Announcement Date
11 December 2024
Link to Announcement
Expanded role for registered nurses to improve access to safe and timely healthcare
Problem Being Addressed
Some Australians currently do not have timely access to medicines or medicines related services. People living in rural and remote areas encounter higher rates of injury, hospitalisation and death in comparison to people living in major cities due in part to poorer access to primary healthcare services. The health system is being placed under increasing stress due to the ageing population and the ongoing effects of the pandemic, which further prevents timely and equitable access to medicines or medicine related services.
Registered Nurses (RNs) working in health services have reported limitations in their current scope of practice, impacting timeliness of care and the overall quality of care and outcomes for patients. The 2022 Strengthening Medicare Taskforce Report recommended removing barriers to health professionals working to their full scope of practice. The Productivity Commission in its 2005 report Australia’s Health Workforce and 2010 Final Report of the National Health Workforce Planning and Research Collaboration have highlighted the need to increase the number of prescribers to maintain access to medicines, including by expanding the scope of practice of RNs.
The Australian Government has committed to addressing the inequity of access to health care through a range of strategies, including the Rural Health Strategy and the Primary Health Care 10-year plan. There is an opportunity for RNs to expand and work to their full scope of practice to improve access to health care and health outcomes for patients.
Proposal
The Decision Regulation Impact Statement (Decision RIS) considers options to allow appropriately trained and supported RNs to prescribe medicines across healthcare settings, with the goal of reducing the pressure on Australia’s healthcare system and increasing timely access to patient care and medicines.
The Decision RIS was prepared by the Nursing and Midwifery Board of Australia (NMBA) and considered four options.
Option 1: Make no changes to the current prescribing arrangements for RNs (Status Quo).
Option 2: Expand the scope of practice of RNs to prescribe Schedule 2, 3, 4 and 8 medicines as a designated RN prescriber under supervision, in accordance with governance frameworks and prescribing arrangements. This option would require the NMBA to bring forward a new Registration Standard for Health Ministers to approve. This option allows suitably educated, qualified and authorised RNs to prescribe the above mentioned scheduled medicines.
Option 2a: Expand the scope of practice of RNs to prescribe Scheduled 2, 3 and 4 medicines only. This option would not allow RNs to prescribe Schedule 8 medicines but would otherwise include all the requirements described in Option 2.
Option 2b: Expand the scope of practice of RNs to prescribe Schedule 2, 3, 4, and 8 medicines, but exclude RNs working in private practice or as sole practitioners.
The Decision RIS identified Option 2 as the preferred option, being the most supported option by respondents to the Consultation Regulation Impact Statement (Consultation RIS). As outlined in the Decision RIS, analysis of scenarios and costing models of care demonstrated that using a designated RN prescriber could decrease pressure points in hospitals, assist with ageing population and chronic disease treatment and have far reaching advantages for patients in rural and remote areas who are disadvantaged through health underservice.
Assessed Impact Analysis Outcome
Compliant