Dietitians burdened with bureaucracy during national medication shortage
During a national shortage of Creon, a dietitian had to complete around 350 clinical management plans during a national medication shortage before patients could access treatment.
Supporting patients during disruption
Claire is a Cystic Fibrosis dietitian working in a hospital.
Cystic fibrosis is a rare, inherited, genetic condition that causes breathing and digestive problems. The majority of people with cystic fibrosis take pancreatic enzyme supplements to help them to digest their food, as their pancreas doesn’t produce enough of these naturally. Without supplements they can suffer abdominal pain, bloating, excess wind and loose stools. Over a longer period, this could cause weight loss and nutrient deficiencies, making them more vulnerable to infection. Most patients receive Creon as a regular prescription through their local pharmacy.
In 2024 there was a national shortage of Creon. This means that people in Claire’s area were struggling to gain access to the medication that they rely on every day.
“Dietitians were receiving 20-30 phone calls a day from patients who couldn't obtain Creon in the community. Our team were able to obtain small supplies from the hospital pharmacy.”
The burden of clinical management plans
As supplementary prescribers, the dietitians in Claire’s unit were not able to prescribe medication without a clinical management plan in place for each one. This means that they have to have a document outlining the medication they will be prescribing, and signed off by an independent prescriber like a doctor.
With so many patients desperately needing access to Creon, dietitians on Claire’s unit now had to create dozens of these plans each day to try to ensure patients wouldn’t go without.
Time away from patient care
“I had to write around 350 clinical management plans so I could action the phone calls. We spent so much time writing up the paperwork that dietitians weren’t able to attend clinics and were pulled back from our work on the wards – this definitely impacted on patient care.”
The impact on patients and services
It wasn’t only the time spent drafting the plans that impacted clinical care. Dietitians also had to spend time locating consultants to get them to sign off on the plans. Administration staff then had to scan and upload every plan into a patient’s records. And all the while patients were waiting to receive their medication, which they have to take with every meal.
One of the most notable impacts was the pressure this placed on the independent prescribers from other professions working in the multidisciplinary team.
“They wanted to help, so some of them were prescribing outside of their scope of practice just to make sure patients got their treatment. This puts their prescribing rights at risk.”
If dietitians were able to independently prescribe, the team would have been able to handle an urgent situation like this much more easily, and with less interruption to patient care.
“Patients would have their prescriptions actioned quicker and it would have had less impact on other healthcare professionals.”
During a national shortage of essential medication, specialist dietitians had the expertise to respond quickly to patients’ needs - but current prescribing restrictions created additional delays, workload, and pressure across the wider multidisciplinary team.
How independent prescribing would have changed this case
Independent prescribing would have allowed Claire to respond more efficiently to the medication shortage, reducing administrative burden and helping dietitians spend more time providing direct patient care.
✅ Patients could have accessed medication more quickly
✅ Dietitians could have remained in clinics and on wards
✅ Reduced pressure on consultants and administration teams
✅ Less reliance on other professionals prescribing outside their usual area of expertise
✅ More NHS time focused on patient care rather than paperwork
