Nurses and pharmacists are to be given greater powers to prescribe drugs by the government, in a move being vigorously opposed by doctors.
GPs are opposed to the plan
Both professions will have to undergo training to get the extended powers, which will allow them to prescribe all but the most powerful drugs.
Health Secretary Patricia Hewitt has given the green light to the move to free up GPs for more complex care.
But doctors' leaders have branded it "irresponsible and dangerous".
Prescribing powers have been gradually rolled out to nurses and pharmacists over recent years, but so far it has been limited to drugs for minor injuries and palliative care.
The latest measures mean nurses and pharmacists will be able to prescribe treatments for more serious conditions such as heart disease and diabetes - traditionally the domain of GPs.
Only controlled drugs, such as diamorphine, will be exempted when the reforms kick in in the spring.
Ministers have opted for the most radical of the proposals put forward at the beginning of the year in a consultation on whether, and how, the prescribing powers of nurses and pharmacists should be expanded.
The powers will only be open to the more experienced nurses and pharmacists, who will have to be nominated by their employers for the extra training.
Ms Hewitt said: "By expanding traditional prescribing roles, patients can more easily access the medicines they need from an increased number of highly trained professionals."
The move has been welcomed by both nurses and pharmacists.
Matt Griffiths, prescribing adviser for the Royal College of Nursing, said: "We have been pushing for this for 20 years. Patients can rest assured that systems are in place to ensure it is done safely and cost effectively.
"We are not trying to be 'mini-doctors', we are trying to be 'maxi-nurses'."
And he added nurses would not be prescribing outside their speciality.
"Diabetes nurses won't start handing out chemotherapy treatment."
David Pruce, of the Royal Pharmaceutical Society of Great Britain, said it was a "significant milestone" which would benefit patients.
But the British Medical Association said it was opposed to the move and demanded a meeting with the health secretary to discuss the plan.
Hamish Meldrum, chairman of the BMA's GPs committee, said: "We believe only doctors have the necessary diagnostic and prescribing training that justifies access to the full range of medicine for all conditions."
And Paul Miller, chairman of the BMA's consultants committee, added: "This is an irresponsible and dangerous move. Patients will suffer.
"I would not have me or my family subject to anything other than the highest level of care and prescribing, which is that provided by a fully trained doctor."