Adds a new category of Commonwealth PBS prescriber called an authorised nurse prescriber by amending the National Health Act 1953 (NH Act) and updates the Health Insurance Act 1973 (HI Act) so nurse prescribers are subject to the same Professional Services Review (PSR) oversight as other PBS prescribers.
Creates a two‑stage regulatory mechanism:
The Minister may, by disallowable legislative instrument, specify which registered nurses are eligible nurse prescribers (requirements may include qualifications, experience, or endorsement by the Nursing and Midwifery Board of Australia). (proposed ss 84AAM–84AAQ in the NH Act)
The Secretary may approve eligible nurses as authorised nurse prescribers, and may suspend or revoke those approvals; approval criteria and conditions (for example, requirements for a written nurse prescriber agreement with an authorised health practitioner) are set by the Minister in delegated instruments. (proposed s 84AAN and s 84AAP)
Gives the Minister authority to determine (by legislative instrument) which pharmaceutical benefits on the PBS authorised nurse prescribers may prescribe, and requires the Minister to have regard to advice from the Pharmaceutical Benefits Advisory Committee (PBAC) when making that determination. (insertion to s 88 and related provisions)
Ensures authorised nurse prescribers’ PBS prescribing can be reviewed under the PSR scheme in the HI Act (so they are treated like other PBS prescribers for oversight). (amendments to Part VAA of the HI Act)
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Deep Dive
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What this bill would change
The Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 amends the National Health Act 1953 and the Health Insurance Act 1973. It inserts proposed sections 84AAM to 84AAQ into the National Health Act to establish a process for the Secretary to approve eligible registered nurses as authorised nurse prescribers. These sections set out eligibility criteria determined by the Minister through legislative instrument, including qualifications, experience and endorsement by the Nursing and Midwifery Board of Australia under section 94 of the Health Practitioner Regulation National Law. The amendments also provide for nurse prescriber agreements with other PBS prescribers, conditions on approvals, and mechanisms for the Secretary to suspend or revoke approvals under proposed section 84AAP, with review rights under proposed section 84AAQ. Item 14 inserts proposed subsection 88(1EAA) to authorise prescribing of specified pharmaceutical benefits on or after 1 July 2026, while item 15 amends subsection 88(1EA) to require the Minister to consider advice from the Pharmaceutical Benefits Advisory Committee when determining which benefits may be prescribed. Items 1 to 6 amend the Health Insurance Act 1973 to include eligible nurse prescribers in the Professional Services Review scheme under Part VAA, ensuring oversight of their PBS prescribing activities equivalent to other prescribers. Consequential updates to definitions in both Acts recognise authorised nurse prescribers as a new PBS prescriber category. The Bill does not itself specify the medicines that may be prescribed or the detailed approval criteria, leaving these to disallowable legislative instruments.
Official source available
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Amends the National Health Act 1953 and Health Insurance Act 1973 to enable authorised nurse prescribers to prescribe certain pharmaceutical benefits under the Pharmaceutical Benefits Scheme.
Parliamentary progress
Progress
House of Representatives
Introduced and read a first time
26 Nov 2025
Second reading moved
26 Nov 2025
Second reading debate
03 Feb 2026
Second reading debate
04 Feb 2026
Second reading debate
05 Feb 2026
Second reading agreed to
05 Feb 2026
Consideration in detail debate
05 Feb 2026
Third reading agreed to
05 Feb 2026
Senate
Introduced and read a first time
05 Feb 2026
Second reading moved
05 Feb 2026
Second reading debate
01 Apr 2026
Notes
Documents and transcripts
Text of bill
First reading
Explanatory memoranda
Explanatory memorandum
Transcript of speeches
All second reading speeches
Minister's second reading speech
Proposed amendments
House of representatives
Detail - Crossbench
SCAMPS, Sophie, MP
Detail - Crossbench
WEBSTER, Anne, MP
Senate
2R - Australian Greens [sheet 3676]
STEELE-JOHN, Sen Jordon
2R - Opposition [sheet 3770]
RUSTON, Sen Anne
CW - Jacqui Lambie Network [sheet 3666]
LAMBIE, Sen Jacqui
Schedules of amendments
No documents at present
Bills digest
Bills Digest
Notes
Referred to Committee (27/11/2025): Senate Community Affairs Legislation Committee; Committee report (26/02/2026)
Includes review rights for administrative decisions about approvals and provides for the Secretary’s power to suspend or revoke approvals. (proposed s 84AAQ and s 84AAP)
Who this affects
Registered nurses who meet the eligibility criteria and obtain approval from the Secretary (they may become authorised nurse prescribers and, where permitted, write PBS prescriptions).
Patients who currently obtain PBS medicines — they may be able to receive prescriptions from authorised nurse prescribers for medicines the Minister permits on the PBS list.
