The Road to Independent Prescribing

The Road to Independent Prescribing for Optometrists

Since the first recognition via the Medicines Act in 1968 that UK-based optometrists could be generally involved in the use of medicines, legislation has changed on a number of occasions. Prior to 1999, optometrists had access to a range of diagnostic and therapeutic medicines, specified in Level 1 or 'entry level' exemptions to the Medicines Act. This allowed all registered optometrists, without further training, access to some prescription-only medicines (POM).

Dr June Crown’s Review of Prescribing, Supply and Administration of Medicines (1999) resulted in her recommendation that general prescribing should be extended to certain non-medical professionals, including optometrists. In 2000, the NHS plan endorsed this recommendation on the understanding that it would provide patients with quicker and more efficient access to medicines, as well as making better use of the skills of health professionals.

This has resulted in an increased range of medicines available to optometrists through further exemptions from the 1968 Medicines Act. To gain access to a wider range of POMs and set up prescribing partnerships with Independent Prescribers, two further levels of exemptions were established, both of which require additional training and qualifications. Since July 2005, optometrists on the Additional Supply (AS) or Supplementary Prescribing (SP) register can supply and administer additional medicines which will allow them to manage a number of common non-sight threatening disorders (AS) or prescribe them in partnership with a medical practitioner (SP).

In August 2006, The Medicine and Healthcare Products Regulatory Agency and the Department of Heath jointly consulted on the proposal to introduce independent prescribing (IP) for optometrists. Rather than linking it to an approved formulary, as has been the case for entry-level and AS prescribing, in June 2007 the Commission for Human Medicines proposed to restrict the scope of optometrist independent prescribing by reference to the competence of the individual prescribing optometrist. The same reference to competence is now taken with regard to Nurse and Pharmacist Independent Prescribing.

The Department of Health and the General Optical Council have since worked to achieve the legislative changes necessary to implement Independent Prescribing for optometrists. Changes to the POM Order came into effect on 4th June 2008 and amendments to the GOC Registration Rules followed.

Registrants who wish to become independent prescribers are required to complete further GOC-approved training and apply for entry of their specialty in the register. Once trained they will have to keep their skills up to date, audit their activity and comply with the additional CET requirement for specialists. The legislation allows optometrists to prescribe any licensed medicine for ocular conditions affecting the eye and the tissues surrounding the eye. In practice, however, IP optometrists will only work with conditions within their area of recognised competence.

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