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Non-medical prescribing in Australasia and the UK: the case of podiatry

By Alan M. Borthwick, Anthony J. Short, Susan A. Nancarrow and Rosalie Boyce


Background: the last decade has witnessed a rapid transformation in the role boundaries of the allied health<br/>professions, enabled through the creation of new roles and the expansion of existing, traditional roles. A strategy<br/>of health care ‘modernisation’ has encompassed calls for the redrawing of professional boundaries and identities,<br/>linked with demands for greater workforce flexibility. Several tasks and roles previously within the exclusive domain<br/>of medicine have been delegated to, or assumed by, allied health professionals, as the workforce is reshaped to<br/>meet the challenges posed by changing demographic, social and political contexts. The prescribing of medicines<br/>by non-medically qualified healthcare professionals, and in particular the podiatry profession, reflects these<br/>changes.<br/><br/>Methods: using a range of key primary documentary sources derived from published material in the public<br/>domain and unpublished material in private possession, this paper traces the development of contemporary UK<br/>and Australasian podiatric prescribing, access, supply and administration of medicines. Documentary sources<br/>include material from legislative, health policy, regulatory and professional bodies (including both State and Federal<br/>sources in Australia).<br/><br/>Results: tracing a chronological, comparative, socio-historical account of the emergence and development of<br/>‘prescribing’ in podiatry in both Australasia and the UK enables an analysis of the impact of health policy reforms<br/>on the use of, and access to, medicines by podiatrists. The advent of neo-liberal healthcare policies, coupled with<br/>demands for workforce flexibility and role transfer within a climate of demographic, economic and social change<br/>has enabled allied health professionals to undertake an expanding number of tasks involving the sale, supply,<br/>administration and prescription of medicines.<br/><br/>Conclusion: as a challenge to medical dominance, these changes, although driven by wider healthcare policy,<br/>have met with resistance. As anticipated in the theory of medical dominance, inter-professional jurisdictional<br/>disputes centred on the right to access, administer, supply and prescribe medicines act as obstacles to workforce<br/>change. Nevertheless, the broader policy agenda continues to ensure workforce redesign in which podiatry has<br/>assumed wider roles and responsibilities in prescribing

Topics: R1
Year: 2010
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Provided by: e-Prints Soton
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