Consultation on registered nurse prescribing

The Nursing Council consulted on two proposals to extend registered nurse prescribing in 2013.

  1. Community nurse prescribing to enable nurses in community and outpatient settings to prescribe medicines for minor ailments and illnesses.
  2. Specialist nurse prescribing, to enable nurses working in a collaborative multi-disciplinary team in specialty services or general practice, to be able to prescribe for common conditions such as diabetes, asthma, hypertension.

 The details of the proposals are contained in the

Final Consultation Document Two proposals registered nurse prescribing 27 Feb 2013 (PDF, 703 KB)

Analysis of submissions concerning registered nurse prescribing

197 written submissions were received in response to the consultation document which outlined a possible framework for nurse prescribing. Proposals for two levels of nurse prescribing were developed following discussions with professional and relevant sector groups and in response to a request from the Minister of Health to build on the success of the 2011 diabetes nurse prescribing project.

The submissions showed a high level of support for specialist nurse prescribing, which would enable nurses who work in collaborative, multi-disciplinary teams in specialty services or in general practice, to prescribe for common conditions such as diabetes, asthma and hypertension. The submissions also supported the proposed qualification of a postgraduate diploma.

A second proposal to enable nurses in community and outpatient settings to prescribe a limited number of medicines for minor ailments and illnesses received a more mixed response. There was strong agreement that the proposal could enhance patient access and care, but concerns were expressed about the education and training of nurses in this area with many saying the qualification should be longer than originally proposed. There were also issues related to the variable support mechanisms (for example, nursing leadership, mentorship, case review, audit and continuing education) available across primary health care to support nurse prescribing and fragmentation of care between different health providers, which could be exacerbated by more prescribers.

Views were divided on the titles of the proposals. 71% of submissions opposed the title for community nurse prescribing finding it confusing and limiting. Alternative suggestions included using ‘primary health’ in the title or registered nurse prescriber - level 1.  Opinion was more equally divided on the title ‘specialist nurse prescribing’ with many of those opposed concerned that it implied the nurse would be working in a specialist area, which may or may not be the case.

The Council decided to progress the specialist nurse prescribing proposal ahead of the community nursing proposal.

More information on the Council’s proposals and the response from submitters can be found in the executive summary and the full analysis of submissions.

Executive summary RN prescribing analysis of submissions October 2013 (PDF, 232 KB)

Analysis of Submissions- Consultation on Two proposals for registered nurse prescribing (PDF, 1 MB)

Submissions from the consultation on registered nurse prescribing

Submission 1) Individual Nurse (PDF, 420 KB)

Submission 2) Rural Women New Zealand (PDF, 249 KB)

Submission 2) Rural Women New Zealand- on submission form (PDF, 384 KB)

Submission 3) Pharmacy Defence Association (PDF, 351 KB)

Submission 4) Individual Nurse (PDF, 397 KB)

Submission 5) Individual Nurse (PDF, 365 KB)

Submission 6) Individual Doctor (PDF, 636 KB)

Submission 7) School of Nursing, Otago Polytechnic (PDF, 359 KB)

Submission 8) Indvidual Nurse (PDF, 345 KB)

Submission 9) Cancer Nurses Section NZNO (PDF, 342 KB)

Submission 10) Individual Nurse (PDF, 371 KB)

Submission 12) Individual Nurse (PDF, 342 KB)

Submission 13) Group of Nurses, DHB CNS (PDF, 392 KB)

Submission 14) Women's Health Action- on submission form (PDF, 404 KB)

Submission 14) Women's Health Action (PDF, 259 KB)

Submission 15) Individual Nurse (PDF, 347 KB)

Submission 17) Tairawhiti District Health (Nurse Leaders) (PDF, 347 KB)

Submission 18) Group of Nurses (PDF, 355 KB)

Submission 19) Wintec (Student Health) (PDF, 311 KB)

Submission 20) Individual Nurse (PDF, 361 KB)

Submission 21) Individual Nurse (PDF, 356 KB)

Submission 22) Individual Nurse Practitioner (PDF, 1 MB)

Submission 24) Individual Doctor (PDF, 250 KB)

Submission 27) Health Care Development (PDF, 362 KB)

Submission 28) Individual Nurse (PDF, 346 KB)

Submission 29) Individual Nurse Practitioner (PDF, 344 KB)

Submission 30) Individual Nurse (PDF, 342 KB)

Submission 31) Individual Doctor (PDF, 344 KB)

Submission 32) Individual Nurse (PDF, 368 KB)

Submission 33) Individual Nurse (PDF, 347 KB)

Submission 35) Group of Nurses (PDF, 362 KB)

Submission 38) Individual Nurse (PDF, 358 KB)

Submission 39) AUT, Faculty of Health & Environmental Sciences (PDF, 360 KB)

Submission 40) Corrections Health Services (PDF, 346 KB)

Submission 43) Group of Nurses (PDF, 359 KB)

