The Role of a DMP and DPP in Non-Medical Prescribing

Hi everyone! It’s Faheem from MEDLRN, and today I want to talk about something I get asked about all the time – the role of a DMP and a DPP.

What do DMP and DPP actually mean?

First, let me explain what these terms actually mean. DMP stands for Designated Medical Practitioner, while DPP means Designated Prescribing Practitioner.

These terms essentially refer to the same role, but there’s a historical reason for the two different names. When non-medical prescribing courses first began, only doctors could supervise non-medical prescribers gaining their qualification. If you wanted to become a prescriber, only a doctor could be your supervisor.

Then it became clear that there weren’t enough doctors available. We needed other prescribers to help with the non-medical prescribing course. So they changed the name to DPP – Designated Prescribing Practitioner – because it doesn’t just include doctors but can also include pharmacists, nurses, and anybody else who can legally act as a supervisor.

What is the Non-Medical Prescribing Course?

The non-medical prescribing course (also called the prescribing course or independent prescribing course) is designed for regulated healthcare professionals who aren’t doctors, such as pharmacists, nurses, physiotherapists, and paramedics, to gain their prescribing qualification.

This course actually began in the 1990s when it was recognized that nurses were already diagnosing and seeing patients, but doctors were still writing the prescriptions. Here’s a scenario – imagine a nurse seeing a patient with a urinary tract infection, taking their history, examining them, but then having to contact a doctor to write the prescription.

The question arose: who’s legally responsible for this patient’s care? Is it the doctor writing the prescription or the nurse doing the diagnosis? The solution was to change the law to allow nurses to prescribe since they were already diagnosing and treating patients.

Hats off to nurses – they’re always at the forefront pushing boundaries. If it wasn’t for nurses, pharmacists probably wouldn’t have prescribing rights today. In the early 2000s, pharmacists also gained the opportunity to qualify as prescribers. Now, many more healthcare professionals can gain this qualification, including paramedics and physiotherapists.

The Purpose of the Non-Medical Prescribing Course

Pay close attention to this part – it’s really important! The non-medical prescribing course is designed to teach you HOW TO PRESCRIBE. It is NOT designed to teach you clinical skills or how to diagnose, manage, and treat disease. That’s a completely separate thing.

The course covers:

• Governance frameworks around prescribing
• How to safely prescribe
• Prescribing for different age groups
• Ethical considerations when prescribing
• Consultation skills

It does NOT teach you:

• The ins and outs of diagnosis
• How to take a thorough history
• How to examine patients
• Internal medicine
• Life sciences (anatomy, physiology, pathophysiology, histology, biochemistry)

Don’t fall into the trap of thinking, “If I don’t have clinical skills or don’t know how to diagnose, I can gain my prescribing qualification and suddenly I’ll be prescribing.” That’s the mistake I made about six or seven years ago – don’t make that same mistake!

Requirements for the Non-Medical Prescribing Course

So how do you get on this course? What are the requirements?

1. Professional registration – You must be registered with a professional body, such as being a pharmacist, nurse, physiotherapist, paramedic, or allied healthcare professional. You need to be qualified first – this isn’t for everyone.
2. Scope of practice – You must identify which area you already have clinical skills in that you’d like to gain your prescribing qualification for. Don’t just say, “I want to gain skills in hypertension.” The university will ask: “Are you already managing and diagnosing hypertension? Do you know how to treat it? Do you know all the guidelines involved?”

Your scope of practice has to come from your existing knowledge and experience. For community pharmacists, consider minor illnesses like UTIs, sore throats, ear/nose/throat conditions, or skin conditions like eczema or impetigo. If you’re working in a GP practice, maybe consider chronic conditions like hypertension, diabetes, or high cholesterol.

The reason I suggest sticking with acute conditions in community pharmacy is because that’s what you’re seeing daily. While you might see hypertensive patients, you’re typically not diagnosing them or ordering blood tests. It makes more sense to focus on chronic conditions in a GP setting and acute conditions in a community pharmacy setting.

3. Finding a supervisor – You need someone willing to supervise you. This is your DMP or DPP.
4. Designated Prescribing Supervisor (DPS) – Some universities require not just a DPP but also a DPS – someone who supports you on a regular basis. Think of this like having a manager in a store and beneath them, a shift supervisor. Your DPS is like your shift supervisor, there to support you day-to-day.

Who Can Act as a DMP or DPP?

In theory, anyone who has been qualified as a prescriber (normally for more than three years), has the skills and knowledge, is up-to-date, and works within your scope of practice can act as a DPP. This could be a pharmacist, nurse, doctor, or physiotherapist.

