MEDICINES Citation, commencement and interpretation 1 1 This Order may be cited as the Medicines for Human Use (Prescribing) (Miscellaneous Amendments) Order 2006 and shall come into force on 1st May 2006. 2 In this Order— “the POM Order ” means the Prescription Only Medicines (Human Use) Order 1997 ; and “the Pharmacy and General Sale Order ” means the Medicines (Pharmacy and General Sale—Exemption) Order 1980 . Amendment of article 1 of the POM Order 2 In article 1 of the POM Order (citation, commencement and interpretation), in paragraph (2)— a after the definition of “Community marketing authorization” insert the following definition— “community practitioner nurse prescriber” means a person— who is a registered nurse or a registered midwife, and against whose name is recorded in the professional register an annotation signifying that he is qualified to order drugs, medicines and appliances from the Nurse Prescribers' Formulary for Community Practitioners in the current edition of the British National Formulary; ; b omit the definition of “district nurse/health visitor prescriber”; c omit the definition of “Extended Formulary”; d omit the definition of “extended formulary nurse prescriber”; e omit the definition of “first level nurse”; f in the definition of “health prescription”, for “a district nurse/health visitor prescriber or an extended formulary nurse prescriber” substitute “a community practitioner nurse prescriber, a nurse independent prescriber or a pharmacist independent prescriber”; g after the definition of “ NHS trust” insert the following definition— “nurse independent prescriber” means a person— who is a registered nurse or a registered midwife, and against whose name is recorded in the professional register an annotation signifying that he is qualified to order drugs, medicines and appliances as a nurse independent prescriber or a nurse independent/supplementary prescriber; ; h after the definition of “Patient Group Direction” insert the following definition— “pharmacist independent prescriber” means a person— who is a pharmacist, and against whose name is recorded in the relevant register an annotation signifying that he is qualified to order drugs, medicines and appliances as a pharmacist independent prescriber; ; i in the definition of “registered nurse”, after “Part” insert “or Specialist Community Public Health Nurses' Part”; j in the definition of “relevant register”, in paragraph (a), for “first level” substitute “registered”; and k in the definition of “supplementary prescriber”— i in paragraph (a), for “first level” substitute “registered”, and ii after “a supplementary prescriber” insert “or, in the case of a nurse or midwife, as a nurse independent/supplementary prescriber”. Amendment of article 2 of the POM Order 3 In article 2 of the POM Order (appropriate practitioners)— a in paragraph (b), for “district nurse/health visitor prescribers” substitute “community practitioner nurse prescribers”; b for paragraph (c) substitute the following paragraphs— c in relation to the descriptions and classes of medicinal products specified in article 3A(1), nurse independent prescribers; and d in relation to the descriptions and classes of medicinal products specified in article 3, other than medicinal products that are controlled drugs, pharmacist independent prescribers. . Amendment of article 3A of the POM Order 4 For article 3A of the POM Order (prescribing by extended formulary nurse prescribers) substitute the following article— Prescribing and administration by nurse independent prescribers 3A 1 Subject to paragraphs (2) and (3), the descriptions and classes of medicinal products in relation to which nurse independent prescribers are appropriate practitioners are— a prescription only medicines that are not controlled drugs; and b prescription only medicines that are controlled drugs and which consist of, or contain, one or more of the substances specified in column 1 of Schedule 3A, but which do not contain any other substance or combination of substances which is a controlled drug not included in Schedule 3A. 2 A nurse independent prescriber may— a give a prescription for a medicinal product referred to in paragraph (1)(b); or b if that medicinal product is for parenteral administration— i administer that medicinal product, or ii give directions for the administration of that medicinal product, only where he complies with any condition as to the cases or circumstances in which he may do so that is specified in paragraph (3). 