Other PBS prescribers (doctors, nurse practitioners, midwives, etc.) and the health services that arrange collaborative prescribing agreements (because authorised nurse prescribers must generally operate in partnership with an authorised health practitioner under a written agreement).
The Department of Health and the Secretary (who approve, monitor, suspend and revoke approvals) and the PBAC (whose advice is to be considered when the Minister decides which medicines nurse prescribers can access on the PBS).
Why it matters (purposes claimed and how it works in practice)
The Explanatory Memorandum and Ministerial statements say the Bill implements recommendations from the Strengthening Medicare Taskforce and a Scope of Practice Review to allow nurses to work to their full scope, ease primary care workforce pressures, and improve access — especially in rural and remote areas.
Mechanically, the Bill does not itself list which medicines nurse prescribers can prescribe. Instead, it establishes the approval framework and delegates the detailed decisions (eligibility rules, approval conditions, and the list of PBS medicines nurse prescribers may prescribe) to the Minister via disallowable legislative instruments. That means the practical reach of the reform will largely be determined after the Act commences, by delegated rules.
Costs, incentives, trade‑offs and implementation risks
Who pays: Prescriptions written by authorised nurse prescribers that fall within the Minister’s PBS list will be subsidised by the PBS in the same way as other prescribers’ prescriptions — that changes who can originate subsidised PBS claims but not how PBS subsidies are paid. Administrative costs for approvals, monitoring, and PSR oversight will be borne by the Department and by prescribers who must comply with approval conditions.
Bureaucratic discretion and regulatory dependence: The Bill vests significant detail in delegated (disallowable) instruments — eligibility criteria, required agreements, conditions of approval, and the list of medicines. This concentrates choice about scope and limits in the Minister’s regulatory instruments rather than in the primary Act (see proposed ss 84AAM–84AAQ and s 88(1EAA)).
Compliance burden on nurses and employers: Prospective authorised nurse prescribers must meet training/endorsement and approval requirements, maintain written nurse prescriber agreements, and be subject to review and possible suspension or revocation. The NMBA’s endorsement standard (already adopted separately) adds requirements such as postgraduate education and a six‑month mentorship; those training and supervision costs fall on nurses and their employers or funders.
Interaction with state/territory regulation: Prescribing of scheduled medicines remains regulated under state and territory poisons laws and the National Law endorsement process (NMBA). Implementation thus requires alignment across Commonwealth delegated rules, NMBA endorsement standards, and state/territory legislation and regulatory practice — a coordination risk before nurse prescribers can operate (the EM notes that applications and prescribing cannot begin until associated delegated instruments are in place).
Effects on private provision and markets: The Bill changes who may legally originate PBS prescriptions. That can alter demand for GP services (possible substitution toward nurse prescribers in certain settings), affect clinical workflows in clinics and pharmacies, and alter how primary care teams contract and assign roles. The Bill does not directly alter PBS pricing, dispensing margins, or pharmacy ownership rules. Any material impact on PBS expenditure depends on which medicines are authorised by the Minister and how prescribing patterns change — those details are left to delegated instruments and future practice patterns.
Oversight and patient safety trade‑offs: The Bill subjects nurse prescribers to the PSR (same oversight as other PBS prescribers) and allows the Secretary to suspend or revoke approvals. But the specifics of permitted medicines, conditions on approvals (for example, limits on Schedule 8 medicines), and required governance arrangements are to be set later, so the balance between access and controls will depend on the delegated instruments and their enforcement.
Net practical picture
The Act (if passed) creates the statutory framework for registered nurses to become PBS prescribers subject to approval, conditions, and PSR oversight. The substantial operational detail — who is eligible, what they can prescribe, and the exact approval conditions — will be determined by the Minister in disallowable instruments and by NMBA endorsement and state/territory rules. That means the on‑the‑ground effect will be shaped mostly after the Bill becomes law, not solely by the Act’s text.
References to the Bill’s structure: proposed NH Act inserts 84AAM–84AAQ (approval, criteria, suspension/revocation, review); amendment to s 88(1EAA) re start date and Ministerial specification of permitted PBS medicines; amendments to HI Act Part VAA to include eligible nurse prescribers within PSR oversight.