But my question to you is: if you’re going to have someone supervise you, shouldn’t it be someone with experience who does this day in, day out?

Here’s an analogy – if you’re going to learn to drive a Formula One car, would you want to learn from someone who drives a regular car, or from Lewis Hamilton who drives Formula One professionally? I’d prefer to learn from Lewis Hamilton because that’s who I want to be like.

What I’m saying is: if you want to learn to prescribe, make sure the person teaching you has the skills, qualifications, experience, and depth of knowledge. Don’t cut corners!

So who can act as a DPP? A doctor, technically a dentist too, a nurse, a pharmacist – anybody who’s been prescribing for generally more than three years, is actively prescribing, is up-to-date, has no legal issues with their registration (like problems with the GMC or GPhC), and has support from their organization.

The Role of a DPP

The DPP is there to supervise you, support you, and teach you. They play a massive role in you gaining this qualification.

That means your DPP needs to:

• Have experience in teaching (ideally with pharmacists if you’re a pharmacist)
• Have experience in supervising
• Know how to teach you history-taking, patient examination, proper documentation, and how to diagnose and treat a range of conditions

Why is this comprehensive knowledge important? Because when a patient presents with symptoms, it’s rarely just one isolated condition. If someone has earache, for example, the person teaching you needs to understand the human body inside out because it’s all connected. An ear, nose, and throat problem could lead to a respiratory problem.

If your DPP doesn’t have that depth of knowledge and understanding of the human body and internal medicine, they may not be able to take you to the next level. That’s why I prefer individuals with comprehensive medical knowledge – not necessarily doctors, but someone with relevant experience who has seen a wide range of conditions.

Your DPP also needs to:

• Allow you to observe them
• Observe you and give feedback
• Motivate you
• Help with your university course (looking at essays, paperwork, reflections)
• Provide support even after you qualify

90 hours of supervised practice is simply not enough when you’re dealing with the human body, which is incredibly complex. Think about when you qualified as a pharmacist or nurse – remember being a pre-reg? One year wasn’t enough! I was constantly calling my pre-reg tutor for help, even after I qualified.

There needs to be a support network in place after qualification. Many universities and the GPhC are now asking what support will be available after you qualify.

Common Pitfalls

Where do things typically go wrong?

1. Not choosing the right supervisor – Sometimes we cut corners, maybe because of cost or convenience. Often, people look for someone local rather than traveling two hours for better training. But remember, your time is the most valuable thing you have. You can make money again, but your time never comes back. Those 90 hours need to be quality hours.
2. Not clarifying expectations – This week alone, I’ve had four or five students contact me because their universities expected more from their supervisors than was initially communicated. The supervisor said, “We were told this much work was involved, and we can’t support anymore.” Now these students are halfway through the course without a supervisor.

Be very clear about the amount of work involved. Your DPP needs to help with paperwork, teach you, support you, and motivate you. Universities provide information packs about the role of the DMP/DPP – share these with potential supervisors before they commit.

3. Passive learning – Make sure you’re not just observing. Your DPP should teach you theory, let you observe them, allow you to practice while they supervise, and give you feedback – just like learning to drive.
4. Missing networking opportunities – If you’re a pharmacist, try to learn from nurses or doctors. If you’re a nurse, learn from pharmacists. Step outside your comfort zone and build a network across different healthcare disciplines. It’s not just what you know in this world, it’s who you know.
5. Misunderstanding university expectations – Universities provide frameworks and governance but can’t teach you everything about your specific scope of practice. If you’re taking this course, you’re already qualified and working at master’s level – don’t get too bogged down with 3000-5000 word essays.

Getting the Best Out of Your Course

1. Be clear about your DPP’s role – They should be actively teaching, supervising, motivating, and inspiring you. They’re not there to put you in a corner to observe – they should allow you to observe them, supervise you, motivate you, and ensure you gain your qualification safely.
2. Choose the correct scope of practice – Don’t make the mistake of working in a pharmacy and saying, “I want to prescribe for epilepsy.” Ask yourself: Am I seeing epileptic patients? Can I diagnose them? Will I be treating them? Can I order the necessary blood tests? Can I take this patient through their entire healthcare journey? If not, reconsider your scope of practice.

Remember, the goal is to become a safe and effective prescriber within your area of expertise. Choose a DPP who can truly support your development, be clear about expectations, and make the most of this valuable learning opportunity.

I hope this clarifies the role of DMPs and DPPs. If you need any help with your prescribing journey, get in touch with us at MedLRN. We can advise you on the best approach for your prescribing qualification and help organize a suitable DPP.

Always push yourself to be the best version of yourself!

-Faheem