Local anaesthetic prescribing changes for hygienists and therapists

Local anaesthetic prescribing changes for hygienists and therapists

The General Dental Council (GDC) is highlighting changes in the law concerning the prescription of local anaesthetics.

Legislation came into force on 1 June 2010 and dental hygienists and therapists can now perform the following functions in certain circumstances:

• The administration of local anaesthetics;

• The sale, supply or oral administration of fluoride supplements and toothpastes with high fluoride content.

An injection of local anaesthetic involves the use of a prescription-only medicine (POM) which means that, under the Medicines Act 1968 it can only be prescribed by a suitably qualified prescriber - traditionally a doctor or a dentist. Legislation was introduced throughout the UK in 2000 to allow certain other healthcare professionals to administer POMs in specific circumstances. This can happen in two ways:

• Via a Patient Group Direction (PGD)

(This is a legal framework that allows a listed group of healthcare professionals to administer medicines to a group of patients, without the need for a written patient-specific prescription or instruction from the approved prescriber).

OR

• An approved prescriber may provide a documented, patient specific direction or PSD (a written instruction) which allows the healthcare professional to administer a POM to a specific patient.

However, in 2008 it became apparent that dental hygienists and therapists had been missed off the list of healthcare professionals able to administer medicines via a PGD when the Department of Health had drafted the legislation. This meant they could only administer local anaesthetic and fluoride varnish to patients on the basis of a PSD.

The GDC immediately publicised the problem and issued a statement to registrants informing them that, until the law could be amended, hygienists and therapists should only give local anaesthesia to patients if it had been specifically prescribed by a dentist.

The Medicines and Healthcare products Regulatory Agency (MHRA) has now added dental hygienists and therapists to the group of healthcare professionals who are able to prescribe local anaesthetic under a patient group direction.

Unfortunately it is not currently possible to set up a PGD for private dental treatment, which means that PSDs are still required in these circumstances.  The Department of Health are working on an amendment to their regulations for PGDs to allow their use in private dental treatment, and the GDC will share developments as they are announced.

Alison Lockyer, Chair of the General Dental Council said:

“We are pleased that this change has been made, it addresses an anomaly in the legislation which we had identified. The change will enable more effective working by the dental team.”

Keddie Kelsall is a dental therapist and member of the GDC’s Fitness to Practise panel. She said:

“I am delighted that this situation has now been resolved. It allows dental hygienists and therapists to carry out their roles more effectively and will help to give patients confidence in their dental professionals.”

For more information please visit the Medicines and Healthcare products Regulatory Agency (MHRA) website or contact the Department of Health on 0207 210 4850.

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