An audit of the prescription and supply of medicines by podiatric surgery teams in the UK

Abstract

Aim: To gain a greater understanding of the methods used by podiatric surgeons to access medicines in the UK. Within that, it is also relevant to establish the range and quantity of medicines utilised to support patient care. With the advent of independent prescribing for podiatrists, the authors were keen to identify whether prescribing was being adopted by a sub-speciality of the podiatry profession and whether alternate means of accessing medicines, such as Patient Group Directions or exemptions remain relevant in clinical practice. Methods: The PASCOM 10 system was accessed to generate reports for the 2019 calendar year relating to podiatric surgery. The following reports were requested; procedures, fixations, anaesthesia, demographics, medications, post-treatment sequelae, patient satisfaction (PSQ-10), Manchester Oxford foot/ankle questionnaire (MOXFQ), providers and referrals. Results: In 2019 there were 11189 admissions for podiatric surgery in England recorded on the PASCOM 10 database. A total of 103 surgery centres contributed data resulting in 18497 procedures. Care was primarily offered in NHS settings accounting for 91% of activity, 94% of these procedures were performed under a local anaesthetic block. 18576 medicines were supplied, administered or prescribed from a list of 70 individual items. 29% of all medicines were prescribed by a podiatrist. Controlled drugs accounted for 28.7% of all recorded medicines. Conclusions: Through analysis of PASCOM 10 data, the range of medicines accessed by podiatric surgeons and their teams to support patient care perioperatively and the routes of accessing these medicines have been identified. Encouragingly, independent prescribing appears to be a frequent choice for accessing certain medicines. There is thorough evidence of a need for greater prescribing rights. Of note, it appears the management of postoperative pain could be improved with wider access to controlled drugs, namely opioid analgesics. PASCOM-10 has the capacity to provide revealing data on prescribing in podiatric clinical practice that is unique in the UK, though more work is required to ensure the validity of the dataset.