Press Release

Nurse/Midwife prescribing to start in 2007; Minister announces implementation plan

The Minister for Health and Children, Mary Harney TD, today 1 February 2007 announced her plans for the introduction of nurse/midwife prescribing this year.

“Improving patient care is at the heart of this initiative on nurse/midwife prescribing. In particular, I believe that in services such as palliative care, care of the older person and in nurse led clinics, patients will receive earlier interventions and therefore a better service. The basis of our health service should be that patients receive the right care from the right person in the right setting.”

Statutory provision for nurse prescribing is provided for in the Irish Medicines Board Act 2006 and draft regulations have been completed in order to make its introduction a reality in 2007.

Draft Regulations to provide for nurse prescribing have been notified to the EU Commission as required under the transparency directive. The Minister said that she intends to sign the Regulations at the end of the three month notification period provided there are no objections from other EU Member States.

The regulations, while attaching a number of conditions to nurse prescribers, will encompass a broad range of drugs. Individual nurse prescribers will be required to be employed by a health service provider and may only prescribe the drugs relevant to the setting in which they are employed. There are specific restrictions on certain controlled drugs.

The regulation of prescribing will be twin track. The draft regulations to be signed by the Minister will be complemented by new rules and requirements which are being introduced by An Bord Altranais, the regulatory body for nurses and midwives. The Department of Health and the HSE have been working closely with the Board to ensure the safe introduction of nurse prescribing. It is important that both sets of requirements are considered together as they will come into effect in tandem.

‘Patient safety is paramount and will be protected by the combination of the specific conditions to be met under the Regulations together with the requirements which will be introduced by the nursing board (An Bord Altranais) which has statutory authority for the regulation of the nursing profession. Nurses work as part of a multidisciplinary team and that is the context for nurse prescribing. They will only be permitted to prescribe within their scope of practice as defined by their regulatory body. This means that the patient must be within the care of a doctor and “additionally the list of drugs the nurse can prescribe will be approved by the employer through a multidisciplinary committee agreement” the Minister said.

The Minister said that the she understood that the Board will also introduce registration for prescribers and will require them to complete a specified education programme and to maintain competence.

The Board is currently drawing up its requirements and is expected to notify the Minister before the regulations are signed.

The Minister provided funding for the HSE in 2007 to train nurse prescribers. The education programme will be provided by two higher education institutes and will commence at the beginning of April, 2007 with a possible further intake in October, 2007. There will be up to 50 places available.

An implementation group has been established by the Minister to oversee the roll-out of nurse prescribing on a national basis. Through this group the Department of Health and Children is working closely with the Health Service Executive and An Bord Altranais to put in place the mechanisms and the safeguards required to implement, monitor and evaluate this initiative.

The Minister said that she intended to review the regulations in two years time to make sure they were working as planned.

“This is a real and significant change in nursing practice in Ireland which will deliver, over time, better and more timely access to medications by patients” the Minister said.