An $18 million pledge in this year’s Victorian state budget was just one sign a serious makeover was underway in Australia’s prescribing landscape. 

The Allan Labor government’s decision to make its pharmacy prescribing model a permanent fixture also came with a promise to extend the scheme in coming years so pharmacists could treat 22 conditions, from asthma to type 2 diabetes.

The plan was sold to constituents as a cost of living relief measure, “saving time and money on GP appointments by enabling pharmacists to provide medications that would usually require a doctor’s script”, the government said. 

Victorian pharmacists had already delivered 23,000 services, including resupplying oral contraceptives and the treatment of UTIs, in the first year of the pilot program. 

Medicines dispensed under the scheme from now on would not attract a PBS subsidy, but patients would not be charged for eligible consultations. Pharmacies would instead receive a $20 fee from the government per appointment. 

News of the scheme’s expansion instantly raised eyebrows among some doctors, with the RACGP warning patients were better off booking in with a regular GP who knew their history than heading to the chemist. 

But the announcement was far from unique. Throughout the course of 2025, policy updates and press releases catalogued the rise of non-medical prescribing models across the country. 

From Queensland to Tasmania, governments around the country had already made moves to enshrine pharmacist prescribing, while a steady flow of updates have expanded these schemes. 

Last month, New South Wales Premier Chris Minns confirmed access to treatment for common skin conditions by pharmacists would be made permanent after the initial phase of the NSW Pharmacy trial was deemed a success, delivering 3,200 patient consultations. 

Just weeks later, the stage was set for registered nurses to gain prescribing privileges, after the Nursing and Midwifery Board of Australia revealed some of the biggest changes to nursing regulation in decades [link here]. 

Medical groups like the Royal Australian College of GPs and AMA have long pushed back against non-medical models of prescribing, and the announcement of the registered nurses scheme was no different, with several voices immediately taking to social media to question the plan.

Yet the AMA, which had previously rejected the idea of registered nurse prescribing privileges, was more generous in its response to the framework, encouraged by the safeguards it said it had successfully lobbied for during consultation.

“At first glance, this development may appear to challenge the role of doctors or suggest “scope creep,” it said this month.

However, it reassured members that “thanks to sustained AMA advocacy, this [nursing] standard differs significantly from pharmacist prescribing models developed by state and territory governments without robust and meaningful consultation.”

How did we get here?

No matter one’s view on the value or risks of non-medical prescribing models, the sheer volume of different programs emerging across Australia makes it hard to deny the genie is out of the bottle.

Those watching this space closely view many of the programs being rolled out by state governments today as a potentially misguided reaction to genuine concerns about healthcare access that have been building in Australia over the past five years.

But nailing down exactly what makes a non-medical prescribing model a success is complicated by the many different approaches being taken. While early data about the number of treatments and scripts written in pharmacy pilot programs is emerging, it could be years before there’s a clear picture of the impact these programs have had on the access issues governments say they are trying to solve.

Pharmacy prescribing pilots have been rolling out across Australia since 2023.

RACGP Rural chair, Associate Professor Michael Clements, told the limbic the push to alternative prescribing models had created an unusual situation for patients where they must evaluate which health provider to access depending on their symptoms.

“We’ve changed that medical interaction from one of somebody seeking care for some symptoms, into one where a patient’s required to self-diagnose and then present to the easiest place that they can get a script to fulfil that need,” he said.

For pharmacist prescribing, the lack of connection between a pharmacist and a patient’s regular GP has been a major concern.

“One of our key concerns is, when we don’t have a team based approach to the patient, when we’re not all working off the same medical record, we don’t learn. We don’t benefit our patients by learning from each other and working together,” he said.

The college does see room for nurses, pharmacists and doctors to collaborate together on care decisions including prescribing – but has emphasised it all comes down to the model of care and the strength of that collaboration.

“We do support pharmacists and nurses and nurse practitioners getting increased scope and working to the top of their scope, which may or may not include prescribing,” Associate Professor Clements said.

“But within the context of a group of people, a group of health professions, working off the same medical record, off the same chart.”

Opportunities for collaboration

Those championing the planned rollout of registered nurse prescribing in Australia believe it could foster than strong collaboration between doctors and nurses for better patient outcomes.

