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Wider prescribing powers approved

Despite opposition from doctors, Australia is now officially on the path to allow a broader range of health professionals to prescribe medicines. 

Nursing associations have applauded the health ministers’ approval of the Health Professionals Prescribing Pathway (HPPP), labelling it a step in the right direction for the Australian health industry.

Health ministers at the Standing Council on Health agreed to endorse the findings from the HPPP project, in a move that will give non-medical practitioners the right to prescribe.

The report, which upholds the National Strategy for the Quality Use of Medicines, aims to develop a national approach to making medicine more readily available.

Findings support allowing health professionals, including nurses, midwives, pharmacists and physiotherapists, to prescribe within their scope of practice and within the context of state and territory law.

For the next step of the HPPP project, Health Workforce Australia (HWA) – a statuary body set up by federal and state governments to coordinate reforms to the health workforce – will work with stakeholders on an implementation plan, guiding Australia in the steps of several other countries, including Ireland, the UK and Spain, which have expanded nurse prescribing rights.

CEO of Australian College of Nursing Debra Thoms welcomes the ministers’ recognition that there is a greater opportunity to use the skills of appropriately educated health professionals.

“If Australia is to meet the growing demands for healthcare, new models and approaches to areas such as prescribing are needed,” she said.

“The time and financial cost to individuals and the community of always relying on medical professionals to prescribe will not be sustainable in the long term.

“The [HPPP] enhances access to safe and quality care and it is time that Australia recognised the need for this change.”

The Australian Nursing and Midwifery Federation agrees, stating that the recommendations will lead to optimal health outcomes for patients.

“This initiative will assist in creating a sustainable model of care across the community by improving patients’ access to be diagnosed and be provided with medications, giving them more choice in terms of accessing primary healthcare, without the lengthy waiting times often experienced in a doctor’s surgery or medical centres,” said ANMF federal secretary Lee Thomas.

“[We] would urge all healthcare professionals to work together to provide patients with improved models of care now and in the future.”

Pharmacists have also welcomed the ministers’ approval, which they believe is backed up by many studies that have demonstrated not only good clinical outcomes, but also safety for pharmacists working in this type of role.

“Enabling pharmacists and other health professionals to prescribe will help ensure that there is equity in access to medicines and healthcare for all Australians,” said the president of the Society of Hospital Pharmacists of Australia, Professor Michael Dooley.

“With the help of the NPS MedicineWise Prescribing Competencies Framework, we can ensure a consistent and standard approach to prescribing for all health professionals that have prescribing rights.”

However, Australian Medical Association president Steve Hambleton has labelled the move as “dangerous”, and has called for HWA to reverse the decision before patients are put at risk.

Hambleton said the AMA argued long and hard with HWA against the autonomous model of prescribing, which he said should not have been put to the health ministers as an option.

“Autonomous prescribing encourages fragmented healthcare and poses greater risks to patient safety,” he said.

“We support prescribing by non-medical professionals that is carried out within strict collaborative care arrangements in partnership with doctors.”

The ANMFs Thomas said critics of the plan needed to realise that doctors were no longer at the centre of patient care.

“We urge all healthcare professionals to work together to provide patients with improved models of care now and into the future,” she said.

A safe path

The HPPP outlines a five-step path for health professionals to follow in order to prescribe with safety, as follows:

Step 1: Complete education and training.

Step 2: Obtain recognition from the National Board of competence to prescribe.

Step 3: Ensure authorisation to prescribe.

Step 4: Prescribe medicines within the scope of their practice.

Step 5: Maintain and enhance their competence to prescribe.

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