Use of non-parenteral prescription only medications by non-registered ambulance staff
Dear North West Ambulance Service NHS Trust,
Please could you supply any information you have regarding the trust's policy on non-registered staff (eg. ambulance technicians) using non-parenteral Prescription only medications such as salbutamol?
Does the trust have a legal framework or policy that describes the legal mechanism for this under the Human medicines regulations 2012?
Has there ever been any feedback given or action taken by the MHRA or CQC in relation to use of salbutamol or ipratropium bromide by ambulance technicians?
If the trust has a medicines policy or medicines governance policy, please could you share this?
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Dear D Wilson
Please see below information in response to your recent Freedom of
Please could you supply any information you have regarding the trust's
policy on non-registered staff (eg. ambulance technicians) using
non-parenteral Prescription only medications such as salbutamol?
There is no current provision in law for emergency medical technicians to
make a decision to treat a person with non-parenteral prescription only
medicines. However, this practice is considered necessary for the urgent
and timely treatment of people using ambulance services. The trust
provides assurance on the delivery of safe and effective care through
considering the risks and having governance arrangements to mitigate and
manage this risk.
This includes the provision of scope of practice, clinical guidelines,
education and training and audit of use.
This practice is restricted to the use of salbutamol nebules only and only
in the absence of paramedics on scene.
Does the trust have a legal framework or policy that describes the legal
mechanism for this under the Human medicines regulations 2012?
As above, there is no current provision in law. A review has been
Has there ever been any feedback given or action taken by the MHRA or CQC
in relation to use of salbutamol or ipratropium bromide by ambulance
There was a verbal discussion during a CQC inspection in 2020, followed
up with evidence by the trust of the governance process in place. The CQC
report (published in June 2020) stated:
Ambulance technicians treated patients with non-injected prescription-only
medicines. Although current legislation does not support this, the service
assessed and managed the risk, trained staff and assessed them as
competent. This ensured patients had timely access to safe and effective
If the trust has a medicines policy or medicines governance policy, please
could you share this?
At this time the policy is under review.
Communications Manager (interim)
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