The largest chunk of the health workforce will have the power to prescribe medicines. Here’s how it will work.
Australia’s 395,000 registered nurses will be able to prescribe Schedule 2, 3, 4 and 8 medicines under a prescribing agreement from mid-2025, AHPRA has announced today.
According to the nursing and midwifery board, additional prescribers will address the shortage of primary care providers in rural and remote Australia.
At last week’s Health Ministers Meeting, state and federal ministers approved a new registration standard endorsement allowing the change.
In order to qualify, registered nurses must be able to show “adequate clinical experience”, have completed certain postgraduate qualifications and also spend six months working in a “clinical mentorship” arrangement with a supervising prescriber.
There is no indication that nurses would be able to diagnose conditions.
“It means more nurses can adjust medicine doses for end-of-life care and prescribe other supportive medicines for cancer patients without unnecessary delays,” nurse practitioner Carmel O’Kane said.
“This ensures people get the care they need quickly, without the stress of waiting for a GP.”
Each registered nurse will need to partner with one or more autonomous prescribers and have a written document in place defining their roles and responsibilities, which must be approved by the relevant health organisation or employer.
These autonomous prescribers can be either doctors or nurse practitioners.
While nothing has changed in terms of prescribing powers for nurse practitioners, the subset of nurses was recently released from the requirement to have a collaborative agreement in place with a doctor in order to access Medicare subsidies.
The removal of this requirement is expected to make entirely nurse practitioner-run clinics more financially viable.
There are less than 3000 nurse practitioners registered in Australia.
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“This prescribing model can improve resource use and enhance care coordination by allowing designated RN prescribers to manage medications, freeing up other healthcare professionals to focus on more complex areas of patient care,” the nursing board said.
It has long been the position of the Australian Nursing and Midwifery Federation that all registered nurses and midwives should be able to prescribe in a partnership arrangement with other providers.
Until April 2023, some registered nurses in rural and isolated Australia were permitted to prescribe under a structured protocol arrangement. According to a 2023 nursing and midwifery board impact statement, this endorsement was retired because the national midwifery and nursing board was no longer required to provide additional regulation to the states.
Between today and the planned implementation of the new registered nurse scheme in mid-2025, state and territory governments will need to individually amend drugs and poisons legislation to allow nurse prescribing.
Autonomous or collaborative registered nurse prescribing is already in place in the UK, Ireland and for some nurses in New Zealand.
An advance copy of the registration endorsement won’t be publicly available until March.
Schedule 8 medicines include drugs of addiction such as opioids, dexamphetamine and alprazolam, while schedule 4 medicines include benzodiazepines, codeine and gabapentin.