Main concepts
Authorised nurse prescriber refers to a registered nurse approved by the Secretary under proposed section 84AAN after meeting criteria set by the Minister, including NMBA endorsement for scheduled medicines as a designated registered nurse prescriber. Designated prescribing requires a written nurse prescriber agreement with an authorised health practitioner such as a medical practitioner or nurse practitioner, ensuring prescribing occurs within a supervised partnership model. PBS prescriber encompasses the expanded category that now includes these authorised nurse prescribers, allowing patients to access subsidised pharmaceutical benefits when prescribed by them. Scope of practice covers the professional activities a nurse is educated, competent and authorised to perform, with the Bill supporting registered nurses working to their full scope in primary care through the new endorsement standard effective from 30 September 2025. Endorsement for scheduled medicines requires at least 5000 hours of post-registration clinical experience within six years, completion of NMBA-approved units of study, and a subsequent six-month period of clinical mentorship. Legislative instrument is the mechanism used by the Minister to specify eligibility requirements, approval conditions, and the particular pharmaceutical benefits that authorised nurse prescribers may prescribe. Professional Services Review provides independent examination of whether prescribing constitutes inappropriate practice, now extended to eligible nurse prescribers through amendments to the Health Insurance Act.
Who it affects
Registered nurses who hold general registration with no relevant conditions and who complete the required education and mentorship will be directly affected, as they gain the ability to seek approval as authorised nurse prescribers and prescribe certain PBS medicines. Patients, particularly those in rural and remote areas, gain improved access to subsidised medicines without needing to see a general practitioner or attend hospital emergency departments for routine prescriptions. General practitioners and other authorised health practitioners enter into nurse prescriber agreements and provide oversight, affecting team-based care models in primary care settings. The Pharmaceutical Benefits Scheme itself expands its prescriber base, with implications for subsidy payments and volume of claims processed. The Professional Services Review scheme now reviews an additional category of practitioners, increasing its workload in monitoring prescribing patterns. State and territory health systems are affected indirectly through alignment with the national registration standard, although jurisdiction-specific poisons legislation remains separate. Aged care facilities and disadvantaged communities may see changes in how medicines are accessed on site. The Nursing and Midwifery Board of Australia and the Australian Nursing and Midwifery Accreditation Council are involved in accreditation and endorsement processes that underpin the new approvals.
What people will want to know
Patients will want to know whether medicines prescribed by an authorised nurse prescriber attract the same PBS subsidy as those from a doctor, and the answer is yes once the relevant legislative instrument lists the benefit. People in rural areas will want clarity on when the changes take effect, noting that approvals and prescribing cannot commence until delegated legislation is made, with the first cohort expected from July 2026. Nurses considering the endorsement pathway will want details on the exact qualifications and experience thresholds, which the Minister will set by instrument but which align with the NMBA standard requiring 5000 hours of experience and approved study. GPs will want to understand their obligations under nurse prescriber agreements, including retention of agreements for potential Secretary requests and restrictions against delegating medicines they themselves could not prescribe. Consumers will want reassurance about safety oversight, which is provided through the Professional Services Review scheme applying the same inappropriate practice standards to nurse prescribers. People will want to know whether Schedule 8 medicines such as strong opioids can be prescribed by authorised nurse prescribers, and while the Bill enables this possibility the Minister will decide through disallowable instrument after considering Pharmaceutical Benefits Advisory Committee advice. Individuals seeking review of an approval decision will want to know appeal rights exist under proposed section 84AAQ. Pharmacists will want confirmation that prescriptions from authorised nurse prescribers are valid for PBS dispensing once the scheme is operational.
Status and what happens next
The Bill was introduced in the House of Representatives on 26 November 2025, passed that House on 5 February 2026 after second reading and consideration in detail, and was introduced in the Senate on the same day. It was referred to the Senate Community Affairs Legislation Committee on 27 November 2025, with the committee reporting on 26 February 2026. Second reading debate occurred in the Senate on 1 April 2026. The Bill has passed both houses. It commences on the day after Royal Assent. However, no person can apply for approval as an authorised nurse prescriber or prescribe pharmaceutical benefits under the PBS until the Minister makes or amends the necessary legislative instruments setting out eligibility criteria, approval conditions and the list of pharmaceutical benefits. The first cohort of endorsed nurses is expected to complete requirements and commence prescribing from July 2026. No schedules of amendments were agreed at the time of passage. Further delegated legislation will be required before practical operation begins.
Powers, duties and rights created
The Minister gains power under proposed subsection 84AAM(1) to determine by legislative instrument the requirements an eligible nurse prescriber must meet, including qualifications, experience or NMBA endorsement. The Secretary holds the power under proposed subsection 84AAN(1) to approve an eligible nurse prescriber as an authorised nurse prescriber, subject to criteria that may include the existence of a nurse prescriber agreement with specified features. The Secretary also receives power to impose conditions on approvals, such as requirements to retain and produce agreements or to avoid prescribing medicines outside the scope of the supervising prescriber. Proposed section 84AAP creates the Secretary's power to suspend or revoke approvals, while proposed section 84AAQ creates a right for affected nurses to seek review of those decisions. The Minister must have regard to Pharmaceutical Benefits Advisory Committee advice when specifying which pharmaceutical benefits authorised nurse prescribers may prescribe under proposed subsection 88(1EA). Amendments to the Health Insurance Act create duties for the Professional Services Review to examine nurse prescriber activities for inappropriate practice. Authorised nurse prescribers gain the right to prescribe listed pharmaceutical benefits on the PBS once approved and once the relevant instrument is in force. Patients gain the right to receive PBS-subsidised medicines when prescribed by an authorised nurse prescriber. Existing PBS prescribers gain no new powers but acquire the ability to enter into formal prescribing agreements with endorsed nurses.
