4 Symptom recognition / diagnose Select therapy Supply and administer therapy Initiate therapy Monitor and modify therapy Stat therapy Continue therapy Discontinue therapy Supervision Independent Full Full No Full Full Full Full Full Independent Collaborative prescribing Medical practitioner diagnosis, initial treatment decision Yes No Yes Yes Yes Yes Yes Collaborative nominated individual independent prescriber Supplementary prescribing Medical practitioner diagnosis, initial treatment decision Agreed patient specific management plan No Agreed patient specific management plan Agreed patient specific management plan Agreed patient specific management plan Agreed patient specific management plan Agreed patient specific management plan Nominated individual independent prescriber Patient referral Medical practitioner diagnosis, initial treatment decision Medical practitioner diagnosis, initial treatment decision No Medical practitioner diagnosis, initial treatment decision Management of specific therapy or specific therapeutic outcome Management of specific therapy or specific therapeutic outcome Management of specific therapy or specific therapeutic outcome Management of specific therapy or specific therapeutic outcome Delegated by nominated individual independent prescriber Formulary List of approved treatable symptoms Pre-approved formulary according to symptoms No Indirect – formulary Criteria for referral Length as per formulary Length as per formulary Length as per formulary Indirect according to preapproved therapy Protocol List of approved treatable symptoms Pre-approved formulary according to symptoms Yes Protocol driven symptoms According to protocol According to protocol According to protocol According to protocol Prescribing delegated by independent prescriber Patient direction List of approved treatable symptoms Written direction under protocols Supply and administration written under protocols No No Yes No No Nil – delegated under conditions and protocols Repeat prescribing (continuance) Medical practitioner diagnosis, initial treatment decision Medical practitioner diagnosis, initial treatment decision Supply (only) sufficient next appointment No No No Yes – previously prescribed medication only – no modification No Nil – delegated pre-approved conditions Administration List of approved treatable symptoms Pre-approved formulary according to symptoms Administer for immediate treatment only No No According to protocol No No Nil- delegated under conditions and protocols approved approved approved
Appendices Appendix A Current legislation for health professionals to prescribe medicines in each State or Territory Note: health professionals are referred to in Appendix A using the descriptors appearing in the relevant legislation. State Professionals Legislation Victoria Nurse practitioner (prescribe) Authorised registered midwives (prescribe) Authorised podiatrist (prescribe) Authorised optometrist (prescribe) Medical practitioner (prescribe) Dentist practitioner (prescribe) Veterinary practitioner (prescribe) Registered nurse (possess and supply) The Poisons and Controlled Substances Act 1981 The Drugs, Poisons and Controlled Substances Regulations 2006 New South Wales Medical practitioner (prescribe) Dentist (prescribe) Veterinary practitioner (prescribe) Pharmacist (prescribe schedule 2 & 3) Nurse practitioner (prescribe) Optometrist (prescribe) Midwife (prescribe) Podiatrist (prescribe) Dental therapist / oral health therapist / dental hygienist (possess and supply) Ambulance officer (possess and supply) Medical superintendent of hospital (possess medicines only unless is an authorised prescriber) Registered involved in vaccination program (possess and supply) Poisons Act 1966 Poisons and Therapeutic Goods and Regulation 2008
Appendix C Summary of analysis of state and territory legislation in relation to HPPP models of prescribing or Territory HPPP 1 Autonomous prescribing HPPP Model 2 Prescribing under supervision HPPP Model 3 Prescribing via a structured prescribing arrangement Vic NP Endorsed Midwife - RN Midwife NSW NP Endorsed Midwife - RN Midwife WA NP Endorsed Midwife - RN (Psychiatry) SA NP Endorsed Midwife - RN Tasmania NP Endorsed Midwife - RN Midwife QLD NP Endorsed Midwife - RN Midwife ACT NP Endorsed Midwife - RN Midwife NT NP Endorsed Midwife - RN Midwife Notes: