NZNO does not sign letters over nurse practitioners.

NZNO has chosen not to sign letters to the Minister of Health Pete Hodgson and Ministry of Health chief nursing adviser Mark Jones, over concerns about the designation of nurse practitioners (NPs) under the Therapeutic Products and Medicines Bill. College of Nurses Aotearoa executive director Jenny Carryer wrote the letters protesting that NPs were designated prescribers, rather than authorised prescribers, under the Bill. When Kai Tiaki Nursing New Zealand went to press, the Bill was before the Health Select Committee.

NZNO, the college and the Nursing Council, in their submissions on the Bill, all support NPs being authorised prescribers, as doctors and midwives are, rather than designated prescribers.

According to council chief executive Marion Clark and Carryer, the Ministry of Health advised the Select Committee against NPs becoming authorised prescribers because of possible concern from doctors. The Council was "extremely concerned" about this.

In a briefing paper on the issue, Carryer said the Minister also wanted to know why it was essential that NPs be authorised prescribers under the Bill, rather than through a later regulatory process. The briefing paper expressed concern that the whole matter would be relitigated and that "once more the fear of upsetting doctors takes precedence over the need to support a flexible and responsive workforce in a manner strongly supported by the evidence and strongly championed by the Ministry itself".

The paper called for "absolute and transparent assurance" that ministry advice to the Minister would be for NPs to be included as authorised prescribers in the Bill, and registered nurses who have met competency requirements and are authorised to prescribe, be included as designated prescribers.

NZNO chief executive Geoff Annals said NZNO understood the concerns of the college and the Council but did not share them and would not be a signatory to the letters.

The Minister had already asked the Ministry to review its advice and wanted that advice to be informed by nursing, Annals said. "NZNO welcomes this response from the Minister and recognises it demonstrates a high degree of confidence in the Ministry's chief nursing adviser. This confidence is nursing's most important asset in advancing nurse prescribing."

NZNO also had confidence in the Minister to listen and act appropriately on "legitimate and substantiated concerns raised by nursing groups," Annals said.

The Nurse Practitioners Advisory Committee--NZ, after extensive discussion with Ministry officials, also decided not to sign the letters, despite its disappointment at the situation.

* The Ministry of Health released a consultation document on collaborative prescribing last month. It defines collaborative prescribing as "where a non-prescribing health practitioner, after authorisation from their registration authority, may prescribe under the supervision of an authorised prescriber."

The Ministry, in consultation on standing orders late last year, identified the need for a class of collaborative prescriber. It believes this could be enabled through the Therapeutic Products and Medicines Bill but that meant a very tight timeframe for consultation, which closed on April 13. Benefits of collaborative prescribing, outlined in the paper, included timeliness, safety, more appropriate services for patients, reduced need for surgery and greater collaboration in the health workforce.