Non-medical prescribing in New Zealand: an overview of prescribing rights, service delivery models and training

Abstract

Aim:In this paper, we aim to provide an updated source of information for nonmedical prescribing (NMP) in New Zealand (NZ). Methods: A variety of NZ sources were used to collect data: legislation, policy documents and information from professional and regulatory organizations, and education providers. Results: In NZ, the legal categories for prescribers include authorized, designated, and delegated prescribers. Authorized prescribers include dentists, midwives, nurse practitioners, and optometrist prescribers. Designated prescribers include pharmacist prescribers, registered nurse prescribers, and dietitian prescribers. There are no delegated prescribers in NZ at this time. There is variation in the regulation, educational programmes and prescribing competencies used by the different prescribing health professionals involved in NMP in NZ. Conclusion: This update collates relevant information relating to NMP in NZ into one consolidated document and provides policy makers with a current overview of prescribing rights, service delivery models, training requirements, and prescribing competencies used for NMP in NZ. As NMP in NZ continues to expand and evolve, this paper will form a baseline for future NMP research in NZ. NZ needs to develop overarching NMP policy to enable consistency in the various aspects of NMP, thereby delivering a safe and sustainable NMP service in NZ.

Barriers to pharmacist prescribing: a scoping review comparing the UK, New Zealand, Canadian and Australian experiences

“…Competence of pharmacist prescribers was a high priority for regulatory organisations in NZ, and despite the requirements for postgraduate qualifications and 2 years postregistration experience in a collaborative team environment, GPs in NZ still held doubts about collaborative PP . The issue of competence resonated in the Australian literature …”

“…The UK adopted supplementary prescribing (SP) in 2003 and independent prescribing (IP) in 2006 – the key difference is that SP is reliant on an existing diagnosis and agreed clinical medication management plan developed in collaboration with patients and their doctors. Collaborative PP rights, introduced in NZ in 2013, enabled pharmacist prescribers to work within multidisciplinary teams . While collaborative prescribers have more freedom in making prescribing decisions than supplementary prescribers, diagnosis and overall patient management remain the role of the medical practitioner .…”

Deprescribing needs to be considered in the pharmacists’ prescribing role

“…In New Zealand and the United Kingdom, recent changes in the legislation have enabled suitably trained pharmacists to prescribe, and various studies have tested the feasibility of pharmacists initiating and deprescribing medications in multiple settings, such as nursing homes and general practice. 4,5 The pharmacists' expanded deprescribing role can be achievable with a teambased approach in which there is a clear delineation of roles and responsibilities, separating the prescribing from the dispensing pharmacist, as in New Zealand. 5,6 In Australia, many health practitioners can prescribe medications.…”

“…There is growing evidence internationally of the effectiveness of pharmacist prescribing roles that include medication cessation. In New Zealand and the United Kingdom, recent changes in the legislation have enabled suitably trained pharmacists to prescribe, and various studies have tested the feasibility of pharmacists initiating and deprescribing medications in multiple settings, such as nursing homes and general practice …”

“…The pharmacists’ expanded deprescribing role can be achievable with a team‐based approach in which there is a clear delineation of roles and responsibilities, separating the prescribing from the dispensing pharmacist, as in New Zealand . In Australia, many health practitioners can prescribe medications.…”