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Source: New Zealand Ministry of Health

A change to prescribing rules will make it easier for almost 100,000 New Zealanders to get the medicines they need, according to both the Ministry of Health’s Chief Nursing Officer Lorraine Hetaraka and PHARMAC’s Director of Operations Lisa Williams. 

From tomorrow (1 July 2021) nurse prescribers will become eligible to initiate and renew a special authority for medicines they are authorised to prescribe. This means they will be able to apply, on behalf of their patient, for a government subsidy on a prescription medicine. 

Some medicines are only funded under certain conditions. To receive funded access to these medicines, a Special Authority approval is required.

“This change means that patients won’t necessarily need to wait for their GP or specialist doctor to sign off much-needed prescriptions for these medicines,” Ms Hetaraka says.

Registered nurses are authorised to prescribe from a list of medicines. More medicines may get added to this list. We are making the change to allow them to initiate or renew the subsidy approval for their patients as well,” Ms Williams says. 

“Being able to start patients on medicines straight away will make better use of nurse prescribers’ expertise and time,” Ms Hetaraka says. 

Ms Williams adds: “We wanted to do this to help more people get access to the medicines they need.  With more healthcare professionals able to initiate a Special Authority, there is a greater opportunity for people to be started on a medicine.”

Before now, a patient who needed a special authority to get a funded medicine would have to see a doctor separately, or the nurse prescriber would need to ask a doctor to apply for it. 

In many cases the change will free up time for doctors and it could ultimately provide more equitable and timely access to healthcare for patients, especially in rural areas.

The Ministry of Health and PHARMAC have worked together to make the change. The Ministry updated the relevant IT systems to permit nurse prescribers to apply for a special authority, and PHARMAC updated the Pharmaceutical Schedule rules to allow nurse prescribers to apply. 

Background 

There are currently 372 nurse prescribers in New Zealand working in primary care and speciality clinics. They are registered nurses who meet Nursing Council requirements to be a nurse prescriber. They can prescribe from a list of medicines for common and long-term conditions and must be a part of a collaborative team.

There are 14 medicines with a current Special Authority that nurse prescribers will now be able to make an application for funding for. These medicines are in the cardiovascular, blood and blood forming, nervous system, diabetes, musculoskeletal and respiratory therapeutic areas. 

They were dispensed to around 96,401 patients in the 12 months to 31 March 2021. 

Nurse prescribing means more people have had improved access to health care. This fundamentally speaks right to the heart of one of our core priorities in health of achieving equity and improving access in the system.

Nurse prescribing in primary health and speciality teams complements the great work already underway by Nurse practitioners. The changes also show just how well-regarded nurses are in our community.

Nurse prescribers are a sub-group of the wider number of registered nurses.

They differ from nurse practitioners. There are more than 500 nurse practitioners in New Zealand. 

Nurse practitioners (NPs) are nurses who have completed a clinical master’s degree with at least four years clinical experience and have been formally authorised as an NP by Nursing Council of New Zealand (NCNZ).

Nurse practitioners are highly skilled autonomous health practitioners who have advanced education, clinical training and demonstrated competency. They have the legal authority to practice beyond the level of a registered nurse, in that they can diagnose and treat people for a range of health conditions and have the same prescribing authority as doctors, dentists and midwives under the Medicines Act 1981.   

MIL OSI