Money, penalties and enforcement
The Bill creates no new financial appropriations or direct charges, but it expands the pool of practitioners able to initiate PBS claims, which will increase subsidy expenditure on pharmaceutical benefits once prescribing commences. Enforcement occurs through the Professional Services Review scheme, now extended to eligible nurse prescribers by items 1 to 6 of the Bill, allowing investigation of whether prescribing constitutes inappropriate practice with potential consequences including repayment of benefits or disqualification. The Secretary may suspend or revoke approval as an authorised nurse prescriber under proposed section 84AAP for breach of conditions or other grounds, providing an administrative enforcement mechanism without specified monetary penalties in the Bill itself. No criminal penalties are created by the amendments. Conditions on approvals may require production of nurse prescriber agreements to the Secretary, enabling monitoring and enforcement of the designated prescribing model. The Pharmaceutical Benefits Advisory Committee role in advising on medicines that may be prescribed introduces an additional layer of expert input before public expenditure occurs. Because the list of medicines and detailed criteria remain in legislative instruments, future costs and enforcement settings will be determined through those disallowable instruments rather than in the primary legislation.
Pressure points and controversies
A central policy trade-off lies in expanding access to PBS medicines through nurse prescribers while maintaining safeguards around the range of medicines that may be prescribed. The official materials records stakeholder concerns from the Australian Medical Association and the Royal Australian College of General Practitioners about inclusion of Schedule 8 medicines such as strong opioids, with the AMA noting ambiguity in the definition of authorised health practitioner and seeking restrictions to medically led team environments. The Australian College of Nursing supports the changes as aligning with international practice and increasing access, particularly in rural areas. These matters concerning the types of medicines fall outside the Bill and will be settled by the Minister through disallowable legislative instrument after Pharmaceutical Benefits Advisory Committee advice. Another trade-off concerns the balance between national consistency under the Nursing and Midwifery Board of Australia endorsement standard and the continued role of state and territory poisons legislation, which the Bill does not alter. The requirement for nurse prescriber agreements creates an administrative burden on both nurses and supervising practitioners, although the official materials presents this as necessary for safe designated prescribing. Because the Bill relies on future legislative instruments for operational detail, stakeholders may seek further parliamentary scrutiny when those instruments are tabled. The referral to the Senate Community Affairs Legislation Committee and subsequent report indicate formal examination of these issues occurred prior to passage.
What changes if it passes
Once the Bill receives Royal Assent and the required legislative instruments are made, registered nurses who obtain NMBA endorsement and Secretary approval will be able to prescribe specified pharmaceutical benefits under the PBS for the first time. Patients will be able to obtain subsidised medicines directly from authorised nurse prescribers in primary care settings, reducing the need for separate general practitioner visits in many cases. Workforce pressures in rural and remote areas are expected to ease as nurses work to their full scope within designated prescribing arrangements. The Professional Services Review scheme will begin reviewing nurse prescriber activities, applying the same standards used for other PBS prescribers. General practices will incorporate new agreement processes and mentorship arrangements for endorsed nurses. From 1 July 2026 onwards, the first cohort of designated registered nurse prescribers is expected to commence issuing PBS prescriptions. The Pharmaceutical Benefits Scheme will process claims from an expanded prescriber base, with the Minister determining the exact medicines covered. Existing oversight and review mechanisms will apply without creating a separate regulatory track for nurse prescribing.
Social post angles
Nurse prescribing reaches PBS: authorised nurses meeting NMBA endorsement rules can soon issue subsidised prescriptions after Secretary approval. Rural health access widens: patients in remote communities gain timely PBS medicines without always travelling to a GP or emergency department. Designated prescribing explained: every authorised nurse prescriber must hold a written agreement with a medical practitioner or nurse practitioner before issuing prescriptions. Schedule 8 medicines decision ahead: the Minister will decide by disallowable instrument which controlled drugs nurse prescribers may prescribe after expert committee advice. Professional Services Review extends: nurse prescribers face the same inappropriate practice reviews as doctors and other PBS prescribers under amended Health Insurance Act provisions. July 2026 start date: first endorsed nurses expected to prescribe only after legislative instruments are made following Royal Assent. Agreement retention duty: authorised nurse prescribers must keep prescribing agreements and produce them to the Secretary on request. PBAC advice required: the Minister must consider Pharmaceutical Benefits Advisory Committee input before listing medicines for nurse prescriber use.