Submission 44) Taranaki District Health Board (PDF, 362 KB)

Submission 45) Individual Nurse (PDF, 321 KB)

Submission 46) Individual Nurse (PDF, 368 KB)

Submission 47) Cafe Incorporated (Cafe for youth health) (PDF, 358 KB)

Submission 49) Kimi Hauora Wairau Marlborough PHO (PDF, 354 KB)

Submission 51) Individual Nurse (PDF, 365 KB)

Submission 53) Nursing and Midwifery Board of Ireland (PDF, 362 KB)

Submission 54) Group of Nurses (PDF, 390 KB)

Submission 55) Auckland University school of nursing (PDF, 417 KB)

Submission 56) College of Nurses Aotearoa New Zealand (PDF, 279 KB)

Submission 58) Individual Nurse (PDF, 351 KB)

Submission 60) Pharmacy Guild of New Zealand (PDF, 360 KB)

Submission 61) Individual Doctor (PDF, 180 KB)

Submission 62) Individual Doctor (PDF, 350 KB)

Submission 63) Individual Doctor (PDF, 346 KB)

Submission 64) Individual Nurse (PDF, 347 KB)

Submission 66) Individual Nurse (PDF, 351 KB)

Submission 67) Training and Development Services- Behavioural Change Interventions (PDF, 350 KB)

Submission 69) New Zealand Medical Association (PDF, 398 KB)

Submission 71) Counties Manukau District Health Board (PDF, 355 KB)

Submission 72) Family Planning (PDF, 319 KB)

Submission 73) Bay of Plenty District Health Board (PDF, 363 KB)

Submission 75) Primary Health Care Leadership across Waitemata & Auckland Districts (PDF, 440 KB)

Submission 76) Te Ao Maramatanga, New Zealand College of Mental Health Nurses (PDF, 358 KB)

Submission 77) Group of Nurses, DHB (PDF, 341 KB)

Submission 78) Matua Raki (PDF, 364 KB)

Submission 81) Individual Nurse (PDF, 346 KB)

Submission 82) College of Emergency Nurses NZ- NZNO (PDF, 355 KB)

Submission 83) Individual Nurse Practitioner (PDF, 344 KB)

Submission 84) Individual Nurse (PDF, 360 KB)

Submission 85) Pharmacy Council of New Zealand (PDF, 1 MB)

Submission 86) Clinical Advisory Pharmacists Association (PDF, 556 KB)

Submission 87) Public Health Service (PDF, 357 KB)

Submission 90) Mercy Hospice Auckland (PDF, 350 KB)

Submission 91) Group of Nurses, DHB (PDF, 422 KB)

Submission 93) Group of Nurses, CNS (PDF, 335 KB)

Submission 94) Wairarapa Hospital (PDF, 372 KB)

Submission 95) Group of Nurses, DHB (PDF, 344 KB)

Submission 95) Group of Nurses,DHB part 2 (PDF, 245 KB)

Submission 96) MidCentral- Wanganui DHB Primary Health Nurse Practitioners and Interns peer group (PDF, 343 KB)

Submission 97) Individual Nurse Practitioner (PDF, 359 KB)

Submission 98) Diabetes Nurse Specialist Section of NZNO (PDF, 495 KB)

Submission 99) New Zealand Institute of Rural Health (PDF, 366 KB)

Submission 101) Individual Nurse (PDF, 345 KB)

Submission 102) Individual Nurse (PDF, 352 KB)

Submission 104) Unitec Institute of Technology (PDF, 431 KB)

Submission 106) New Zealand Sexual Health Society (PDF, 363 KB)

Submission 110) Group of Nurses, CNS (PDF, 419 KB)

Submission 111) Waitemata District Health Board (PDF, 499 KB)

Submission 112) Individual Nurse (PDF, 344 KB)

Submission 113) Individual Nurse (PDF, 343 KB)

Submission 114) New Zealand National Committee of the Australia & New Zealand College of Anaesthetists (PDF, 407 KB)

Submission 116) Non Government Organisation (PDF, 425 KB)

Submission 118) Individual Nurse (PDF, 331 KB)

Submission 121) Massey University School of Nursing (PDF, 375 KB)

Submission 122) District Health Board (PDF, 458 KB)

Submission 123) Individual Nurse (PDF, 367 KB)

Submission 124) New Zealand Home Health Association (PDF, 470 KB)

Submission 125) Group of Nurse Practitioners (PDF, 434 KB)

Submission 126) Auckland Sexual Health Service (PDF, 356 KB)

Submission 128) Pharmacist and Therapeutics SIG of the Paediatric Soceity of New Zealand (B) (PDF, 363 KB)

Submission 129) Individual Doctor cover letter (PDF, 201 KB)

Submission 129) Individual Doctor (PDF, 369 KB)

Submission 130) Hawke's Bay District Health Board (PDF, 373 KB)

Submission 131) Individual Nurse (PDF, 373 KB)

