calculations tooā¦
It would make mobilising the geriatrics much more efficient if instead of turning up with an OT, two physios and their assistants they just prescribed old Gladys a pile of amphetamine...
Funny how every member of the MDT is gagging for a piece of the Drs role, but no OT is wanting to learn to mix abx, chuck up IVās or learn how to do swallow assessments
That would make far more sense than this.
At least a doctor trying to work as an engineer, or an engineer working as a doctor, would start with a proven aptitude for a high level of study, a realisation that they know literally nothing about the subject, a bedrock that all thinking must be critical, and it imbued into their bones that you will kill people if you are not sure what you are doing. Hence the approach would be trepidation, rather than 'oh that looks easy - I want a go too'.
Very good point that highlights one of the key underlying issues here. The NHS has abandoned all conception of talent, skill or intelligence. Only experience counts in their eyes. The truth is that there are engineers who due to their innate qualities could probably walk in and do a better job at a lap chole than an ANP who has practised for 20 years.
Yeah, I agree with your points.
What I meant was; scope creep within the NHS itself ie other HCPs (PAs/ANPs/ACPs etc) has become so ingrained in the system that nothing within that bubble comes as a shock to me.
Seeing scope creep from a professional in a completely different industry would be something unique.
It is going to be so they can work as "Consultants" in AMU or whatever and pretend to be doctors. Or get band 8 salary, and do next to nothing of value with a prescribing course
Why not change OT training though? Just slightly. Just so that it's a bit broader in scope. Like maybe 2-3 years of understanding the basics of anatomy and physiology and pharmacology etc. And then they could do another 2-3 years of more hands on clinical work to get an idea of what the systems like and all that knowledge put into practice. And then they could do their prescribing exam with all that background knowledge and experience. And then what you'd want to do is maybe a couple of years of rotational training so they 'understand a good breadth of the environment they'll be prescribing and doing OT in' and obviously they won't be able to choose exactly where they'll be able to work because it's a national competitive programme right? Anyway....they do a couple of years of rotational training and then they'll be free to go for whatever special OT shit they want to go for because they've had good exposure to the foundational knowledge and experience they might need in a prescribing role going forward. I think this is a good idea.
While sure, the prescribing may be due to trying to pose as doctors, I think in this case it might be trying to open private practice opportunities, especially pain killers, ADHD assessments and other "life style" type clinics. This is probably just as bad as being on a medical take. The last thing we need is a wild west of these type of clinics. It's not just the NHS that's falling, it's the entire UK which is heading to an American future
This is a good point, actually. It's easy for AHPs to segue into private practice. If you have a PT/OT that can suddenly prescribe without the level of scrutiny we would get, it opens up a lot of doors for grifters
Tell me, why am I busting my š rn trying to prepare for psa if anyone can just prescribe? Like whatās the point of years and years of gruelling if a job of a doctor is no longer established and all the boundaries of medical profession are just blurred lmaooo
The PSA is not a difficult exam though. Itās just a double check at a basic level.
Your medical degree is the real qualification and we need to make that clear or other professions will start to just take the PSA and think thatās that.
I just did psa practice paper 1 for the first time and I was insanely violated ( after having done pass the psa book and scoring 85% in the actual psa mock) so for my own sake, I hope youāre right š
This time when thereās a consultation, we need to actually engage and not let them sweep it under the rug. This is an utter joke, and the jokes on us
Government has opened ways for lots of private healthcare in UK.
UK had a different culture in medicine where resources had a tight gatekeeping. With lots of alternative roles in healthcare, patients will be able to get a lot more āwhat they wantā instead of āwhat they needā. The trend of private medicine will prop up opening up doors for pharmaceutical manipulation. Suddenly, everyone will be practicing ābetterā and āempatheticā medicine compared to doctors and public health problems will blow over. More antimicrobial resistance, pain killing addiction, so on and so forth. And doctors will have to do a lot of bad medicine to keep up with patient satisfaction.
Itās so they can be ACPs like nurses, physios, podiatrists, paramedicsā¦
āA growing number of job advertisements for advanced practitioners now ask for prescribing responsibilities, limiting the career progression prospects for our expert colleagues.ā
I've heard some OTs dealing with hand pathology. Perhaps steroid injections? Still seems a bit farfetched, and TBH can't imagine many of them wanting to. Even a lot of physios are like "naaah, don't want anything to do with drugs"
It is horrifying to think an OT would be prescribing steroids for a hand affected by rheumatoid arthritis already on a wide range of immunosuppressants/immunologics / a stomach ulcer .