The policy’s success actually hinges on that relationship: in order to be endorsed to prescribe, registered nurses must fulfil a strict set of criteria which includes successful completion of a prescribing course and a six-month clinical mentorship with an authorised health practitioner.

From there, they will only be allowed to prescribe under a formal prescribing arrangement with an authorised health practitioner.

The AMA said at the start of this month that there were still key issues to work through – for example, the association remains against registered nurses being able to prescribe Schedule 8 medicines under the standard – but that elements like the prescribing agreement were an important safeguard.

“The uptake of RN prescribing will be restricted to certain limited medications and conditions, and under carefully designed prescribing agreements,” the association said. 

Acting CEO of the Australian College of Nursing, Dr Zach Byfield (PhD), told the limbic collaboration was at the heart of the model.

“This isn’t a system where it is ‘come one, come all’, where any RN can enrol into a course and call themselves an RN prescriber,” he said.

To receive endorsement, nurses have to complete an approved course of study – set to begin in 2026 – and show evidence that they are employed in a position where RN prescribing is a requirement of the role.

Acting CEO at the Australian College of Nursing, Zach Byfield, said the RN prescribing model had collaboration at its core.

“That collaborative arrangement and that system has to actually already be in place. We’re not going to have RNs working in random,  unsupervised, unseen areas,” he said.

The rollout of the scheme would also be gradual, given the first accredited courses for nurse prescribing are not set to launch until 2026.

This meant GPs and specialists also had time to start thinking about whether this model could provide value for their patients in the future.

“[It’s a] great time to be thinking about whether it is relevant to the particular settings people may be working in at the moment, and thinking about how it might be of use to the populations that they serve.”

The Australian Nursing and Midwifery Board confirmed that while nurse prescribing would require a partnership with an authorised health professional, liability for decision making will rest with the nurse, not the doctor they partner with.

“The designated registered nurse prescriber will be responsible and accountable for prescribing within their scope of practice and authorisation,” it told the limbic. 

“The authorised health practitioner in the partnership is not legally liable for errors made by the registered nurse, provided they have fulfilled their obligations under the clinical governance framework and prescribing agreement.” 

Charting the unknowns

While alternative models of prescribing have put down roots across the country this year, there are still uncertainties about they will truly reshape Australia’s health system.

For example, just how many nurses will put their hands up for prescribing privileges is not yet known.

The Australian Nursing and Midwifery Board said it “did not publish any modelling that projects a specific number of registered nurses that may be interested in applying for endorsement to prescribe, nor how many authorised health practitioners are interested in clinical mentoring or entering prescribing partnership agreements” prior to releasing the endorsement standard”. 

Changes would also be needed at a federal level to give nurses the ability to write PBS-subsidised scripts.

“Legislation and processes need to be amended to enable prescriptions written by designated registered nurse prescribers to be subsidised by the Pharmaceutical Benefits Scheme,” a government spokesperson said.

The department of health, disability and ageing was progressing work to enable the rollout of the scheme. “Consultation is underway both internally and with a wide range of stakeholders on this,” the government spokesperson said. 

Dr Byfield acknowledged nurse prescribing would not become widespread overnight. “We know this is going to be a gradual, steady and safe stand up of those models of care,” he said.

At the same time that alternative prescribing models become permanent across the states, there are signs that Australia’s GP access crisis may be easing.

“I do think we are seeing a turnaround in the number of doctors entering training. I do think we are going to see people find it easier over the next year or two, to get into a doctor who knows them and a medical practice that knows them,” Associate Professor Clements said.

“I do think that the drive for patients seeking care away from a GP is going to decrease.”

He noted broad agreement that looking crunching the Australia will need to follow the data closely to understand how non-medical prescribing is impacting patient and health system outcomes.

“We need to make sure that whatever is happening is still evaluated for safety and cost effectiveness,” he added.

The Australian College of Nursing’s Dr Byfield agreed: “The properly regulated and safe healthcare system that we have in Australia is one in which we take a step forward, then we reassess and then we decide, ‘Is this the right way to go?'”

“Once we take this step forward, we really do need to stop, assess, look at the data, and make sure we’re standing on solid, comfortable ground.”