Consultation on Registered Nurse Prescribing in Community Health

We are seeking your views

The Nursing Council is currently consulting on possible changes to the medicine list for Registered Nurse Prescribers in Community Health (RNPCH). As well as medication changes, this also involves some possible changes to the language used in the Council’s RNPCH documentation to describe patient, client, and consumer groups.

These changes have been proposed to the Council by our RNPCH operational group. We are now seeking broader commentary and feedback on the group’s recommended changes from the sector and stakeholders.

A consultation document, which includes the operational group’s rationale for recommending each change, can be downloaded below.

The current RNPCH medicines list is available here. 

Who are RN Prescribers in Community Health?

An RNPCH is a Registered Nurse who has completed additional work-based education, that authorises them to prescribe a limited number of medicines for people with minor ailments and common conditions. The medicines they can prescribe form a subset of the medicine list for approved RN Designated Prescribers in Primary Health and Specialty Teams, and are already approved for that group of nurse prescribers.

Further information about the RNPCH designation and programmes can be found here.

Since their inception, RNPCH nurses have demonstrated they are safe and cautious prescribers who use their prescriptive authority responsibly and in line with recommended national guidelines and health pathways. We have never undertaken proceedings against an RNPCH for fitness to practise issues related to prescribing competence or conduct.

Who has proposed these changes?

These changes have been recommended to the Nursing Council by the RNPCH operational group. This group consists of representatives from each of the education programmes required for RNPCH authorisation, and was established in October 2021 to promote programme consistency and national development of RNPCH nurses. It reports to the Council’s Expert Advisory Group for Designated RN Prescribers.

The changes proposed by the operational group are based on feedback from across the areas in which RNPCHs work. This includes not only commentary and recommendations from RNPCH nurses themselves, but also nurse practitioners, senior medical officers, clinical nurse specialists, and programme leads working alongside RNPCH nurses.

Once consultation is complete we will consider the comments and feedback we’ve received alongside the rationale that the operational group has provided. We may ask the operational group for further clarification or their response to issues that have been raised during consultation, before the Council decides to adopt or reject the proposed changes.

What changes are being proposed?

The operational group has proposed amending some language, re-categorising some medicines, removing an indication, and adding some common medicines to the RNPCH list. Note that the medicines recommended for addition are all currently included on the list for RN Designated Prescribers in Primary Health and Specialty Teams. 

These recommendations are summarised below, and further information is available in the consultation document above.
  1. That in the Council’s Standards for Recertification Programmes in Registered Nurse Prescribing in Community Health 2019, the final sentence of paragraph one on page two be amended to:            
    2.                        Registered nurses practising in community health settings can complete a work-based education programme and apply for prescribing authority for a limited number of medicines for minor ailments and illnesses in normally healthy  people without significant co-morbidities. 

  2. That in the Council’s Standards for Recertification Programmes in Registered Nurse Prescribing in Community Health 2019, the definition of normally healthy people should be amended to:            
    3.  
      Normally healthy people are people without serious or complex health conditions, or whose conditions are well-controlled and/or stable.

  3. That medicines for treatment of urinary tract infection only be moved from the Prescription medicines for contraception and sexual health category to the Prescription medicines for common conditions category.

  4. That lidocaine be added to the RNCPH medicine list under the Prescription medicines for common conditions category.

  5. That stimulant laxatives be added to the RNPCH list within the Prescription medicines for common conditions category.

  1. That the following topical ointments be added to the RNPCH list within the Prescription medicines for common conditions category:
    • Triamcinolone acetonide 0.02%
    • Hydrocortisone 17-butyrate 0.1%
    • Mometasone furoate 0.1%
    • 50:50 Paraffin.

  2. That the following metred dose inhalers be added to the RNPCH list within the Prescription medicines for common conditions category:
    • Salbutamol
    • Fluticasone
    • Budesonide + Formoterol.

  3. That the indication for metrondiazole be removed in order to extend treatment to include trichomoniasis infections and sexual partners.

  4. That medroxyprogesterone oral (10mg) be added to the RNPCH list within the Prescription medicines for contraception and sexual health category, for post-Jadelle-insertion breakthrough bleeding.

How do I provide feedback on these recommendations?

We value your views on these recommendations. As well as the perspectives of health practitioners and service managers, we would value hearing the views of health and disability support service consumers, patients, clients, and advocates.

Consultation on these recommendations is now open, and will close at 5pm on Monday 9 January, 2023.

We have prepared a short questionnaire to help people provide feedback, which you can complete by following this link.

If you have any questions about the consultation, please contact us on [email protected]