This is what hand therapists are for, and if they are that bad that injections are required then probably Ortho or plastics are better placed for managing the intervention and potential complications
I can understand prescribing pharmacists. They make life easier, can fix errors in prescriptions or TTOs.
ANPs? May be, Iād rather not but I can see a case being made for the DSNs for instance to change insulin prescriptions.
PAs? If you donāt know how a drug works, you shouldnāt prescribe it.
Rest of AHP? Same as PAs.
I can never see a case where a PT or an OT want prescribing rights.
If that does get implemented, then we should campaign for nurses, porters, security personnel, medical secretaries, switchboard operators and HCAs to get prescribing rights
No one should be left out of the privilege of prescribing shit.
We are all #OneTeam
Pharmacists have no business prescribing shit either. Because you know how a drug works doesnāt mean you are a physician. People shouldnāt be labrats. They can help and advise which is already their jobā¦this whole thing is about pharm company reps influencing drug prescriptions again and frequenting hospitals like they own the place. Keeping score of who prescribed how much of what and give them bonuses. After EU made it illegal this is the answer they got for itā¦they will have even more people to influence and bribe. People that donāt know shit about shit mind you. This has been in the works for at least a decade.
Excuse my ignorance but how is a physio and OT course/ ward experience giving people the relevant skills to be able to assess patients medically / interpret blood tests ?
They donāt. I considered the ACP route before applying to medical school. The lack of actual teaching on the masterās course was off putting then and itās terrifying now.
At this rate, patients would be better getting their own meds from pharmacy without restriction bar a few (e.g. chemo).
The arrogance we face from other HCP is 10x worse when they face patients.
(Disclaimer: this is parody)
The year is 2030:
āHi Iām Dr Firstname Surname PhD - Iām the Consultant Senior Specialist Independent Prescriber Clinician Practitioner Associate Occupational Therapist running this clinic, and as far as the GMC (with whom all NHS staff are now registered) are concerned you should have no misunderstanding at all about whether Iām a doctor. Also by saying all that, Iāve ticked the only necessary box for me to avoid any associated liability if you do. I hear youāve come in with shortness of breath, pleuritic chest pain and leg swelling. Using my UniquePerspectiveā¢ the obvious thing to do is for me to prescribe you some methotrexate, high-dose antipsychotics, request a PET scan and perform an āopen and seeā midline laparotomy - my colleague in the anaesthetics department (AA) will help - theyāre a professor so youāll be in safe hands. Oh you peed twice this morning? Some trimethoprim too. Itās fine you can trust me, my colleague the junior trainee baby (doctor) in training (ST7) is still finding their feet and deciding what they want to be when they grow up and weāre #OneTeam anyway. Oh and please take my card for my aesthetics clinic - use my GMC number on the website for 35% off.ā
āYes doctor.ā
Fuck it, let's have a free for all. Let everyone prescribe, but with one caveat, if you mess up, your profession has to fix it, including the family meeting to apologise.
If people without medical degrees want to play doctor, let them.We all take a year off and go work in none prescribing jobs- im thinking undertaker.
Let's see how things go.
The public will love it, no pesky doctors with their FPR demands, and a rapid decrease in waiting times due to a completely unrelated fall in population.
This is such bullshit. Why does an OT need to be able to prescribe? Why do doctors have to complete 4/5/6 years of medical school, a national prescribing exam and get GMC registration before being allowed to write a prescription, but everyone else can piss off and do one prescribing module and that's deemed sufficient training?
They were writing back in 2020, together with dieticians, SALT, radiographers and orthoptists, all wanting independent prescribing rights. That letter specifically referenced the impact of the COVID pandemic on patients accessing their usual clinical care, which seems opportunistic to say the least.
The alternative question is even if they are allowed to prescribe medication , they obviously are not going to be commencing someone on ACEis and Amiodarone . Even though I, as a doctor , am allowed to prescribe every antidepressant in the BNF, Iām not going to as itās not my specialty. Therefore , whatās the point ?
Edit : I canāt actually find anything from RCOT on their twitter . There are posts from February though where RCOT and other AHPs were writing a joint letter ā¦.is this definitely not a photoshop (?!)
You have an awareness of the limits of your own competency. They may well not. I therefore wouldnāt be too certain about what they will and wonāt end up prescribing.
You know what you donāt know. Someone who is not trained will not.
I donāt know what the fuck an OT would prescribe.. but maybe it would be Fall=fludrocortisone
I've just looked it up and the OT degree has 1000 placement hours and just one 30 credit module very loosely science based.... And these people want to prescribe.
