The Health Professionals Prescribing Pathway (HPPP) provides a nationally consistent approach to the prescribing of medicines by health professionals, other than medical practitioners, who are registered under the National Registration and Accreditation Scheme (the National Scheme).
The HPPP was published by Health Workforce Australia (HWA) in 2013 and sets out:
The HPPP states that safe prescribing models can be described in three categories:
Prescribing occurs where a prescriber with a limited authorisation to prescribe medicines by legislation, requirements of the National Board and policies of the jurisdiction or health service prescribes medicines under a guideline, protocol or standing order. A structured prescribing arrangement should be documented sufficiently to describe the responsibilities of the prescriber(s) involved and the communication that occurs between team members and the person taking medicine.
Prescribing occurs where a prescriber undertakes prescribing within their scope of practice under the supervision of another authorised health professional. The supervised prescriber has been educated to prescribe and has a limited authorisation to prescribe medicines that is determined by legislation, requirements of the National Board and policies of the jurisdiction, employer or health service. The prescriber and supervisor recognise their role in their healthcare team and ensure appropriate communication occurs between team members and the person taking medicine.
Prescribing occurs where a prescriber undertakes prescribing within their scope of practice without the approval or supervision of another health professional. The prescriber has been educated and authorised to autonomously prescribe in a specific area of clinical practice. Although the prescriber may prescribe autonomously, they recognise the role of all members of the healthcare team and ensure appropriate communication occurs between team members and the person taking medicine.
In 2012 NPS MedicineWise published the Prescribing Competencies Framework which describes ‘the competencies required to prescribe medicines judiciously, appropriately, safely and effectively in the Australian healthcare system’. The framework describes the foundation competencies required for a health practitioner to prescribe autonomously.
No, the Board cannot authorise pharmacists to prescribe. Authorisation to prescribe medicines is set out in state and territory medicines and poisons legislation. Granting authorisation to pharmacists to prescribe would require a decision by each state and territory government to change legislation in its jurisdiction.
An endorsement for scheduled medicines must be approved by Ministerial Council.
An endorsement of registration for scheduled medicines indicates that a registered health practitioner is qualified to administer, obtain, possess, prescribe, sell, supply or use scheduled medicines (for example, Schedule 2, 3, 4 and/or 8 medicines). The health practitioner must hold a qualification relevant to the endorsement (an approved qualification or substantially equivalent qualification) as set out in a registration standard approved by Ministerial Council.
However, an endorsement does not authorise a health practitioner to administer, obtain, possess, prescribe, sell, supply or use scheduled medicines. The authorisation is provided by or under legislation and regulations of the state or territory in which the health practitioner practises. This may be different in each state and territory.
If the profession decides to pursue a model of pharmacist prescribing that would require an endorsement for scheduled medicines, the Australian Health Ministers’ Advisory Council (AHMAC) guidance should be read to understand the information needed for the Board to recommend a proposal for endorsement to the Ministerial Council. AHPRA’s Guide for National Boards outlines that the development of a proposal for endorsement for scheduled medicines involves a cycle of development, implementation, monitoring and evaluation. The key stages in the process are:
The summary of key stages clearly outlines the outcomes of each stage and the roles of stakeholders in doing the preparatory work to achieve those outcomes.
If an endorsement were sought and approved, the Board and AHPRA would take the necessary administrative actions to give effect to the Ministerial Council approval. These actions would include:
Following Ministerial Council approval, each health minister would endeavour to give effect to the Ministerial Council-approved endorsement and to confer the necessary authorities under state or territory laws. This is likely to require changes to relevant legislation.