Supply of medicines to podiatrists and their patients quick reference guide
Produced in association with:
Why is this guidance important to you?
Podiatrists (also know as chiropodists) can obtain some medicines from a registered pharmacy for onward sale, supply or administration to patients in the course of their professional practice.
Selected medicines can also be supplied directly to patients by the pharmacy upon receipt of a signed order written by a podiatrist.
What this guidance will tell you
This guidance provides information on the medicines that can be supplied to a podiatrist and their patients. It also explains how to check the registration of a podiatrist.
- Registered podiatrist »
- Other annotations »
- Supply of medicines »
- Which medicines can be supplied to the podiatrist »
- Supplying directly to a patient on a signed order from a podiatrist »
- Signed order requirements »
- How much can I supply? »
- Table 1 - list of POMs that can be supplied to a podiatrist and directly to a patient via a signed order written by a podiatrist with the appropriate annotation (POM) »
- Table 2 - list of GSL and P medicines that can be supplied by all registered podiatrists »
- Table 3 - list of medicines that registered podiatrists who can adminster with the appropriate annotation (LA) »
- References and further information »
You can check the podiatrist is registered on the Health Professional Council (HPC) register online at http://www.hcpc-uk.org/check or call 0845 300 6184.
In order for you to legally make the supply, the podiatrist needs to be registered and have the appropriate annotation on the register.
Prescription Only Medicines (POM)
- The (POM) annotation means the podiatrist is qualified to sell, supply or administer selected POMs (see table 1). Pharmacists can sell or supply these to podiatrists and directly to a patient via a signed order.
Local anaesthetics (LA)
- The (LA) annotation means the podiatrist is qualified to administer certain prescription only medicines including a range of local anaesthetics and adrenaline as part of their professional practice. (see table 3)
Supplementary prescriber (SP)
- The (SP) annotation means the podiatrist is able to prescribe medicines to patients as part of a ‘clinical management plan’. This is a plan agreed between the supplementary prescriber and, a doctor and the patient.
Independent Prescriber (IP)
- The (IP) annotation means the podiatrist is able to prescribe any medicine (not including Controlled Drugs) within their scope of practice and legislation. Podiatrists (IPs) can also prescribe the following Controlled Drugs for organic disease, however, they are unable to posses or supply: (see Home office circular)
- Lorazepam (oral)
- Diazepam (oral)
- Dihydrocodeine (oral)
Registered podiatrists with annotation ‘Prescription Only Medicines (POM)’ are able to write a signed order which allows pharmacists to supply selected POMs (table 1) directly to the patient. The medicine requested must be a medicine that can be legally sold or supplied by the podiatrist rather than on which the podiatrist can only adminster. This supply against a signed order allows for increased flexibility and improved access.
- Date the POM was supplied
- Name, quantity and, where it is not apparent, formulation and strength of the POM supplied
- Name and address, trade, business or profession of the person to whom the medicine was supplied
- The purpose for which it was sold or supplied
It is important to remember that a signed order is not a prescription, therefore the usual prescription requirements would not be needed. However, you should be satisfied the podiatrist has provided sufficient advice to enable the patient to use the medicine safely and effectively. We would recommend as good practice that you label the medicine with a dispensing label, provide a patient information leaflet and counsel appropriatley.
The sale or supply should be recorded in the POM register.
In order to minimise the risk of overuse and addiction, the RPS and the College of Podiatry recommends pharmacists to supply podiatrists the closest pack sizes commercially available to a maximum of three days treatment. For example, if the podiatrist requests 100 co-codamol tablets and the smallest pack size available at the time of request is 32, the pharmacist should supply 3 packs of 32. N.B. Only whole packs in original manufacturers containers can be supplied.
For supplies made directly to the patient from a signed order the closest commercially available pack for three days treatment should be supplied. Pharmacists can advise the podiatrist on appropriate pack sizes.
- Amorolfine hydrochloride cream where the maximum strength of the Amorolfine in the cream does not exceed 0.25 per cent by weight in weight,
- Amorolfine hydrochloride lacquer where the maximum strength of Amorolfine in lacquer does not exceed 5 per cent by weight in volume,
- Co-dydramol 10/500 tablets,
- Codeine Phosphate,
- Silver Sulfadiazine,
- Tioconazole 28%,
- Topical hydrocortisone where the maximum strength of hydrocortisone in the medicinal product does not exceed 1 per cent by weight in weight.
- Registered podiatrists can sell, supply and GSL medicine which is for external use
- Potassium permanga-nate crystals or solution;
- ointment of heparinoid and hyaluronidase; and
- products containing, as their only active ingredients, any of the following substances, at a strength, in the case of each substance, not exceeding that specified in relation to that substance
- 9.0 per cent Borotannic complex
- 10.0 per cent Buclosamide
- 3.0 per cent Chlorquinaldol
- 1.0 per cent Clotrimazole
- 10.0 per cent Crotamiton
- 5.0 per cent Diamthazole hydrochloride
- 1.0 per cent Econazole nitrate
- 1.0 per cent Fenticlor
- 10.0 per cent Glutaraldehyde
- 1.0 per cent Griseofulvin
- 0.4 per cent Hydrargaphen
- 2.0 per cent Mepyramine maleate
- 2.0 per cent Miconazole nitrate
- 2.0 per cent Phenoxypropan-2-ol
- 20.0 per cent Podophyllum resin
- 10.0 per cent Polynoxylin
- 70.0 per cent Pyrogallol
- 70.0 per cent Salicylic acid
- 1.0 per cent Terbinafine
- 0.1 per cent Thiomersal.
- Bupivacaine hydrochloride,
- Bupivacaine hydrochloride with adrenaline where the maximum strength of adrenaline does not exceed 1 mg in 200 ml of bupivacaine hydrochloride,
- Levobupivacaine hydrochloride,
- Lidocaine hydrochloride,
- Lidocaine hydrochloride with adrenaline where the maximum strength of adrenaline does not exceed 1 mg in 200 ml of lignocaine hydrochloride,
- Mepivacaine hydrochloride,
- Prilocaine hydrochloride,
- Ropivacaine hydrochloride.