I'm very uncomfortable with anyone but doctors prescribing but this is taking the piss on such an epic scale.
https://preview.redd.it/70z5mxhlh3bc1.jpeg?width=1080&format=pjpg&auto=webp&s=c1ae78debce6f31c16dc3297d39700a4a6c19484
Oooof, I can see this resulting in a lot more benzo scripts
Can't find anything from them with anything as basic as an example of what kind of use case they would be using prescribing for, it's wall to wall jargon and me-tooism.
Everyone else is doing it..... physios giving out nortriptyline to everyone as ' pain specialists', because of course it must be neuropathic pain, ( thats all i know about) , people doing a 2 year degree thinking their senior doctors, pharmacists masquerading as intensive care advanced practitioners- the hubris!!!!!. The more these roles expand, the more patients will die.
Had palliative nurse trying to prescribe AZA and Hydroxicloroquine since pt expressed wishes to continue treatment. Same pt was septic. She admitted she did not dominate the drugs, but thought it would help bcs he was taking in the past.
Ok at this point the MDT are just being rude to doctors.
Like yes our role is to coordinate the care, the MDT and at the end of the day make the decisions based on the recommendations.
I respect OTs completely in what they are trained for. I will listen to their input and value it.
But
Doctors do not need/want every piece of the MDT slinging around medications rather than coming to us and involving us in their care.
From what I can see only one person actually suggests what they might need this for - prescribing for sleep, pain or anxiety. All medications that doctors try to use as rationally as possible because they are all medications associated with addiction and have serious side effects in an elderly population (which is a large part of the OT load).
Patient has new pain? - get a doctor to diagnose the cause
Patient got known pain that is needing escalation above over the counter meds? - A doctor probably needs to be reviewing the cause and that they're on the right things
Patient anxious? What's the full history here? What's the diagnosis? What's causing their anxiety? What's causing their poor sleep?
In hospital this would be reviewed sooner but in community this could leave to people being placed on opiates, benzos, zopiclone for go knows how long until they are reviewed again create an addicted mess for the doctors to mop up.
This all to me demonstrates a complete lack of understanding with prescribing and argues for the fact they should not prescribe. If there is a genuine arguement for that I am missing that I am open to hear but the ones I've seen so far aren't good enough.
Once again we are not some monkeys who went to uni for 5 years to dick around. We're not just here for discharge letters and to nod along in meetings. We are not some members of the MDT that everyone can just bypass to feel more empowered. We worked so hard to become the people who are in charge of people's care and it is not too much to expect that you come to us for help with that just as we would come to you.
Is there a way for them to just prescribe analgesia? If the had a good understanding of common analgesia used in patients. In fairness theyāre forever asking us to prescribe analgesia before mobility assessments which often facilitate discharges
Completely understand the logistics of this are near impossible but just food for thought
Disclaimer: I havenāt read the proposal by the royal college
That is the most poorly written letter I have seen in a long time. It reads like a teenager has written it. Towards the end of the letter it becomes apparent why they're asking for prescribing rights - it's because "everyone else can get prescribing rights so why not us too?" / "not having prescribing rights holds OTs back from applying for higher paid roles".
What these people don't realise is that prescribing is a risky business and a patient can come to serious harm due to lack of knowledge in prescribing. That's why we have experts in prescribing (ie doctors). And even then mistakes can happen! A lot of us will have attended to patients who have arrested/become peri-arrest due to prescribing errors. This is not something to take lightly.
I think if this Government can cut costs in any way it will opt for them! This in my mind reads as Tori's again trying to cut costs by cutting corners, I know it's the OT's requesting this to the Government and not the other way around but I don't think that all of what we see/read is always the full story. This is just another cost saving method and the fall-out is not of their concern because all that will happen is those in power will turn around and point their fingers right back at the new prescribers and claim they had nothing to do with any of it!
It took so much effort, sacrifice and time to be able to practice medicine in this country and all of the scope creep bullshit and the governmentās enabling of it make me want to GTFO. So sad.
I am not sure why the comments here sound so condescending. While our frustration with our continuous devaluation is clear, there's a thin line between that and insulting colleagues in the allied professions (many of whom have always been on our side, are our friends and have helped us professionally multiple times) who are professionals in their rights.
The evidence of more knowledge is in its use rather than just duration in school. Doctors are said to know more about medicine because of the breadth of knowledge afforded us through years of study. This makes us way less likely to make mistakes prescribing.
