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RACGP Submission to the NPS: Prescribing Competencies Framework Consultation

15 February 2012

The RACGP supports safe and effective prescribing and wise use of medicines in Australian health care. We acknowledge the worthy intention of this framework to support this aim and we hope the framework can be developed so it can be used to reduce existing inappropriate prescribing practices and address the critical quality and safety gaps that our community would expect in prescribing across multiple clinical domains.

Whilst we are supportive of the intentions of the framework, we are concerned that the work on this framework is progressing without an open and transparent debate about the need, benefits and risks of a health system with multiple prescribers.

Over the last 20 years, 22 countries have undertaken graduated expansion of non-medical prescribing. Despite this experience, and the existence of a growing body of research evidence, the quality, safety and cost-effectiveness of their initiatives are not clear. A recent systematic review found that there are substantial gaps in the knowledge base to help evidence based policy making in this arena. With this in mind, we are concerned that a key report by Nissen et al to COAG’s National Health Workforce Taskforce on this issue, contains no strong data to support any existing problem, and many unsubstantiated assumptions in their arguments for reform.