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ACMD opinion on the proposed provision of interim podiatrists from NHS England (accessible version)

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From: ACMD President: Prof. Owen Bowden-Jones
ACMD Secretary: Zahi Sulaiman

1st floor (NE), Peel Building

2 Marsham Street

London

SW1P 4DF

[email protected]

To: Kit Malthouse MP
Minister of State for Crime Reduction and Policing

2 Marsham Street

London

SW1P 4DF

June 14, 2022

Dear Minister

SUBJECT: ACMD advice on NHS-England’s interim proposal to allow podiatrists to provide co-codamol, co-dydramol and codeine phosphate

The Advisory Council on Misuse of Drugs (ACMD) has considered an interim proposal from NHS-England that would allow advanced clinical podiatrists to continue to provide co-codamol (8/500, 15/500 and 30/500), co – dydramol 10/500 and codeine phosphate.

The Misuse of Drugs Regulations 2001 were not amended when the Human Medicines Regulations (HMR) were created in 2012, resulting in an anomaly with respect to the supply of codeine products by podiatrists, where co-codamol, co-dydramol and codeine phosphate are included. on the HMR exemption list and podiatrists continue to provide these drugs through exemptions.

This interim proposal completes the legislative framework for co-codamol, co-dydramol and codeine phosphate products to continue to be supplied under the RMH exemption mechanism. A separate, longer-term future proposal will require further amendments to the Misuse of Drugs Regulations to allow independent prescribing of these drugs by podiatrists.

The Royal College of Podiatry has confirmed to NHS-England that it is not aware of any supply problems with these medicines reported by its members regarding the use of the above medicines in surgical practice.

  • Recommendation: Given that there is potential for abuse with long-term use of co-codamol, codeine phosphate and co-dydramol products, the ACMD supports the restriction of the duration of supply to the using the proposed interim mechanism to a maximum of three days, as recommended by the current Royal Councils of the College of Podiatry. [footnote 1]
  • Target audience: Home Office and DHSC
  • Implementation Measure: Amendment to the Misuse of Drugs Regulations 2001
  • Recommendation: The ACMD Technical Committee will review the longer-term proposal in its entirety following the results of a public consultation conducted by NHS-England, for the addition of co-codamol, co- dydramol and codeine phosphate to the list of controlled drugs that podiatrists can prescribe under the Misuse of Drugs Regulations 2001.
  • Target audience: Home Office and DHSC
  • Implementation Measure: Future Amendment to the Misuse of Drugs Regulations 2001

Cordially,

Professor Owen Bowden-Jones, ACMD President
Professor Roger Knaggs, Chairman of the ACMD Technical Committee