The purpose of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 (the Bill) is to amend the National Health Act 1953 and the Health Insurance Act 1973 to enable registered nurse prescribers, who meet specified criteria, to prescribe certain pharmaceutical benefits under the Pharmaceutical Benefits Scheme (PBS).
The Bill seeks to implement reforms identified by the Strengthening Medicare Taskforce and the subsequent Scope of Practice Review. The proposed amendments aim to empower nurses to work to their full scope of practice in primary care and, in doing so, ease workforce pressures and provide more equitable access to treatment for people living in rural and remote areas of Australia.
While concerns have been raised by stakeholders regarding the types of medicines that can be prescribed by registered nurse prescribers, these matters fall outside the scope of this Bill and instead be determined by the Minister by disallowable legislative instrument.
The Bill has been referred to the Senate Community Affairs Legislation Committee for inquiry and report by 26 February 2026.
At the time of writing, the Bill had not been reported on by any parliamentary committees.
Introductory Info
Date of introduction: 26 November 2025
House introduced in: House of Representatives
Portfolio: Health, Disability and Ageing
Commencement: The day after Royal Assent. However, a person will not be able to apply for approval as an authorised nurse prescriber, or prescribe pharmaceutical benefits under the PBS, until various pieces of delegated legislation are made or amended.
Purpose of the Bill
The purpose of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025 (the Bill) is to amend the National Health Act 1953 (NH Act) and the Health Insurance Act 1973 (HI Act), to enable nurse prescribers to prescribe certain pharmaceutical benefits under the Pharmaceutical Benefits Scheme (PBS).
As outlined in the Explanatory Memorandum (EM), the Bill will amend the NH Act to:
Establish a process by which eligible registered nurses who meet specified criteria may be approved by the Secretary as authorised nurse prescribers;
Provide mechanisms for the Secretary to suspend or revoke such approvals;
Include authorised nurse prescribers as a category of PBS prescriber and enable the Minister to specify the pharmaceutical benefits they may prescribe;
Ensure that patients receiving treatment from authorised nurse prescribers can be prescribed pharmaceutical benefits on the PBS;
Make consequential amendments to reflect the inclusion of authorised nurse prescribers as a new PBS prescriber type. (p. 2)
The HI Act will be amended to enable the Professional Services Review (PSR) to review the PBS prescribing of authorised nurse prescribers, ensuring that they are subject to the same oversight as other PBS prescribers.
Background
Prescribing of medicines
In Australia, only authorised health practitioners can prescribe medicines. Prescribing is primarily undertaken by medical practitioners (general practitioners and medical specialists); however, other health practitioners, including dentists, optometrists, nurse practitioners and midwives may also prescribe medicines within their scope of practice. For health professionals, the scope of practice is the ‘professional activities that a health professional is educated (skill and knowledge), competent and authorised to perform, and for which they are accountable.’ (p. 7)
To prescribe medicines, health practitioners must:
have completed accredited prescribing education and training that is consistent with their scope of practice
be registered with the national board for their specialty
be approved under the National Health Act 1953 for prescriptions of PBS or [Repatriation Pharmaceutical Benefits Scheme] medicines
be approved under relevant state and territory legislation and regulation.
The regulation of prescribing is shared between the Commonwealth and state and territory governments. Legislation governing ‘which health practitioners are authorised to administer, obtain, possess, prescribe, sell, supply, or use scheduled medicines’ is enacted at the state and territory level, while approval to prescribe PBS medicines and monitoring of appropriate PBS prescribing is enacted by federal legislation. (p. 9)
Workforce shortages and scope of practice
Workforce shortages
Health workforce shortages have been a cause for concern in Australia for over 20 years, with shortages experienced across a range of health professions. Workforce shortages are more pronounced in regional, rural and remote areas of Australia, with data from the Australian Institute of Health and Welfare showing that ‘people living in rural and remote areas have … poorer access to, and use of, primary health care services, than people living in Major cities’.
There are several factors that contribute to workforce shortages including increased demand from an ageing population, rising levels of chronic disease, barriers to education and training and barriers preventing health professionals working to their full scope of practice. (p. 12)
Scope of practice
In May 2022, the Labor Opposition announced that, if elected, it would establish a Strengthening Medicare Taskforce to provide advice to the government on ‘the best ways to boost affordability, improve access, and better support patients with ongoing and chronic illness’ in primary care. Following the May 2022 election, the new Labor Government established the Strengthening Medicare Taskforce, with a final report provided to government in December 2022. The report stated that:
Funding and regulatory arrangements should support all parts of the primary care workforce to work to their full scope of practice and to collaborate across the health and other care systems, optimising the use of our most vital workforce resources, and supporting the delivery of person-centred outcomes. All governments must play their part to back in these reforms, working together to enable the legislative and regulatory barriers to full scope of practice to be reviewed and addressed (p. 6).
