RN Prescribing in Community Health Consultation 2023

What was this consultation all about?

The Council sought feedback from the health sector on proposed changes to the Medicines List for Registered Nurse Prescribing in Community Health (the Medicines List) and defined population for Registered Nurse Prescribers in Community Health (RNPCH).

The Council consulted on nine recommendations which included two wording changes and seven amendments to the Medicines List.

Proposed wording changes

Wording change Recommendation
Registered Nurses Practicing in Community Health settings can complete a work-based education programme and apply for prescribing authority for a limited number of medicines for minor ailments and illnesses in normally healthy people without significant co-morbidities. One
Normally healthy people are people without serious or complex health conditions, or whose conditions are well-controlled and/or stable. Two

Proposed Amendments to the Medicines List.

Amendment to the Medicines List Recommendation label
That medicines for urinary tract infections only be moved from the prescription medicines for contraception and sexual health category to the prescription medicines for common conditions category. Three
That lidocaine be added to the RNCPH medicine list within the prescription medicines for common conditions category. Four
That stimulant laxatives be added to the RNPCH list within the prescription medicines for common conditions category. Five
That the following topical ointments be added to the RNPCH list within the prescription medicines for common conditions category:
  • triamcinolone acetonide 0.02%
  • hydrocortisone 17-butyrate 0.1%
  • mometasone furoate 0.1%
  • 50:50 paraffin
That the following metered dose inhalers be added to the RNPCH list within the prescription medicines for common conditions category:
  • salbutamol
  • fluticasone
  • budesonide + formoterol.
That the indication for metronidazole be removed in order to extend treatment to include trichomoniasis infections and sexual partners Eight
That medroxyprogesterone oral (10mg) be added to the RNPCH list with the prescription medicines for contraception and sexual health category, for post-Jadelle-insertion breakthrough bleeding. Nine

Who are Registered Nurse Prescribers in Community Health?

An RNPCH is a registered Nurse who has completed additional work-based education, that authorises them to prescribe a limited number of medicines for people with minor ailments and common conditions. The medicines they can prescribe form a subset of the medicine list for approved RN Designated Prescribers in Primary health and Specialty Teams and are already approved for that group of nurse prescribers.

Since their inception, RNPCH nurses have demonstrated they are safe and cautious prescribers who use their prescriptive authority responsibility and in line with recommended national guidelines and health pathways. The Council has never undertaken proceedings against an RNPCH for fitness to practice issues related to prescribing competence or conduct.

How was this consultation conducted?

The Council conducted a formal consultation process between 9 November 2022 and 9 January 2023.

The council received a total of 109 submissions from a broad range of submitters made up of 94 individuals and 15 organisations.

Submission by Individuals and Organisation

To assist submitters in their decision-making process, the Council provided a comprehensive consultation document. You can download this below.

RNPCH Proposed Changes Consultation

What did we hear from the consultation?

The Council received 109 submissions from across a broad range of submitters from both individuals and organisations.

Of these 109 submitters, 99 submitted through the “Form Submission” that was provided by the Council. The remaining 12 submitters provided their feedback via email to the Council as a “Written submission”.

Both submission types have been counted with equal weighting; however, for the purposes of statistical analysis they have been separated into “Form Submissions” and “Written Submissions”.

Submission by Form or Written Submission

Submission Type Number of submissions
Form Submission 97
Written Submissions 12
Total 109

A summary analysis of the Consultation can be downloaded below and those submitters who have agreed to have their written responses made public are included at the end of this page.

Consultation Feedback

Number of submissions in support of Recommendations One and two

Views from Pacific respondents

No organisations that specifically identified as a pacific health service provider or as operating primarily with a Pacific perspective or heath model, responded to this consultation. Three (4.7%) individual submitters identified with one or more Pacific identities, of which an average of 89% support was registered across the nine proposed recommendations.

RNPCH and sector perspectives

Data captured for the Form submission has allowed the Council to identify the nursing status of respondents to the from submission survey. 85 submitters who answered the form submission chose to provide the council data relating to their nursing status. 52 of these (61%) identified as an RNPCH.

Nursing Status of individual submitters

RNPCH were more supportive of the proposed changes, with an average of 89 % support registered across the nine proposed recommendations.

What has the Council decided?

The Council has taken into consideration the feedback provided as part of the consultation process. It has agreed to implement the proposed wording changes and amendments to the Medicines List following high levels of support from respondents. These changes have been published and the new Medicines List is able to be downloaded below.

Medicines List for RN Prescribing in Community Health
 Standards for Recertification Programmes for RN Prescribing in Community Health

Additional feedback

The Council received feedback that included lists of medicines and procedures that submitters believed should be included in addition the ones that were consulted on. This information has been collated and is published below. However, as the medicines and procedures were not consulted on the Council is unable to add these currently to the Medicines List without further consultation in the future.

Appendix of changes and additional medicines that were requested to be added to the Medicines List
Below are the written submissions we received for this consultation and which we have received permission to publish.

Alex long - Nurse Educator, Primary Health Nursing Development Team Waitematā te Whatu Ora
 Burnett Foundation Aotearoa
Capital and Coast Hutt Valley
Carol Smith
Claire Stewart
Di Vicary
Jeff Symonds
Jennifer Sutton
Manatū Hauora  
Rhoena Davis Kaitohu Whakatapuhi - Director of Nursing (Primary Care)