Parliament backs Bill to allow pharmacists and paramedics to prescribe medication 

A Bill amending the Medical and Health Act 1997 to allow specially trained pharmacists and paramedics to prescribe certain medicines was passed by Parliament on Wednesday. 

The changes aim to improve efficiency and patient care, Parliament heard. 

The Minister for Health, Gemma Arias-Vasquez, said the amendment would replace the term “medical practitioner” in the legislation with “authorised prescriber” to reflect the expanded role of some healthcare professionals.  

“Allowing specially trained pharmacists to prescribe within the GHA will enable us to deliver better clinical care by better utilising workforce skills,” she said.  

“It frees up doctors to focus on more complex cases, whilst pharmacists can handle routine prescriptions and follow ups.” 

“It will help to build greater capacity and capability within the GHA and ease pressures in areas such as primary care and emergency services, including out-of-hours services.” 

Ms Arias-Vasquez said that pharmacists and paramedics would only be able to prescribe medicines from the Gibraltar National Formulary and only within their clinical competence, scope of practice and level of experience.  

She said pharmacists seeking prescribing rights would need to be registered in accordance with the Act, work for the GHA, hold registration with the UK General Pharmaceutical Council and have an annotation on the register confirming they are qualified as independent prescribers.  

Similar provisions would apply to paramedics, who would need the relevant annotation from the UK Health and Care Professions Council.  

GSD MP Joelle Ladislaus, speaking for the Opposition, said the amendments would provide statutory recognition, protection and clarity for professionals who had undertaken further training to prescribe medication.  

She said the changes should enhance accountability and help reduce the workload on medical practitioners, and confirmed that the Opposition supported the Bill in principle.  

Ms Ladislaus, however, questioned why other professional groups identified in equivalent UK regulations, including podiatrists, physiotherapists and therapeutic radiographers, had not been included. She asked whether the scope of the legislation could be widened in future.  

Keith Azopardi, the Leader of the Opposition, asked how paramedic prescribing would work in practice and what form of regulation would apply.  

He said he was unclear in what circumstances a paramedic would need to prescribe medication, given that patients attended by ambulance staff would often then be taken to hospital and seen by a doctor.  

GSD MP Craig Sacarello asked how risks would be mitigated if pharmacists were able to prescribe, particularly in cases involving over-prescribing or combinations of medicines, and whether pharmacists would have access to a patient’s full medical history.  

Ms Arias-Vasquez said the Government had taken a policy decision to limit the reform at this stage to pharmacists and paramedics after advice from senior primary care practitioners.  

She said the roles these professionals would play had already been identified and that the gradual approach was intended to safeguard patients.  

She said pharmacists would have access to the full patient history and could help identify over-prescribing.  

On paramedics, she said there were cases where patients could be treated at home and prescribed certain medicines without an unnecessary trip to Accident and Emergency, provided this was done in limited circumstances and with clinical support where needed.  

Ms Arias-Vasquez also said regulation would come through the relevant professional bodies, as well as Gibraltar’s own Medical Registration Board and Public Health, with further regulations to set out the powers and limits of prescribing.