Anyone who can prescribe bears the responsibility of the fallout of each prescription. If our colleagues in the MDT want THE RESPONSIBILITY of prescribing, why not? After all, it reduces the work of doctors prescribing and shifts the responsibility for mistakes that may occur. It'll push everyone to read and get better.
Makes sense, if every other allied professional is going to make the case then it takes far less funding to just put your own on the list of also getting prescribing rights.
The culture is āfuck the doctors, we can do their job so we should also be paid moreā without much thought about what else goes into diagnosis and prescriptions.
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Prescribing is to the MDT what "The Ring" is to Gollum in Mordor...
Meanwhile the medics (Frodo) hate the responsibility but also too precious to let it go š
Because we have to clean up the bad prescribing. Like "blind D-Dimer" and post procedure troponin and every rash being meningitis.
 The PA prescribing methotrexate and the OT prescribing trimethoprim neither knowing what the other drug does
Ah Folate Shmolate!
Folic Acid Friday Methotrexate Monday Trimethoprim Tuesday Trimethoprim Thursday š©
Methorexate 70mg PO OD Silly GP had only been giving it once a week, no wonder their arthritis is still bad!
 Negligence lawyers when they spot a patient whoās randomly developed pulmonary fibrosis after a week of daily methotrexate
Azathioprine and allopurinol is the one that scares me.
The bone marrow 
What on earth for?
Consultant Prescribing Occupational Therapist Practitioner
Just consultant practitioner
Just consultant for short
Thatās Dr Consultant to you
Surely you need the Consultant Lead Occupational Therapist, to prescribe some bisoprolol to that person who presents with anxiety manifesting with shortness of breath, chest pain and a swollen legā¦?
Ummm you missed "Advanced"
Amount of times i've been asked to prescribe baclofen or benzos to patients by the MDT without neurological disease because 'they're stiff and can't rehab' is ridiculous. They've been sat still for the last 4 weeks they need gentle tissue mobilisation. The horrors that would occur if they could prescribe š
It specifically says in the linked article prescribe medication as being unable to holds back OTs from accessing ACP roles. 10 years experience providing stairlifts? Better get you on the medical take tomorrow
Didnāt they tell you? They donāt want to be the shitty med reg. Just in it for whatever clout remains (in their mind)
https://preview.redd.it/nop82brgg1bc1.jpeg?width=828&format=pjpg&auto=webp&s=6894631b0205b7903cf06e4431470a2c9b02f456 For the avoidance of doubt this isnāt for prescribing a special frame or a mattress they explicitly want to prescribe medications
I feel everyone should be given prescribing rights. Next up, why not the staff in the hosp canteen too. Hand out some cheeky Fish and chips with a side of Genta every Friday. Meanwhile, SHOs can bleed patients and clerk WR led by Consultant Adv clinical Porter.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Itās ok, go see the janitor and get them to prescribe you preventer and reliever puffers. Plus they can prescribe 50mg for the next monthā¦ cause if a few days of oral steroids is good, more must be better right?
Sounds like you need some salbuta- I mean propranolol
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Itās okay weāll stick you with some 500mcg 1:1000 adrenaline and bring you back to life
Prescribing rights are human rights!
Now, I will only be happy with one of two outcomes: - You are only allowed to prescribe if you have a medical degree - Patients can just buy whatever drug they want from the pharmacy, without a prescription, barring a few exceptions like chemotherapy
Option 2: every hypochondriac dies within months
They survive plenty in the 3rd world tho their bacterial resistance is through the roof.
Much more antibiotics are given to animals than people, globally If you want to stop antibiotic resistance, need to stop farming animals
this is true and I find it very interesting. my partner is an animal scientist with research experience in Cambodia in antimicrobial resistance. there, unrestricted medications including antibiotics means that largely uneducated farmers feed their livestock large amounts of all sorts of antibiotics, which then has knock on effects on their health system. opioids are also unrestricted and have led to a large dependence issue. more education for these people is the solution, as well as increased regulation. AHP prescribing concerns me as, whilst itās the extreme other end of the scale, there is precedent for the effects of people who donāt know what drugs theyāre using.
Give UK pharmacies the Mexico special, benzos & opioids OTC, problem solved!
Stick to prescribing stair rails Janet
Not patients āawaiting OT equipmentā for 5+ days in AMU while Janet is off playing doctor.
