Nurse practitioners make full-scope moves

4 minute read


The profession’s new workforce plan rides a wave of promises to remove restrictions on MBS and PBS access.


Under a new workforce plan, trained nurse practitioners could practise, prescribe and bulk bill with fewer limitations by 2026.  

The government has also committed to lifting the “red tape” that prevents nurse practitioners from independently providing MBS services and prescribing on the PBS.  

This is a marked departure from the current rules, which require all nurse practitioners to have a collaborative arrangement in place with a medical practitioner as a prerequisite to accessing the PBS and MBS.  

The Nurse Practitioner Workforce Plan, the first of its kind, was launched by Assistant Health Minister Ged Kearney on Tuesday.  

Buried within last week’s budget were measures to increase Medicare rebates for nurse practitioner-led care by 30%, as well as a $50 million scholarship program to support registered nurses to undertake postgraduate nurse practitioner training.  

Nurse practitioners will also be eligible to participate in Medicare-subsidised multidisciplinary team case conferences.  

Ms Kearney, a former nurse herself, said that enabling nurse practitioners to work to full scope was a key part of fulfilling the Strengthening Medicare Taskforce recommendations.  

“We want everyone to be able to access quality care in a primary health setting and supporting our nurse practitioners is a critical part of that,” she said. 

“For too long nurse practitioners have faced barriers to providing the care that they are trained and want to deliver.” 

Not all stakeholders were happy.

AMA president Professor Steve Robson told The Medical Republic that the association did not agree with the decision to release nurse practitioners from collaborative arrangements.

“The MBS has rules that require collaboration between health professionals, whether it is the requirement for a referral from a GP or non-GP specialist, or the rules associated with a team care arrangement or a mental health treatment plan,” he said.

“Nurse practitioners should not be sheltered from these requirements, particularly as they often practice in quite specialised fields.”

The plan itself recommends pivoting nurse practitioner education programs more toward a generalist focus, allowing for a broader scope of practice rather than a specialised skillset.  

There are four broad themes: education and lifelong learning, recruitment and retention, models of care and health workforce planning.  

This last theme may create the biggest change for general practice. 

Its four short-term action items, estimated to take between one and three years, include: 

  1. Reviewing regulations that allow nurse practitioner medication prescribing,  
  1. Supporting a review of what PBS-subsidised scripts nurse practitioners can write,  
  1. Supporting nurse practitioners to deliver MBS items, and 
  1. Developing and implementing a legislative review to set up a nationally consistent model allowing nurse practitioners to work to full scope of practice.  

Earlier this year, WA received $11 million in federal funding to employ 20 nurse practitioners in different primary care settings to work to use their “full range of skills”.  

The Australian College of Nurse Practitioners welcomed the plan, and president Leanne Boase said she had “full confidence” that consumers had informed its development. 

“Any improvement to health, and access to health care is a win for all Australians,” she said.  

“In order to reform health care to meet today’s and future needs, bold change needs to occur, and enabling people to access nurse practitioners is a key part of this.” 

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