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

One hundred and ninety-seven 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 can be supplied on request to the Nursing Council.

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:

Application for registered nurse prescribing in primary health and specialty teams

Application for registered nurse prescribing primary health and specialty teams (PDF, 460 KB)

Appendix 1 Consultation Document Two proposals registered nurse prescribing (PDF, 1 MB)

Appendix 2 Analysis of Submissions (PDF, 1 MB)

Appendix 3 Standards for the Postgraduate diploma for registered nurse prescribing for long-term and common conditions (PDF, 200 KB)

Appendix 4 Competencies for nurse prescribing (PDF, 429 KB)

Appendix 5 Guidelines for Prescribing Practicum for DN Priority 2014 (PDF, 743 KB)

Appendix 5 Guideline Medical Supervision of Diabetes Nurse Prescribers Priority 2014 (PDF, 428 KB)

Appendix 6 Indicative list of prescription medicines according to NZ Formulary therapeutic groups (PDF, 269 KB)

Appendix 7 Medicines report (PDF, 1 MB)

Appendix 8 List of devices (PDF, 33 KB)

Appendix 8 Non-prescription subsidised medicines (PDF, 225 KB)

Appendix 9 Non Prescription medicines non subsidised (PDF, 154 KB)

Appendix 10 Letter from PHARMAC re non prescription medicines (PDF, 372 KB)

Appendix 11 Consultation email and List of organisations sent to (PDF, 329 KB)
Appendix 12 List of submitters Consultation on two proposals for registered nurse prescribing (PDF, 167 KB)

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)

Appendices

Appendix 1 Consultation Document Two proposals registered nurse prescribing (PDF, 1 MB)

Appendix 2 Analysis of Submissions (PDF, 1 MB)

Appendix 3 Application for registered nurse prescribing primary health and specialty teams (PDF, 460 KB)

Appendix 4 List of stakeholder meetings to discuss the modified proposal 2015-16 (PDF, 49 KB)

Appendix 5 Community Health Medicines lists- 16 September 16 update 6 April 17 (PDF, 289 KB)

Appendix 6 Standards for recertification programmes for RN prescribing in community health September 2016 (PDF, 32 KB)