Submission 132) Health Hawke's Bay (PHO) (PDF, 373 KB)

Submission 133) Individual Nurse (PDF, 344 KB)

Submission 134) Health and Disciplinary Commissioner (PDF, 106 KB)

Submission 135) Council of Medical Colleges (PDF, 152 KB)

Submission 136) Group of Nurses, Public Health (PDF, 359 KB)

Submission 137) Nurse Practitioner New Zealand (PDF, 376 KB)

Submission 138) District Health Board (PDF, 358 KB)

Submission 140) Palliative care Nurses New Zealand (PDF, 363 KB)

Submission 141) Immunisation Advisory Centre (PDF, 356 KB)

Submission 142) Individual Nurse (PDF, 344 KB)

Submission 143) Royal Australian & New Zealand College of Phychiatrists (PDF, 521 KB)

Submission 144) Group of Nurses (PDF, 367 KB)

Submission 145) Individual Nurse (PDF, 353 KB)

Submission 146) Group of Nurses, DHB (PDF, 357 KB)

Submission 147) Rural Canterbury Primary Health Organisation (PDF, 437 KB)

Submission 148) Government Agency (PDF, 357 KB)

Submission 149) District Health Board (PDF, 452 KB)

Submission 151) New Zealand Nurses Organisation (PDF, 411 KB)

Submission 152) Medical Council of New Zealand (PDF, 404 KB)

Submission 153) Nurse Maude Association (PDF, 380 KB)

Submission 154) Individual Nurse (PDF, 345 KB)

Submission 155) Auckland School Nurses Group (PDF, 358 KB)

Submission 156) CMDHB School Health Awareness Raising Group (PDF, 362 KB)

Submission 157) Individual Nurse (PDF, 349 KB)

Submission 158) Canterbury Regional Directors of Nursing & Canterbury Postgraduate Nursing Education (PDF, 451 KB)

Submission 159) Mary Potter Hospice (PDF, 349 KB)

Submission 159) Mary Potter Hospice (PDF, 349 KB)

Submission 160) Northland District Health Board (PDF, 356 KB)

Submission 162) Ear Nurse Group NZ Aotearoa (PDF, 358 KB)

Submission 164) Group of Nurses, DHB (PDF, 391 KB)

Submission 165) Victoria University of Wellington (PDF, 426 KB)

Submission 166) Group of Nurses (PDF, 314 KB)

Submission 170) Health Reporoa (PDF, 2 MB)

Submission 175) Individual Nurse (PDF, 365 KB)

Submission 176) Individual Pharmacist (PDF, 346 KB)

Submission 177) New Zealand Dermatological Society (PDF, 359 KB)

Submission 178) Pharmaceutical Society of New Zealand (PDF, 431 KB)

Submission 179) MidCentral District Health Board- Nursing (PDF, 1 MB)

Submission 181) PHARMAC (PDF, 356 KB)

Submission 182) Nursing and Midwifery Shared Governance Committee (PDF, 373 KB)

Submission 183) New Zealand Private Surgical Hospital Association (PDF, 644 KB)

Submission 184) Individual Nurse Practitioner (PDF, 343 KB)

Submission 185) Royal New Zealand Plunket Society Incorportated (Plunket) (PDF, 430 KB)

Submission 186) New Zealand Society of Anaesthetists (PDF, 127 KB)

Submission 187) DHB Shared Services (PDF, 505 KB)

Submission 188) Midwifery Council of New Zealand (PDF, 1 MB)

Submission 189) The Royal Australasian College of Physicians (PDF, 128 KB)

Submission 191) Individual Nurse (PDF, 1 MB)

Submission 192) Neonatal Nurse's College of Aotearoa- NZNO (PDF, 354 KB)

Submission 197) Group of Nurses, DHB (PDF, 360 KB)

Application for prescribing rights for registered nurses

Registered nurses prescribing in primary health and specialty teams

In October 2014 the Council submitted an application for designated prescribing rights for registered nurses practising in primary health and specialty teams to the Ministry of Health.

The application built on the success of the diabetes registered nurse prescribing demonstration project and the Council’s consultation for ‘Specialist nurse prescribing’ in 2013 (see above). The application was for a broader group of registered nurses who work with patients with long term and common conditions in primary health and specialty teams.

In June 2016 the Medicines (Designated Prescriber—Registered Nurses) Regulations 2016 was passed to allow some suitably qualified registered nurses to prescribe.

Further information about registered nurse prescribing in primary health and speciality teams can be found here

Below is a copy of the application for registered nurse prescribing in primary health and speciality teams:

Registered nurses prescribing in community health

In September 2016 the Council submitted a proposal to the Minister of Health to introduce a second class of registered nurse prescribers practising in community health under the regulation. This proposal builds on Council’s consultation for community prescribing in 2013 (see above).

Below is a copy of the proposal for designated prescriber: registered nurse practising in community health.

Proposal for designated prescriber registered nurses practising in community health September 2016 (PDF, 184 KB)

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