3 If the entry in column 2 of Schedule 3A relating to a substance specifies one or more requirements as to use or route of administration, it is a condition for the purposes of paragraph (2) that a medicinal product which consists of, or contains, that substance is administered, or is prescribed or directed for administration, in accordance with the specified requirements. 4 A nurse independent prescriber may prescribe or administer a medicinal product referred to in paragraph (1)(b), or give directions for administration of such a product, without complying with any condition specified in paragraph (3) if— a he is a supplementary prescriber; and b he complies with the applicable conditions set out in article 3B(3). Amendment of article 3B of the POM Order 5 In article 3B of the POM Order (prescribing and administration by supplementary prescribers) , in paragraph (2)— a in sub-paragraph (a), for “district nurse/health visitor prescriber” substitute “community practitioner nurse prescriber”; b in sub-paragraph (b)— i for “an extended formulary nurse prescriber” substitute “a nurse independent prescriber”, and ii in head (ii), after “3A(3)” insert “; and”; and c after sub-paragraph (b), insert the following sub-paragraph— c the supplementary prescriber is a pharmacist independent prescriber and the medicinal product prescribed or administered, or in respect of which he gives directions for administration— i is a prescription only medicine, and ii is not a controlled drug. . Amendment of article 3C of the POM Order 6 In article 3C of the POM Order (exemptions from conditions in respect of the cases or circumstances in which an extended formulary nurse prescriber or supplementary prescriber may administer a medicinal product) — a in the heading, for the words “an extended formulary nurse prescriber” substitute “a nurse independent prescriber”; and b for “an extended formulary nurse prescriber” substitute “a nurse independent prescriber”. Amendment of article 8 of the POM Order 7 In article 8 of the POM Order (exemptions for emergency sale or supply)— a in paragraph (2)— i in sub-paragraph (a), for “a district nurse/health visitor prescriber or an extended formulary nurse prescriber” substitute “a community practitioner nurse prescriber, a nurse independent prescriber or a pharmacist independent prescriber”, ii in sub-paragraph (b), for “district nurse/health visitor prescriber or extended formulary nurse prescriber” substitute “community practitioner nurse prescriber, nurse independent prescriber or pharmacist independent prescriber”, and iii in sub-paragraph (c), for “district nurse/health visitor prescriber or extended formulary nurse prescriber” substitute “community practitioner nurse prescriber, nurse independent prescriber or pharmacist independent prescriber”; and b in paragraph (4), in sub-paragraph (a), in head (ii), for “district nurse/health visitor prescriber or extended formulary nurse prescriber” substitute “community practitioner nurse prescriber, nurse independent prescriber or pharmacist independent prescriber”. Amendment of article 10 of the POM Order 8 In article 10 of the POM Order (exemption for medicinal products at high dilutions), in paragraph (1), for “or 2” substitute “or in Schedule 2”. Amendment of article 12 of the POM Order 9 In article 12 of the POM Order (exemption for sale and supply in hospitals), in paragraph (3), for “an extended formulary nurse prescriber” substitute “a nurse independent prescriber”. Amendment of article 13A of the POM Order 10 In article 13A of the POM Order (exemptions relating to prescriptions given by nurses) — a in the heading, for “nurses” substitute “certain health professionals”; and b in paragraph (2)— i for “an extended formulary nurse prescriber” substitute “a nurse independent prescriber”, and ii for “the extended formulary nurse prescriber” substitute “the nurse independent prescriber”. Amendment of article 15 of the POM Order 11 In article 15 of the POM Order (prescriptions), in paragraph (2), in sub-paragraph (c)— a in head (iii), for “a district nurse/health visitor prescriber, an extended formulary nurse prescriber” substitute “a community practitioner nurse prescriber, a nurse independent prescriber, a pharmacist independent prescriber”; and