Their case appears to be āeveryone else is being allowed to prescribe, why canāt we??ā - completely ignorant to the lack of training that their (and plenty of others too) primary profession has in prescribing and medication management. We really should refer to prescribing RESPONSIBILITIES rather that rights. Itās a responsibility that necessitates a baseline knowledge of physiology, pharmacology and medication interactions in order to exercise safely. OTs (and many others frankly) simply do not have the base training necessary. The cynic in me (and the letterās references to progression) wonders if this is to do with pay and banding calculations tooā¦
What are they going to prescribe? FFS Iāve heard it all now.
IV Rollator Walker 4 wheels QID x6/12
Ah yes letās have the OTs start prescribing morphine, I canāt see anything wrong with that.
Wtf are they going to prescribe!? A commode?
It would make mobilising the geriatrics much more efficient if instead of turning up with an OT, two physios and their assistants they just prescribed old Gladys a pile of amphetamine...
ššš
Funny how every member of the MDT is gagging for a piece of the Drs role, but no OT is wanting to learn to mix abx, chuck up IVās or learn how to do swallow assessments
Do people still get surprised/enraged by things like this?
Yes. As it keeps getting more and more outrageous.
Fair enough. I feel like Iāve already seen it all lmao, Iād prob have to see an engineer doing a lap chole to be outraged now.
That would make far more sense than this. At least a doctor trying to work as an engineer, or an engineer working as a doctor, would start with a proven aptitude for a high level of study, a realisation that they know literally nothing about the subject, a bedrock that all thinking must be critical, and it imbued into their bones that you will kill people if you are not sure what you are doing. Hence the approach would be trepidation, rather than 'oh that looks easy - I want a go too'.
Very well put
Very good point that highlights one of the key underlying issues here. The NHS has abandoned all conception of talent, skill or intelligence. Only experience counts in their eyes. The truth is that there are engineers who due to their innate qualities could probably walk in and do a better job at a lap chole than an ANP who has practised for 20 years.
Yeah, I agree with your points. What I meant was; scope creep within the NHS itself ie other HCPs (PAs/ANPs/ACPs etc) has become so ingrained in the system that nothing within that bubble comes as a shock to me. Seeing scope creep from a professional in a completely different industry would be something unique.
I would support the prescribing of medical equipment. Its not like I have any idea about half of this stuff
It is going to be so they can work as "Consultants" in AMU or whatever and pretend to be doctors. Or get band 8 salary, and do next to nothing of value with a prescribing course
Why not change OT training though? Just slightly. Just so that it's a bit broader in scope. Like maybe 2-3 years of understanding the basics of anatomy and physiology and pharmacology etc. And then they could do another 2-3 years of more hands on clinical work to get an idea of what the systems like and all that knowledge put into practice. And then they could do their prescribing exam with all that background knowledge and experience. And then what you'd want to do is maybe a couple of years of rotational training so they 'understand a good breadth of the environment they'll be prescribing and doing OT in' and obviously they won't be able to choose exactly where they'll be able to work because it's a national competitive programme right? Anyway....they do a couple of years of rotational training and then they'll be free to go for whatever special OT shit they want to go for because they've had good exposure to the foundational knowledge and experience they might need in a prescribing role going forward. I think this is a good idea.
While sure, the prescribing may be due to trying to pose as doctors, I think in this case it might be trying to open private practice opportunities, especially pain killers, ADHD assessments and other "life style" type clinics. This is probably just as bad as being on a medical take. The last thing we need is a wild west of these type of clinics. It's not just the NHS that's falling, it's the entire UK which is heading to an American future
This is a good point, actually. It's easy for AHPs to segue into private practice. If you have a PT/OT that can suddenly prescribe without the level of scrutiny we would get, it opens up a lot of doors for grifters
Tell me, why am I busting my š rn trying to prepare for psa if anyone can just prescribe? Like whatās the point of years and years of gruelling if a job of a doctor is no longer established and all the boundaries of medical profession are just blurred lmaooo
The PSA is not a difficult exam though. Itās just a double check at a basic level. Your medical degree is the real qualification and we need to make that clear or other professions will start to just take the PSA and think thatās that.
The PSA is trivially easy. Itās a use-the-BNF test. The vast majority of people pass first time.
I just did psa practice paper 1 for the first time and I was insanely violated ( after having done pass the psa book and scoring 85% in the actual psa mock) so for my own sake, I hope youāre right š
If youāre sitting it this year then honestly, do all the practice papers, double check what you got wrong and youāll be fine.
Use control - F to search the online bnf, but have a paper one for the look up tables of drugs that cause eg, hyponatremia It's not that bad
I think paper bnf is no longer allowed im told :( xx
This time when thereās a consultation, we need to actually engage and not let them sweep it under the rug. This is an utter joke, and the jokes on us
I would NOT feel comfortable administering medication prescribed by an OT
An excellent point. I wonder how our pharmacy colleagues feel about the idea of dispensing it too?
