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RACGP questions push for nurse prescribing
A proposal that will allow registered nurses to prescribe medication alongside nurse practitioners has been queried by the RACGP.
The RACGP recognises the valuable role nurses play as part of a GP-led team, but remains concerned that nurse prescribing could increase fragmentation of care and lead to worse health outcomes.
The Nursing and Midwifery Board of Australia (NMBA) has proposed a new prescribing endorsement for registered nurses, allowing them to prescribe with a ‘partner prescriber,’ who could be a GP – or another authorised prescriber, including a nurse practitioner.
In its submission to the NMBA, the RACGP recognised the valuable role nurses play as part of a GP-led team. But the college raised significant concerns about the consequences of the proposal, stating that it could result in registered nurses prescribing independently from the GP-led team.
The RACGP was particularly concerned that the proposal could increase fragmentation of care and, in turn, lead to worse health outcomes for patients.
‘Introducing multiple prescribers is not the solution to addressing challenges in Australia’s health system,’ the submission states.
‘GPs must remain patients’ first point of contact within the healthcare system and retain ultimate oversight of patient care.’
The stated rationale of the NMBA proposal was to increase access to medicines for patients in underserved communities.
However, the RACGP maintains there are already programs in place to increase access to medicines in areas of need, and believes the NMBA proposal, which is intended to be applied universally, will have more adverse consequences than benefits.
‘International and Australian experience has repeatedly demonstrated that GP-led multidisciplinary healthcare teams achieve the best health outcomes for patients,’ the RACGP stated in its submission.
The NMBA proposal envisages two years’ post-registration experience and two units of additional study before being able to prescribe alongside a partner.
But the RACGP believes this is insufficient.
‘Prescribing medicines is not always as straightforward as it may initially appear, and is a responsibility that should not be taken lightly,’ the RACGP submission states.
‘Many patients suffer from multiple chronic conditions with a complex interplay of medications and medical conditions.
‘Managing these requires the expertise that doctors gain from study across a number of disciplines over at least nine years’ graduate and postgraduate training, the majority of which focuses on distinguishing diagnoses.
‘Nurse prescribing of medicines may result in unusual, and sometimes serious, conditions not being recognised and managed appropriately due to a lack of adequate training and expertise.
‘Nurses do not have the right diagnostic skills to identify all possible health issues arising from a consultation.’
The NMBA move comes soon after the Pharmacy Guild of Australia called for pharmacists to be able to independently prescribe certain medications during a Queensland Government review of the pharmacy sector.
The RACGP also strongly opposed this move, believing a push to expand the scope of pharmacy puts patients at risk of poorly coordinated care and wastes valuable health resources.
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