b in head (iv), for “a district nurse/health visitor prescriber, or an extended formulary nurse prescriber” substitute “a community practitioner nurse prescriber, a nurse independent prescriber or a pharmacist independent prescriber”. Substitution of Schedule 2 to the POM Order 12 For Schedule 2 to the POM Order , substitute the following Schedule— SCHEDULE 2 SUBSTANCES WHICH MAY BE EXCLUDED FROM THE CLASS OF PRESCRIPTION ONLY MEDICINES AT HIGH DILUTION Article 10(1) Codeine and its salts Dihydrocodeine and its salts Ethylmorphine and its salts Morphine and its salts Medicinal Opium Pholcodine and its salts . Amendment of Schedule 3 to the POM Order 13 In Schedule 3 to the POM Order (descriptions and classes of prescription only medicines in relation to which appropriate nurse practitioners are appropriate practitioners), in the heading, for “appropriate nurse practitioners” substitute “community practitioner nurse prescribers”. Substitution of Schedule 3A to the POM Order 14 For Schedule 3A to the POM Order (substances which may be prescribed, administered or directed for administration by extended formulary nurse prescribers and conditions for such prescription or administration) , substitute the following Schedule— SCHEDULE 3A CONTROLLED DRUGS WHICH MAY BE PRESCRIBED, ADMINISTERED OR DIRECTED FOR ADMINISTRATION BY NURSE INDEPENDENT PRESCRIBERS AND CONDITIONS FOR SUCH PRESCRIPTION OR ADMINISTRATION Article 3A Column 1 Column 2 Substance Requirements as to use or route of administration Buprenorphine Transdermal administration in palliative care Chlordiazepoxide hydrochloride Oral administration Codeine Phosphate Oral administration Co-Phenotrope Oral administration Diamorphine hydrochloride Oral or parenteral administration Diazepam Oral, parenteral or rectal administration Dihydrocodeine Tartrate Oral administration Fentanyl Transdermal administration in palliative care Lorazepam Oral or parenteral administration Midazolam Parenteral or buccal administration Morphine sulphate Oral, parenteral or rectal administration Morphine hydrochloride Rectal administration Oxycodone hydrochloride Oral or parenteral administration in palliative care . Amendment of the Pharmacy and General Sale Order 15 1 The Pharmacy and General Sale Order shall be amended as follows. 2 In article 1 (citation, commencement and interpretation), in paragraph (2)— a omit the definition of “first level nurse”; b in the definition of “nurse prescriber”— i in paragraph (a), for “first level” substitute “registered”, and ii in paragraph (b), after “appliances” insert “as a community practitioner nurse prescriber, a nurse independent prescriber or a nurse independent/supplementary prescriber”; c after the definition of “Patient Group Direction” insert the following definition— “pharmacist independent prescriber” means a person— who is a pharmacist, and against whose name is recorded in the relevant register an annotation signifying that he is qualified to order drugs, medicines and appliances as a pharmacist independent prescriber; ; d after the definition of “registered homeopathic medicinal product for human use” insert the following definitions— “registered midwife” means a person registered in the Midwives' Part of the professional register; “registered nurse” means a person registered in the Nurses' Part or Specialist Community Public Health Nurses' Part of the professional register; ; e in the definition of “relevant register”, in paragraph (a), for “first level” substitute “registered”; and f in the definition of “supplementary prescriber”— i in paragraph (a), for “first level” substitute “registered”, and ii after “a supplementary prescriber” insert “or, in the case of a nurse or midwife, as a nurse independent/supplementary prescriber”. 3 In article 4AA (exemption for sale, offer for sale or supply in hospitals and health centres), after “supplementary prescriber” insert “, a pharmacist independent prescriber”. 4 In Schedule 3, in Part III (classes of individual by whom supplies may be made), omit “Registered health visitors.”. Signed by authority of the Secretary of State for Health Jane Kennedy Minister of State, Department of Health 23rd March 2006 Sealed with the Official Seal of the Department of Health, Social Services and Public Safety Andrew McCormick Permanent Secretary, Department of Health, Social Services and Public Safety 16th March 2006