1 July 2014 changes to prescribing

From 1 July 2014, the Medicines Amendment Act 2013 and Misuse of Drugs Amendment Regulations 2014 come into effect.

These amendments:

  • name nurse practitioners and optometrists as authorised prescribers
  • create a new delegated prescriber category
  • change the definition of medicines and medical devices
  • change the restrictions on nurse practitioners’ prescribing of controlled drugs
  • change the controlled drugs that midwives can prescribe
  • allow for controlled drug prescriptions to be generated electronically.

Changes to the Medicines Act

Nurse practitioners and optometrists are now authorised prescribers

The changes to the Act name nurse practitioners and optometrists as authorised prescribers. This change enables these professionals to prescribe all medicines appropriate to their scope of practice, rather than limiting them to a list of medicines specified in regulation. This recognises the safe and appropriate prescribing practice of nurse practitioners and optometrists over the past 9 years.

New delegated prescriber category

The changes to the Act create a new category of prescriber – the delegated prescriber. This category adds a prescribing option for professional groups beyond the existing categories of authorised prescriber and designated prescriber.

The new delegated prescriber category would enable registered health professionals to prescribe within limited parameters (as set out in a delegated prescribing order) under the sanction of an authorised prescriber. The delegated prescribing order would set specific conditions and restrictions on prescribing (such as only certain medicines for certain patients) for an individual delegated prescriber.

The competence, training and qualifications required of delegated prescribers would be set in consultation with the relevant responsible authority.

Changes to the definition of medicines and medical devices

The Medicines Amendment Act also modernises the definitions of medicine, medical device and therapeutic purpose so that they are better aligned with international norms.

Further information on these changes can be found on the Medsafe website.

Changes to the Misuse of Drugs Regulations

Changes to controlled drug prescribing

The Misuse of Drugs Amendment Regulations 2014 (the Regulations) change controlled drug prescribing for nurse practitioners and midwives.

These amendments reflect current policy settings and changes in clinical practice. The amendments are expected to:

  • improve patient access to timely care
  • make best use of the skills of the nurse practitioner and midwifery workforces
  • reduce patient cost.

To find out more about controlled drug prescribing, go to Controlled drugs.

Nurse practitioner prescribing

From 1 July 2014, the Regulations allow nurse practitioners to prescribe controlled drugs within their scope of practice for:

  • up to 1 month’s supply for Class A and B controlled drugs
  • up to 3 months’ supply for Class C controlled drugs.

(Prior to 1 July the existing Regulations require nurse practitioners to prescribe from a set list of drugs, in an emergency, for up to 3 days.)

Midwife prescribing

From 1 July 2014, the Regulations allow midwives to prescribe morphine, fentanyl and pethidine. (Prior to 1 July, under the existing legislation the only controlled drug midwives can prescribe is pethidine.)

Role of responsible authorities in ensuring safe prescribing practice

The Nursing and Midwifery Councils and the Optometrists and Dispensing Opticians Board respectively are the responsible authorities for nurse practitioners, midwives and optometrists.

Responsible authorities ensure all registered health practitioners are fully competent in the practice of their profession. Find out more at Responsible authorities under the Act.

The Nursing and Midwifery Councils and the Optometrists and Dispensing Opticians Board strongly support the changes to prescribing for their professional groups. Each responsible authority has information and processes in place to support implementation of the prescribing changes.

Controlled drug prescriptions will be able to be generated electronically

The Regulations are also being changed to allow prescriptions for controlled drugs to be electronically generated (rather than requiring handwritten prescriptions). Prescribers will still be required to sign all controlled drug prescriptions.

This change includes a requirement that the Director-General of Health approve the specific systems used for electronically generating prescriptions. Systems will only be approved to generate prescriptions if they:

  • are robust and secure
  • have a data feed to Medicines Control and Sector Services (units within the Ministry of Health with responsibility for monitoring of controlled drug prescribing and payment services).

The change to the Regulations to allow electronically generated prescriptions will come into effect on 1 July 2014. However, prescribers will not be able to start issuing electronically generated prescriptions for controlled drugs immediately as the IT system to support this is still under development.

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