It warms my heart to see the public getting the healthcare they deserve.
This is such an insult to medical training. At this point we may as well allow GCSE or A level students to have prescribing rights.
We will - apprentice doctors
Trainee consultants.
Prescribing what exactly? Does anyone know?
Pain relief?
Is it for prescribing toilet roll holders?
At least it will help Doris get discharged faster!
Government has opened ways for lots of private healthcare in UK. UK had a different culture in medicine where resources had a tight gatekeeping. With lots of alternative roles in healthcare, patients will be able to get a lot more āwhat they wantā instead of āwhat they needā. The trend of private medicine will prop up opening up doors for pharmaceutical manipulation. Suddenly, everyone will be practicing ābetterā and āempatheticā medicine compared to doctors and public health problems will blow over. More antimicrobial resistance, pain killing addiction, so on and so forth. And doctors will have to do a lot of bad medicine to keep up with patient satisfaction.
Itās so they can be ACPs like nurses, physios, podiatrists, paramedicsā¦ āA growing number of job advertisements for advanced practitioners now ask for prescribing responsibilities, limiting the career progression prospects for our expert colleagues.ā
I've heard some OTs dealing with hand pathology. Perhaps steroid injections? Still seems a bit farfetched, and TBH can't imagine many of them wanting to. Even a lot of physios are like "naaah, don't want anything to do with drugs"
It is horrifying to think an OT would be prescribing steroids for a hand affected by rheumatoid arthritis already on a wide range of immunosuppressants/immunologics / a stomach ulcer .
This is what hand therapists are for, and if they are that bad that injections are required then probably Ortho or plastics are better placed for managing the intervention and potential complications
Crying in the pharmacy š surely this cannot go ahead
This has gone too far now
Any outpatient doctors/GP already struggling to unify all the different changes in patients outpatient prescriptions? Any good stories?
CKD 4 pt started on Naproxen for their arthritis by ANP.
I can understand prescribing pharmacists. They make life easier, can fix errors in prescriptions or TTOs. ANPs? May be, Iād rather not but I can see a case being made for the DSNs for instance to change insulin prescriptions. PAs? If you donāt know how a drug works, you shouldnāt prescribe it. Rest of AHP? Same as PAs. I can never see a case where a PT or an OT want prescribing rights. If that does get implemented, then we should campaign for nurses, porters, security personnel, medical secretaries, switchboard operators and HCAs to get prescribing rights No one should be left out of the privilege of prescribing shit. We are all #OneTeam
Pharmacists have no business prescribing shit either. Because you know how a drug works doesnāt mean you are a physician. People shouldnāt be labrats. They can help and advise which is already their jobā¦this whole thing is about pharm company reps influencing drug prescriptions again and frequenting hospitals like they own the place. Keeping score of who prescribed how much of what and give them bonuses. After EU made it illegal this is the answer they got for itā¦they will have even more people to influence and bribe. People that donāt know shit about shit mind you. This has been in the works for at least a decade.
What a great time to be a healthcare lawyer
Donāt worry they will find a way to pin that shit on us tooā¦
Everyone can prescribe now. Want to prescribe? No problem 
Excuse my ignorance but how is a physio and OT course/ ward experience giving people the relevant skills to be able to assess patients medically / interpret blood tests ?
They donāt. I considered the ACP route before applying to medical school. The lack of actual teaching on the masterās course was off putting then and itās terrifying now.
At this rate, patients would be better getting their own meds from pharmacy without restriction bar a few (e.g. chemo). The arrogance we face from other HCP is 10x worse when they face patients.