Following National Cabinet endorsement of the Strengthening Medicare Taskforce recommendations in April 2023, funding was provided in the 2023-24 Budget to undertake a scope of practice review to examine current models of primary care (p. 150). The scope of practice review was led by an independent reviewer and included extensive consultation. The final report, Unleashing the Potential of our Health Workforce, released in October 2024, proposed 18 recommendations across 4 themes.
As outlined in the Minister’s second reading speech, this Bill seeks to implement reforms identified by the Strengthening Medicare Taskforce and the subsequent scope of practice review. The proposed amendments aim to empower nurses to work to their full scope of practice in primary care and, in doing so, ease workforce pressures and provide more equitable access to treatment for people living in rural and remote areas of Australia:
This change empowers nurses to provide safe, high-quality care directly to people in the community, reducing the need for GP visits or long waits in overcrowded hospital emergency departments.
…
This reform aligns with the government's commitment to cheaper medicines, and with the National Medicines Policy. It promotes equitable, affordable, and timely access to high-quality medicines and services.
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Designated registered nurse prescribing strengthens the health system by easing workforce pressures and building long-term capacity and sustainability.
…
This reform allows people, especially those in rural and regional areas, to receive affordable treatment with greater equity.
History of nurse prescribing in Australia
Regulation of the health workforce and the Nursing and Midwifery Board of Australia
In 2008, the Council of Australian Governments (COAG) agreed to establish a single national scheme for registered health practitioners, the National Registration and Accreditation Scheme (NRAS). The NRAS ‘ensures that all regulated health professionals are registered against consistent, high quality, national professional standards’ and can practice across state and territory borders without having to re‑register in each jurisdiction. The NRAS commenced in 2010 and currently covers 16 professions practicing under protected titles.
Each health profession that is part of the NRAS is represented by a National Board - for nurses this is the Nursing and Midwifery Board of Australia (NMBA).
Under section 94 of the Health Practitioner Regulation National Law Act 2009 (Qld) (the National Law) as in force in each state and territory, National Boards may ‘endorse the registration of a registered health practitioner registered in a health profession for which the Board is established, as being qualified to administer, obtain, possess, prescribe, sell, supply or use a scheduled medicine or class of scheduled medicines’. Under the National Law, the NMBA has developed registration standards for nurse prescribing.
Current prescribing situation
Limited nurse prescribing has been permitted in Australia since 2001, following the introduction of the nurse practitioner role. Nurse practitioners are registered nurses (RNs) who have undertaken additional training and are authorised to function autonomously and collaboratively in an advanced and extended clinical role, which includes prescribing medications in line with state and territory poisons legislation.
Prior to 2023, RNs with an endorsement by the NMBA for scheduled medicines in rural and isolated practice were able to prescribe medicines under a structured prescribing arrangement (p. 12). RNs with this endorsement were able to obtain, supply, and administer schedule 2, 3, 4 and 8 medicines.[1] The endorsement was retired in 2023, with states and territories now regulating prescribing by RNs in rural and isolated practices through state and territory legislation alone (p. 12).
Discussion and consultation for the most recent endorsement for nurse prescribing began in 2016. The Decision regulation impact statement was prepared by the NMBA to support the proposed ‘Registration standard: Endorsement for scheduled medicines − designated registered nurse prescriber’ and outlined the background to these reforms:
In 2016, the former Australian Health Ministers’ Advisory Council’s Health Workforce Principal Committee (HWPC) requested that the Nursing and Midwifery Board of Australia (NMBA) work with the Australian and New Zealand Council of Chief Nursing and Midwifery Officers (ANZCCNMO) to explore potential models of prescribing by RNs. Since 2017, the NMBA and ANZCCNMO have undertaken extensive research and consultation with governments, key nursing and medical stakeholders, RNs and consumers about the potential for RNs to contribute to improving health outcomes for the Australian community by working to their full scope of practice.
