Good and bad in medicines amendment bill.
Subject: Nurses (Practice)
Nurses (Laws, regulations and rules)
Prescription writing (Laws, regulations and rules)
Medical societies (Beliefs, opinions and attitudes)
Pharmaceutical policy (Interpretation and construction)
Pub Date: 04/01/2012
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2012 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: April, 2012 Source Volume: 18 Source Issue: 3
Topic: Event Code: 200 Management dynamics; 930 Government regulation; 940 Government regulation (cont); 980 Legal issues & crime Advertising Code: 94 Legal/Government Regulation Computer Subject: Government regulation
Product: Product Code: 8043100 Nurses; 8622000 Medical Associations NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners; 81392 Professional Organizations SIC Code: 8621 Professional organizations
Organization: Organization: New Zealand Nurses Organisation
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 288872528
Full Text: NZNO has some accolades for, and some concerns about, aspects of the Medicines Amendment Bill, now out for consultation. The Bill amends the outdated Medicines Act, 1981. One of its major features is that nurse practitioners (NPs) will be authorised prescribers, the same designation as doctors, midwives, dentists and optometrists.

"Obviously we are delighted NPs will be authorised prescribers. We also support the designated prescriber role. This is designed for health professionals who have done further study to become a designated prescriber and could apply, for example, to the diabetes nurse specialists involved in the prescribing pilot," NZNO professional services manager Susanne Trim said.

But NZNO is concerned about a new category which has emerged in the Bill, that of delegated prescriber, for which no evidence or policy base has been presented to or discussed with the health sector. "Collaborative prescribing was part of discussions in 2007, but delegated prescribing has come from nowhere and is problematic for a number of reasons," Trim said. "While it may appear this category plugs a gap in the prescribing continuum--in particular. covering the 'grey" area between standing orders and prescribing--it introduces more complexity without resolving current barriers to prescription medicines." How the new prescriber category will work is unclear, but NZNO has concerns about safety and efficiency. Under the Bill, the Minister can also authorise a further category of temporary prescriber and NZNO has the same concerns about this category.

"We need clarity around who can prescribe, not a crowded prescriber base that will include standing orders, delegated prescribers, designated prescribers, temporary prescribers and authorised prescribers. It will just be confusing," Trim said.

"Prescribing is only one aspect of an NP's or the registered nurse designated prescribed professional practice and it should be governed in the same way as all other aspects of nursing practice, ie through scopes of practice. The regulatory authorities, such as the Nursing Council, have the expertise and ability, through scope of practice and regulation, to determine which practitioners are competent to prescribe within their scope of practice," she said. "NZNO believes Nursing Council is the appropriate body to control nurse prescribing, under the aegis of the Health Practitioners Competence Assurance Act."

Medicines legislation must provide clarity and safety for the public and accommodate changing models of care, just as prescription medicines must be made available through appropriately trained and qualified health practitioners right across the regulated health workforce. "The Bill does not alter the underlying issues which have inhibited NPs prescribing, eg access to diagnostic tests, and there will have to be constant amendments as more practitioners become authorised or designated prescribers," Trim said.

While nurses welcome some aspects of the Bill, such as NPs being moved into the authorised prescriber category and having a designated category for RNs who meet the Nursing Council's standards and criteria, the introduction of delegated and new prescriber categories is a major concern, not only for nurses but for all health professionals". Trim said.

NZNO policy analyst Marilyn Head co-ordinated NZNO's submission on the Bill which had to be with the Health Select Committee by April 13.
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