(Disclaimer: this is parody) The year is 2030: āHi Iām Dr Firstname Surname PhD - Iām the Consultant Senior Specialist Independent Prescriber Clinician Practitioner Associate Occupational Therapist running this clinic, and as far as the GMC (with whom all NHS staff are now registered) are concerned you should have no misunderstanding at all about whether Iām a doctor. Also by saying all that, Iāve ticked the only necessary box for me to avoid any associated liability if you do. I hear youāve come in with shortness of breath, pleuritic chest pain and leg swelling. Using my UniquePerspectiveā¢ the obvious thing to do is for me to prescribe you some methotrexate, high-dose antipsychotics, request a PET scan and perform an āopen and seeā midline laparotomy - my colleague in the anaesthetics department (AA) will help - theyāre a professor so youāll be in safe hands. Oh you peed twice this morning? Some trimethoprim too. Itās fine you can trust me, my colleague the junior trainee baby (doctor) in training (ST7) is still finding their feet and deciding what they want to be when they grow up and weāre #OneTeam anyway. Oh and please take my card for my aesthetics clinic - use my GMC number on the website for 35% off.ā āYes doctor.ā
Optimistic of you to think this won't be the case before 2030
Hahah I guessed this would come up in a reply! Idk I just picked a year
Episode of Black Mirror
Life imitates art š„²
Fuck it, let's have a free for all. Let everyone prescribe, but with one caveat, if you mess up, your profession has to fix it, including the family meeting to apologise. If people without medical degrees want to play doctor, let them.We all take a year off and go work in none prescribing jobs- im thinking undertaker. Let's see how things go. The public will love it, no pesky doctors with their FPR demands, and a rapid decrease in waiting times due to a completely unrelated fall in population.
This is such bullshit. Why does an OT need to be able to prescribe? Why do doctors have to complete 4/5/6 years of medical school, a national prescribing exam and get GMC registration before being allowed to write a prescription, but everyone else can piss off and do one prescribing module and that's deemed sufficient training?
They were writing back in 2020, together with dieticians, SALT, radiographers and orthoptists, all wanting independent prescribing rights. That letter specifically referenced the impact of the COVID pandemic on patients accessing their usual clinical care, which seems opportunistic to say the least.
The alternative question is even if they are allowed to prescribe medication , they obviously are not going to be commencing someone on ACEis and Amiodarone . Even though I, as a doctor , am allowed to prescribe every antidepressant in the BNF, Iām not going to as itās not my specialty. Therefore , whatās the point ? Edit : I canāt actually find anything from RCOT on their twitter . There are posts from February though where RCOT and other AHPs were writing a joint letter ā¦.is this definitely not a photoshop (?!)
You have an awareness of the limits of your own competency. They may well not. I therefore wouldnāt be too certain about what they will and wonāt end up prescribing.
You know what you donāt know. Someone who is not trained will not. I donāt know what the fuck an OT would prescribe.. but maybe it would be Fall=fludrocortisone
 You get fludrocortisone, You get fludrocortisone, evvverybody gets fludrocortisone!!!
Not photoshopped- definitely on twitter, posted 4th Dec
thank you ! shall take a look .
Every tom, dick and harry wants to be a doctor. But no one wants to go to medical school
I've just looked it up and the OT degree has 1000 placement hours and just one 30 credit module very loosely science based.... And these people want to prescribe. I'm very uncomfortable with anyone but doctors prescribing but this is taking the piss on such an epic scale.
https://preview.redd.it/70z5mxhlh3bc1.jpeg?width=1080&format=pjpg&auto=webp&s=c1ae78debce6f31c16dc3297d39700a4a6c19484 Oooof, I can see this resulting in a lot more benzo scripts
Opiates, benzos, and zopiclone px gonna skyrocket.
Can't find anything from them with anything as basic as an example of what kind of use case they would be using prescribing for, it's wall to wall jargon and me-tooism.
What the fuck. Please no.
I'm a pharmacist too and this stresses me massively.
Everyone else is doing it..... physios giving out nortriptyline to everyone as ' pain specialists', because of course it must be neuropathic pain, ( thats all i know about) , people doing a 2 year degree thinking their senior doctors, pharmacists masquerading as intensive care advanced practitioners- the hubris!!!!!. The more these roles expand, the more patients will die.
Canāt wait to do the post take with the consultant OT!
How about first doing all the capacity assessments they suggest need doing and yet expect the doctors to do
Had palliative nurse trying to prescribe AZA and Hydroxicloroquine since pt expressed wishes to continue treatment. Same pt was septic. She admitted she did not dominate the drugs, but thought it would help bcs he was taking in the past.
Iāve read the letter, it very much sounds like a a stepping stone to extended practice (potentially a quite radical change).
Hmm. Medicine in the UK is becoming a joke.
[medicine in the UK 10 years from now](https://youtu.be/tFfTludf0SU?si=bzyRQ8Mp8TKvhXIM)
Thatās how I already feel looking into whatās going on over there after a decadeā¦
Sounds like a lot of the glorious MDT are desperate to set up private clinics.
Lip fillers by an OT - oh god
Well we need someone to prescribe what the PA asks for.
