Urgent Safety Notice: Platelet Rich Plasma

Urgent safety notice – unrestricted please share.

The Medicines and Healthcare Agency is urgently reviewing the status of Platelet Rich Plasma prepared and injected at point of care. This now has been given provisional status as an unlicensed human medicine. Podiatrists, including podiatrist independent prescribers may NOT prepare and administer this WITH IMMEDIATE EFFECT unless or until the MHRA advise otherwise at some time. Podiatrist supplementary prescribers would be permitted to within a named patient clinical management plan that was agreed with a medical doctor only (not another type of prescriber). Insurance will retrospectively cover past treatments but from date of this urgent notice insurance cover for this procedure is suspended. Similar notices are being circulated by other podiatry and physiotherapy professional bodies. Issued and in effect from Friday 9th June 2023.

Martin Harvey, Director of Education IOCP

Joint statement agreed by NHS England, the Health & Care Professions Council, the Institute of Chiropodists and Podiatrists, the College of Podiatry, and the Chartered Society of Physiotherapy:

From 00:00am on 1st April 2019, gabapentin and pregabalin will be reclassified as Schedule 3 controlled drugs, under the Misuse of Drugs Regulations (2001), and Class C of the Misuse of Drugs Act (1971), as is already the case with Tramadol.

Their reclassification follows a Government consultation and recommendations from the Advisory Council on the Misuse of Drugs that additional safeguards be put in place as a result of concerns around the misuse of these drugs.

Until 1st April 2019, physiotherapist and podiatrist independent prescribers registered with the Health and Care Professions Council may continue to prescribe gabapentin and pregabalin.

After this date, they will no longer be able to independently prescribe these medicines and must use supplementary prescribing for new or existing patients. This must be in partnership with an independent prescriber who can prescribe pregabalin and gabapentin (a doctor or dentist). Where supplementary prescribing is not possible, patients in need of these medicines should be referred to an appropriate independent prescriber.

Independent prescribers are reminded that they must work within the law and comply with the HCPC Standards for Prescribing at all times. The HCPC may investigate concerns about inappropriate prescribing practice.

NHS England, together with the professional bodies representing physiotherapists and podiatrists, has identified additional controlled drugs that physiotherapist and podiatrist independent prescribers may require to prescribe in practice, where there is demonstrable evidence of need. Both pregabalin and gabapentin will be considered for both physiotherapist and podiatrist independent prescribing. Work is underway to progress the proposal to public consultation in the near future.

Should gabapentin and pregabalin become approved additions to the existing list of controlled drugs available to physiotherapist and/or podiatrist independent prescribers, then such prescribers will again be able to prescribe them. NHS England and the professional bodies will update the professions if these changes are agreed.