Evaluation of physiotherapy, podiatrist independent prescribing, mixing of medicine and prescribing of controlled drugs
The aim is to evaluate the effectiveness and efficiency of independent prescribing by physiotherapists and podiatrists (PPs). The study will compare services provided by physiotherapists and podiatrists who are qualified to independently prescribe to those provided by physiotherapists and podiatrists who are not qualified to prescribe. This will help determine whether there are any differences in the quality of care or cost of services. We will ask PPs their views, what training they have had, what makes their job difficult and seek views of other professionals working in the same setting. Patients will also be asked what they think.
Plan of investigation
This study will be conducted in three phases. Phase 1 will comprise of a literature review, to understand the different ways that physiotherapists and podiatrists use prescribing in practice. Phase 2 will be an analysis of key documents and survey of trainee PP independent prescribers. The survey will explore how and where physiotherapist and podiatrist independent prescribing is being put into action. Phase 3 will comprise a comparative case study of 6 sites where physiotherapists or podiatrists use independent prescribing and 6 non-prescribing PP sites. Case studies will be from different hospital or community based clinics around England.
Integrative literature review has been completed and currently under review for publication.
Data collection for the longitudinal online-survey, exploring trainee PP-IPs views and experiences regarding implementation of PP-IP, and educational preparation for training is now complete. The survey had two data-collection points; enrolment and end of IP course and closed at the end of March 2016. 85 people responded to the first questionnaire, and 40 people responded to questionnaire 2.
Information was collected on:
- Intended practice areas
- Service provision and care organisation
- Organisational preparedness
- Barriers/facilitators for PP-IP
- Educational preparation.
Documentary evidence - Case study sites were asked to provide relevant documents relating to service specification, organisational support and resources. Data collection closed for this phase of the project at the end of April 2016.
Fourteen case sites were recruited to the project from Berkshire, Dorset, Sussex, Surrey, South London, Kent, Hampshire, Middlesex and Lancashire and County Durham. The roles of the practitioners collaborating in the study varied widely, including community physiotherapists, diabetic podiatrists and those operating in private practice. Data collection at all 14 sites (6 podiatrists and 8 physiotherapists) is now complete. 488 participants were recruited, out of which 314 completed questionnaires (67.1% response rate), and 195 subsequently completed the telephone/email follow-up questionnaire (68.4% response rate).
Nicola is a Reader and lead for the Long Term Conditions and Ageing Cluster within the School of Health Sciences. Nicola is a qualified nurse who has worked in a variety of posts across the country in primary care as both a practice nurse and nurse practitioner. She also spent two years in the United States whilst undertaking her Master's in Public Health in community health education and was involved in several national and state level projects including the Youth Risk Behaviour Survey. Her research interests include quality improvement, workforce development, non-medical prescribing and patient self-management. She has significant experience in the conduct and management of multi-site studies and mixed methods research.
She has also previously worked as a member of the HTA pharmaceutical panel and the NIHR grant awarding body Research for Patients Benefit (RfPB) and is Vice-Chair for the Association of Prescribers.
Karen is a lecturer in the School of Health Sciences with extensive experience in health services research. Her research interests include the evaluation of extended roles in medicines optimisation and non-medical prescribing. She has published widely on the impact and implementation of prescribing by nurses and other healthcare professionals, with a focus on long-term conditions. Current interests include the expansion of prescribing rights to allied health professions and the impact of delegation of medicines administration to non-registered healthcare workers. She is experienced in multi-site studies and mixed method approaches. She is a member of the University of Surrey ethics Committee.
University of Surrey researchers
A project dissemination event was held in London in July 2017.
Study findings have also been presented at:
- Association for Prescribers Annual Conference, London, 9 November 2017
- 8th Non-Medical Prescribing Conference, Weston Super-Mare, 27 June 2017
- Allied Health Professions Medicines Mechanisms Seminar, AHP Medicines Project, NHS England, The Place Aparthotel, Manchester, 23 February 2017
- College of Podiatry Conference 2016, SEC, Glasgow, 17-19 November 2016
- IFOMPT (International Federation of Manipulative Physiotherapists) Conference 2016, SEC, Glasgow, 4-8 July 2016.
Research team articles
Carey N, Stenner K, Courtenay M. (2014) 'An exploration of how nurse prescribing is being used for patients with respiratory conditions across the east of England.'. BMC Health Serv Res, England: 14 (1)
Carey N, Courtenay M, Stenner K. (2013) 'The prescribing practices of nurses who care for patients with skin conditions: a questionnaire survey.'. Wiley J Clin Nurs, England: 22 (13-14), pp. 2064-2076.
Stenner K, Carey N, Courtenay M. (2012) 'Prescribing for pain - how do nurses contribute? A national questionnaire survey'. Journal of Clinical Nursing, 21 (23-24), pp. 3335-3345.
Stenner K, Carey N, Courtenay M. (2012) 'Prescribing for pain - how do nurses contribute? A national questionnaire survey.'. J Clin Nurs,
Courtenay M, Carey N, Stenner K. (2012) 'An overiew of non medical prescribing across one strategic health authority: a questionnaire survey.'. BMC Health Serv Res, England: 12
Read the full text. Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP) has been implemented within organisations across a strategic health authority (SHA). The aim of the study was to provide an overview of NMP across one SHA.
Carey N, Stenner K. (2011) 'Does non-medical prescribing make a difference to patients?'. Nurs Times, England: 107 (26), pp. 14-16.
Stenner KL, Courtenay M, Carey N. (2011) 'Consultations between nurse prescribers and patients with diabetes in primary care: A qualitative study of patient views'. Elsevier International Journal of Nursing Studies, 48 (1), pp. 37-46. doi:10.1016/j.ijnurstu.2010.06.006. Read the full text.
Research information sheets
- Parent information Sheet (PDF)
- Patient information Sheet (PDF)
- Physiotherapy patient information sheet - child 7 - 12 (PDF)
- Podiatrist patient information sheet - child 7 - 12 (PDF)