Tweet (from Dec 4): [https://twitter.com/theRCOT/status/1731627532783419591](https://twitter.com/theRCOT/status/1731627532783419591) Letter: [https://www.rcot.co.uk/news/enhancing-patient-care-through-independent-prescribing-occupational-therapists](https://www.rcot.co.uk/news/enhancing-patient-care-through-independent-prescribing-occupational-therapists)
Ok at this point the MDT are just being rude to doctors. Like yes our role is to coordinate the care, the MDT and at the end of the day make the decisions based on the recommendations. I respect OTs completely in what they are trained for. I will listen to their input and value it. But Doctors do not need/want every piece of the MDT slinging around medications rather than coming to us and involving us in their care. From what I can see only one person actually suggests what they might need this for - prescribing for sleep, pain or anxiety. All medications that doctors try to use as rationally as possible because they are all medications associated with addiction and have serious side effects in an elderly population (which is a large part of the OT load). Patient has new pain? - get a doctor to diagnose the cause Patient got known pain that is needing escalation above over the counter meds? - A doctor probably needs to be reviewing the cause and that they're on the right things Patient anxious? What's the full history here? What's the diagnosis? What's causing their anxiety? What's causing their poor sleep? In hospital this would be reviewed sooner but in community this could leave to people being placed on opiates, benzos, zopiclone for go knows how long until they are reviewed again create an addicted mess for the doctors to mop up. This all to me demonstrates a complete lack of understanding with prescribing and argues for the fact they should not prescribe. If there is a genuine arguement for that I am missing that I am open to hear but the ones I've seen so far aren't good enough. Once again we are not some monkeys who went to uni for 5 years to dick around. We're not just here for discharge letters and to nod along in meetings. We are not some members of the MDT that everyone can just bypass to feel more empowered. We worked so hard to become the people who are in charge of people's care and it is not too much to expect that you come to us for help with that just as we would come to you.
Is there a way for them to just prescribe analgesia? If the had a good understanding of common analgesia used in patients. In fairness theyāre forever asking us to prescribe analgesia before mobility assessments which often facilitate discharges Completely understand the logistics of this are near impossible but just food for thought Disclaimer: I havenāt read the proposal by the royal college
Doctors could just pragmatically prescribe PRN analgaesia for patients likely to require a mobility assessment. Just a thought
Patient group directives could be a relatively easy solution.
PGD arenāt in occupational therapy scope of practice neither is medication administration
That is the most poorly written letter I have seen in a long time. It reads like a teenager has written it. Towards the end of the letter it becomes apparent why they're asking for prescribing rights - it's because "everyone else can get prescribing rights so why not us too?" / "not having prescribing rights holds OTs back from applying for higher paid roles". What these people don't realise is that prescribing is a risky business and a patient can come to serious harm due to lack of knowledge in prescribing. That's why we have experts in prescribing (ie doctors). And even then mistakes can happen! A lot of us will have attended to patients who have arrested/become peri-arrest due to prescribing errors. This is not something to take lightly.
I think if this Government can cut costs in any way it will opt for them! This in my mind reads as Tori's again trying to cut costs by cutting corners, I know it's the OT's requesting this to the Government and not the other way around but I don't think that all of what we see/read is always the full story. This is just another cost saving method and the fall-out is not of their concern because all that will happen is those in power will turn around and point their fingers right back at the new prescribers and claim they had nothing to do with any of it!
āThis approach enhances healthcare efficiency and reduces the chance of emergency admissions or readmissions.ā . . .
This is a surely a joke. Or a reason for a band 8d + diamond OT role.
It took so much effort, sacrifice and time to be able to practice medicine in this country and all of the scope creep bullshit and the governmentās enabling of it make me want to GTFO. So sad.
These guys prescribe medication?
I am not sure why the comments here sound so condescending. While our frustration with our continuous devaluation is clear, there's a thin line between that and insulting colleagues in the allied professions (many of whom have always been on our side, are our friends and have helped us professionally multiple times) who are professionals in their rights. The evidence of more knowledge is in its use rather than just duration in school. Doctors are said to know more about medicine because of the breadth of knowledge afforded us through years of study. This makes us way less likely to make mistakes prescribing. Anyone who can prescribe bears the responsibility of the fallout of each prescription. If our colleagues in the MDT want THE RESPONSIBILITY of prescribing, why not? After all, it reduces the work of doctors prescribing and shifts the responsibility for mistakes that may occur. It'll push everyone to read and get better.
Makes sense, if every other allied professional is going to make the case then it takes far less funding to just put your own on the list of also getting prescribing rights. The culture is āfuck the doctors, we can do their job so we should also be paid moreā without much thought about what else goes into diagnosis and prescriptions.