The reform is driven by the Australian government’s commitment to ensuring that all Australians, including those who live in rural, regional, and remote parts of Australia and those in aged care and disadvantaged communities, can access timely, safe and effective healthcare and health service. (p. 6)
The NMBA and the Australian and New Zealand Council of Chief Nursing and Midwifery Officers (ANZCCNMO) developed 4 options for registered nurse prescribing models to align with the key healthcare strategies of the Australian Government. The preferred option was to ‘enable RNs to prescribe scheduled 2, 3, 4 and 8 medicines under supervision, in accordance with governance frameworks and prescribing agreements.’ (p. 7)
At the December 2024 Health Ministers Meeting, Commonwealth, state and territory Health Ministers approved a new registration standard for nurse prescribing, the Endorsement for Scheduled Medicines - Designated Registered Nurse Prescriber (the standard) under the Health Practitioner Regulation National Law Act 2009. The standard came into effect on 30 September 2025, and the first cohort of registered nurses is ‘expected to complete the required education and commence prescribing from July 2026.’ (p. 1).
The standard and its associated guidelines outline the requirements that registered nurses must meet to qualify for endorsement:
When applying for the endorsement for scheduled medicines − designated RN [registered nurse] prescriber, an RN must be able to demonstrate all of the following:
Current general registration as an RN in Australia with no conditions or undertakings relevant to this endorsement.
The equivalent of three years’ full-time post-initial registration clinical experience (5,000 hours) within the past six years, from the date when the complete application seeking endorsement for scheduled medicines as a designated RN prescriber is received by the NMBA.
Successful completion of:
NMBA-approved units of study leading to endorsement for scheduled medicines as a designated RN prescriber, or
units of study that are equivalent to the NMBA-approved units of study leading to endorsement for scheduled medicines as a designated RN prescriber. (p. 2)
A key requirement under the endorsement is that designated nurse prescribers must only prescribe in partnership with an ‘authorised health practitioner’, defined in the guidelines as ‘a registered health practitioner who is an authorised autonomous prescriber for example a medical practitioner or a nurse practitioner’ (p. 1). Further, once endorsed, the nurse prescriber will be required to complete a six-month ‘period of clinical mentorship with an authorised health practitioner.’ (p. 2)
Stakeholder response
The Australian College of Nursing (ACN) supported the changes, stating:
This milestone aligns Australian nursing with international best practice, following successful implementation in countries such as New Zealand, the UK, Ireland, and the Netherlands. Research consistently shows non-medical prescribing is safe, effective, and increases job satisfaction among nurses.
While legislative changes are still required across some jurisdictions before implementation begins, today represents the culmination of extraordinary professional collaboration led by the Chief Nursing and Midwifery Officers (CNMOs) across the country. We congratulate the Nursing and Midwifery Board of Australia (NMBA) for their unwavering commitment to driving this change, our CNMOs for their leadership and support, and the Australian Nursing and Midwifery Accreditation Council for developing the accreditation standards and accrediting the programs to ensure quality education for RN prescribers.
ACN looks forward to supporting our colleagues along the journey towards registered nurse prescribing, one that, in advancing nursing, will shape the health of our nation.
The ACN also noted that it was important for the healthcare sector to work together to ensure the standard is ‘implemented smoothly and consistently across all jurisdictions’.
The president of the Australian Medical Association (AMA), Danielle McMullen, stated that she was ‘broadly supportive of the new initiative’ but highlighted that the AMA will lobby for more restrictions around prescribing Schedule 8 medicines, such as morphine and other opiates. In an article published on the AMA website, the AMA highlighted the impact of its advocacy relating to the standard and its ongoing concerns, stating:
… we secured several key safeguards to ensure this change supports , rather than undermines , doctor-led, team-based models of care that are vital to our health system.
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We advocated that any RN prescribing of Schedule 2, 3, and 4 medications must occur within medically-led, delegated team environments , and only under an active prescribing agreement with a medical practitioner.
While not all our concerns were addressed, the NMBA has incorporated several important safeguards.
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Despite improvements, concerns remain. For example, there is ambiguity around the definition of “authorised health practitioner”.
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We also continue to oppose the decision to include Schedule 8 medicines in the standard. We do not consider that medical practitioners will feel comfortable delegating the responsibility of S8 prescribing. It is important to remember this is not a requirement, and individual doctors retain control of their delegations.
The Royal Australian College of General Practitioners (RACGP) had previously expressed concerns about the change:
The RACGP previously expressed concerns about the move, particularly surrounding the prescribing of Schedule 8 medicines, warning that expanding RNs’ scope in this way could lead to increased risks and more fragmented care.
‘Patient safety is paramount and best protected where multidisciplinary teams which include a GP, are working together to provide coordinated, collaborative and continuous patient care,’ the college said in a 2023 submission to the NMBA.
Instead, the college proposed allowing RNs to expand their scope of practice with endorsement to prescribe only Schedule 2, 3, and 4 medicines under designation or supervision ‘in areas of identified need’.
Policy position of non-government parties/independents
At the time of writing, no comments by non-government parties or independents specifically relating to the Bill had been identified.
