Supply of medicines to  podiatrists and their patients quick reference guide

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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

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.

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Other annotations

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)

    • Temazepam(oral)
    • Lorazepam (oral)
    • Diazepam (oral)
    • Dihydrocodeine (oral)

Supply of medicines

The MHRA have published a statement of guidance to enable small quantities of medicines to be supplied on an occasional basis to meet patients needs. (see full MHRA statement.)

Which medicines can be supplied to the Podiatrist?

Selected POMs (table 1), selected Ps and all GSLs (table 2) can be supplied to a podiatrist from a registered pharmacy for them to sell/supply or adminster to their patients.

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Supplying directly to a patient on a signed order from a podiatrist

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 one which the podiatrist can only adminster. This supply against a signed order allows for increased flexibility and improved access.

Signed order requirements

  • Signed by a podiatrist
  • Medicine requested is listed in table 1
Also recommended:
  • Date the order was written
  • Podiatrist details
  • Patient details
  • Purpose of order

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.

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Limitations on supply

The RPS and the College of Podiatry believe that there is a need to minimise the risk of over-use and addiction from analgesics containing codeine and dihydrocideine.
For supplies direct to patients on a signed order from a podiatrist, the closest commercial pack size available for a maximum of 3 days treatment should be supplied (i.e. one pack)
For supplies from the pharmacy to the podiatrist, the quantity should be made up from multiples of the commercial packs available so that the podiatrist can supply these to a patient. (i.e. if 100 requested, and 32 is the commercial pack size,  3 packs of 32 are supplied)

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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)

  • 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,
  • Amoxicillin,
  • Co-Codamol,
  • Co-dydramol 10/500 tablets,
  • Codeine Phosphate,
  • Erythromycin,
  • Flucloxacillin,
  • 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.
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Table 2 - list of GSL and P medicines that can be supplied by all registered podiatrists

All registered podiatrists can sell, supply any GSL medicine. External GSL medicines can only be supplied during the course of a podiatrist's professional practice.

  • Potassium permanganate 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.
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Table 3 - list of medicines that registered podiatrists who can adminster with the appropriate annotation (LA)

  • Adrenaline,
  • 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,
  • Methylprednisolone,
  • Prilocaine hydrochloride,
  • Ropivacaine hydrochloride.
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