Mel Langley and Mandy Stock are the first dietitians to qualify as Supplementary Prescribers at CHFT. They are part of a small but rapidly growing number of specialist dietitians choosing to extend their scope of practice in this way. Many other professions have been eligible to train as non-medical prescribers (both supplementary and independent) since the early 2000s, however dietitians have only had this opportunity since 2016. There is definitely appetite for acquiring prescribing rights within the dietetic profession, as dietitians see the benefit of being able to prescribe for their patients when they see them.

Team coordinator, Karen Turkington, said: "I am very proud of Mandy and Mel's achievements. The enthusiasm and tremendous hard work they have put in is a credit to them and the department. They have paved the way for other CHFT dietitians to follow in their footsteps." 

What does it all mean?

Traditionally only doctors (and vets!) were able to prescribe. However, the benefit of extending prescribing rights for other suitably qualified and trained health care professionals has been recognised since the late 1990s.

Within dietetics, non-medical prescribing works extremely well in conditions that require long term management where reviewing and adjusting medications are an integral part of daily management, for example conditions such as diabetes, bariatric surgery, and cystic fibrosis.

The ability to make appropriate adjustments or prescribe additional medications when you see the patient is of tremendous benefit not only to the patient, as it reduces the number of appointments they are required to attend but also improves the efficiency of the service and reduces duplication. It puts the patient right at the centre of what we do, where they should be.

How will life be different now you have gained your supplementary prescribing qualification?

Mandy: As a specialist diabetes dietitian I work with patients who have Type 1 diabetes. My role is to enable individuals to confidently and safely adjust their insulin based on what they chose to eat and do and so enabling them to live as a normal a life as possible.

Prior to qualifying as supplementary prescriber if I thought someone’s insulin dose required adjustment, I would have to refer this back to another health care professional with prescribing rights, such as their nurse or doctor. This would mean another appointment for the individual, more work for other clinicians, possible duplication of information and leaving me feeling frustrated that I was unable to make the appropriate dose adjustment despite having the necessary skills and experience to do so.

As a supplementary prescriber I will now be able to make the necessary dose adjustments within the scope of a clinical management plan agreed and overseen by the doctor in charge of their care. This is one step closer to becoming an independent prescriber meaning that I can make decisions on insulin dose adjustment within my scope of practice without the need to consult anyone else. Supplementary prescribing will enhance the service I offer my patients and my own job satisfaction.

Mel: Works as a bariatric surgery specialist dietitian, working across both acute hospital sites. My role includes providing information on the appropriate diet for each bariatric procedure, monitoring micronutrient status and advising on nutritional supplementation and general health. Achieving this qualification will enable me to prescribe various medications to improve nutritional status and improve gastrointestinal symptoms, reducing the workload of other primary and secondary care professionals, within the scope of my specialism by following a clinical management plan.

Currently recommendations on medications are made on a daily basis both to the patient, and to prescribing colleagues, in the hospital environment and in primary care for changes in micronutrient dosage, frequency, time and route. Previously I have not been able to prescribe the medication myself, resulting in delays in treatment, more healthcare appointments for patients and additional workload for other health professionals.

I am looking forward to being able to prescribe selected medications and micronutrients within my scope of practice, to benefit the patient. It could improve patient safety by reducing delays in care and create clear lines of responsibility and accountability for prescribing decisions. My prime concern is in efficiency, well- being and safety of patients.

How do you become a supplementary prescriber?

The route to becoming a supplementary prescriber is exactly the same as the route to becoming an independent prescriber……..six gruelling months of hard work and no social life!

Mel and Mandy completed their course of study at Leeds Beckett University. They undertook a level seven module of study over a six month period. This involved twenty six days of face to face taught lectures, accruing ninety clinical practice hours shadowing colleagues with prescribing rights, two exams and the creation of an extensive portfolio of evidence to prove their competence to qualify as supplementary prescribers.

Our work was measured against nine learning outcomes laid out by the Royal Pharmaceutical Society in conjunction with our governing body, The Health and Care Professions Council.

At times we thought it would never end and we were tempted to throw in the towel. However we got through it and came out the other side, qualifying as Supplementary Prescribers….relatively unscathed!

How has CHFT supported you through this course of study?

A special thank you has to go to Karen Turkington (Team Coordinator / Professional Lead for Dietetics) for believing in our ability and for giving us this opportunity, Karen Austin (CHFT Non-Medical Prescribing Lead), Jennie Hunter (Surgical Pharmacist), Ian Harrison (Medical Pharmacist) and our Designated Medical Practitioners, Dr Haliza Hanif and Mr Arin Saha, (CHFT consultants) for their guidance and support.

We also want to thank all the colleagues who were willing to allow us to shadow them in their day to day clinical practice and share their knowledge and experience. It was invaluable and we are very thankful.

How does it feel to have gained the Supplementary Prescriber qualification and be in the first wave of dietitians in the country to be prescribing medications?

We feel proud to have accomplished this and are a mixture of nerves and excitement to get going and use our new skills, always respecting the responsibility that it brings.

We would also like to play an active role in helping the dietetic profession evolve and progress towards independent prescribing in the future.