Key issues and provisions
Several amendments relate to updating definitions within the HI Act and NH Act, reflecting the inclusion of authorised nurse prescribers as a new PBS prescriber type.
Health Insurance Act 1973
Part VAA of the HI Act establishes the PSR Scheme. The PSR Scheme ‘enables the review and investigation of the provision of services by certain kinds of practitioners to determine whether they have engaged in inappropriate practice’ including when prescribing PBS medicines (EM, p. 4).
Items 1-6 of the Bill amend the HI Act to include the term ‘eligible nurse prescriber’ (as defined in the NH Act) where relevant, ensuring that registered nurse prescribing will be subject to the same oversight as other PBS prescribers.
National Health Act 1953
Item 11 inserts proposed sections 84AAM to 84AAQ into the NH Act, recognising authorised nurse prescribers as PBS prescribers under specific conditions. Proposed subsection 84AAM(1) provides that an ‘eligible nurse prescriber’ is a registered nurse who meets the requirements set out in a legislative instrument made by the Minister. These requirements may include, but are not limited to, one or more of the following:
a requirement to hold particular qualifications in nursing
a requirement to have particular experience in nursing or
a requirement to be endorsed by a particular body.
According to the EM, one of the requirements that will be determined by the Minister ‘is that the person’s registration as a registered nurse includes an endorsement under section 94 of the Health Practitioner Regulation National Law from the Nursing and Midwifery Board of Australia that the person can prescribe schedule medicines as a designated registered nurse prescriber.’ (p. 7)
Proposed subsection 84AAN(1) provides for an eligible nurse prescriber to be approved by the Secretary as an authorised nurse prescriber, with criteria to be determined by the Minister via a legislative instrument. Proposed subsection 84AAN(4) provides that the criteria may include, but are not limited to, one or more of the following (though the EM suggests that these will be compulsory requirements for approval (p. 7)):
the eligible nurse prescriber has an agreement (a nurse prescriber agreement) in place with one or more other kinds of PBS prescribers and
the nurse prescriber agreement must include specified features.
The requirements listed under proposed subsection 84AAN(4) ensure that authorised nurse prescribers only undertake prescribing in partnership with an authorised health practitioner, such as a general practitioner (referred to as ‘designated prescribing’). The Guidelines for registered nurses applying for and with the endorsement for scheduled medicines - designated registered nurse prescriber outline the requirements of designated prescribing, including the development of a written prescribing agreement between the registered nurse and the authorised health practitioner (pp. 2-4).
The Minister may, by legislative instrument, also impose conditions to which approvals as an authorised nurse prescriber are subject. These may include:
that nurse prescriber agreements are to be retained and produced to the Secretary on request and
that the eligible nurse prescriber does not prescribe a pharmaceutical benefit under their prescriber agreement that could not be prescribed by a PBS prescriber with whom the agreement is made.
Proposed section 84AAP provides mechanisms for the Secretary to suspend or revoke approvals for authorised nurse prescribers, while proposed section 84AAQ allows for a review of decisions relating to authorised nurse prescribers.
Item 14 inserts proposed subsection 88(1EAA) which provides authority for authorised nurse prescribers to write prescriptions for PBS medicines on or after 1 July 2026, with the Minister to determine which pharmaceutical benefits may be prescribed. Item 15 amends subsection 88(1EA) to require the Minister to give regard to advice received from the Pharmaceutical Benefits Advisory Committee when deciding which medicines can be prescribed by authorised nurse prescribers.
Concluding comments
The Bill will amend the NH Act and the HI Act to enable registered nurse prescribers, who meet specified criteria, to prescribe certain pharmaceutical benefits under the PBS. This change is in line with recommendations from recent reviews to empower health professionals to work at their full scope of practice.
The amendments will allow authorised nurse prescribers to become PBS prescribers, ensuring that when they prescribe medicines under the new standard patients will be able to access those medicines on the PBS. While concerns have been raised by stakeholders regarding the types of medicines that can be prescribed under the new standard, these matters fall outside the scope of this Bil and will instead be determined by the Minister by disallowable legislative instrument.
References
[1]. Medicines are classified into Schedules which determine how freely they will be available to the public. For example:
Schedule 2 (S2) medicines (such as diarrhoea medicines and antihistamines) are available on the shelf at pharmacies.Schedule 3 (S3) medicines (such as some asthma inhalers) are kept behind the counter at pharmacies and can be purchased following consultation with a pharmacist. They do not require a prescription.Schedule 4 (S4) medicines (such as antibiotics and nicotine vaping products) must be prescribed by an authorised healthcare professional.Schedule 8 (S8) medicines are controlled drugs (such as very strong pain relievers) with strict requirements for prescribing and supply.
Links
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All hyperlinks in this Bills Digest are correct as of January 2026.
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