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Minutes

15 March 2006 | 21 June 2005 | 17 June 2002 | 12 March 2002 | 30 October 2001 | 31 July 2001

Confirmed minutes of the First Meeting of the New Prescribers Advisory Committee (NPAC)

Meeting held on 31st July 2001
Conference Rooms, Ministry of Health, Molesworth Street
10:00am - 4:30pm

Present:

Associate Professor Margaret Horsburgh (Chair)
Dr Mark Adams
Ms Beryl Anderson
Dr Patrick Ball
Mr Alister Brown
Trish Compton
Dr Denise Dignam
Ms Sue Driver
Dr John Edwards
Mr Peter Glensor
Professor Keith Grimwood
Ms Marion Hunter
Dr Stewart Jessamine
Professor John Shaw
Dr Dennis Thorburn

In Attendance:

Caroline Greaney (Secretary)
Helen Lockyer
Frances Hughes, Chief Advisor (Nursing), for part of the meeting
Sue Scobie, Nursing Council, for part of the meeting

Apology:

Judy Kilpatrick

ITEM 1 - Introduction

  1. The meeting began with an introduction and welcome from Margaret Horsburgh (Chair). Members then introduced themselves.
  2. There was a discussion about the role of those people who belong to or are employed by bodies/organisations (for example, the Medical Council) and whether those individuals act autonomously or as representatives of the bodies/organisations.
  3. Agreed: that there is a difference between being a "delegate" of an organisation and a "representative" of an organisation. Members are not on NPAC with instructions to vote one way or another but as individuals with expert knowledge.

ITEM 2

  1. Stewart Jessamine gave an overview of the legislative framework that regulates medicines and the differences between prescription medicines and "over the counter" medicines. Stewart also gave an explanation of the differences between "food" and "medicine" and the interface between food and the Medicines Act.
  2. There was a discussion about "off label" prescribing, particularly with relation to paediatrics and how NPAC may have 'off-label" issues when considering applications.
  3. There was a brief discussion about the rights of dentists and nurses to prescribe any of the medicines in the Medicines Schedule, and how the registering bodies limit the prescribing rights of their members.

ITEM 3 - Presentation on the Background to the Proposals to Extend Prescribing Rights (Helen Lockyer and Frances Hughes)

Frances Hughes joined the meeting at this point.

  1. Only "Nurse Practitioners" will be able to seek prescribing rights and initially only in the scopes of the "Child and Family Health" and "Aged Care" when the regulations are enacted.
  2. There was a discussion about the role of NPAC in relation to nurse prescribing in Child & Family Health and Aged Care and reasons for the delay in these regulations being finalised.
  3. Agreed: there are some givens as a great deal of the background and policy work has been completed (refer Cabinet paper, May 2000). There is a role for NPAC in reviewing the draft regulations around nurse prescribing rights in aged care and child family health. Any future proposals for nurse prescribing will be seen by NPAC.

ITEM 4 - (Presentation by Nursing Council on Framework for Nurse Practitioners and Nurse Prescribing)

Sue Scobie joined the meeting at this point.

  1. Sue Scobie gave a presentation on the framework developed by the Nursing Council, the competencies required to be a nurse practitioner and nurse prescriber, and the national competency assurance framework.
  2. Action: Sue agreed to arrange copies of Nursing Council documents on "Nurse Practitioner" and "Framework for Post-Registration Nursing Education" to be provided to members of NPAC (these arrived before the end of the meeting and were distributed to the members).

ITEM 5 - NPAC Handbook and Terms of Reference (TOR)

  1. It was noted that the current draft of the handbook contains some spelling errors.
  2. Reporting to the Minister - NPAC will report to the Minister via the Secretariat. The Ministry is able to provide alternate views and conflicting advice. NPAC will have their own letterhead.
  3. Confidentiality of Minutes - it was noted that the Terms of Reference state that members will keep minutes confidential. There was a discussion about how members who are representatives of bodies will report back to the bodies/organisations.
  4. Agreed: no individual Committee member will be identified in Minutes. The Minutes will be a series of discussions with recommendations/action points. It is intended that NPAC Minutes will eventually be placed on the MoH website.
  5. Each member then took the opportunity to comment on the purpose and objectives of the NPAC as stated in the TOR.

ITEM 6 - Standard Application Form (template) and Letter to Registering and/or Professional Bodies

  1. It was suggested that the template start with a definition of prescribing (based on the one contained in the 1997 discussion paper).
  2. There was a discussion about the criteria that professional groups will have to demonstrate they meet. It was agreed that a sub-group of NPAC would meet before the next meeting to undertake further work on developing a template. The draft will be circulated to all members for comment/refinement prior to it being forwarded to potential applicants. The NPAC agreed on the following general criteria:
  3. Prescribing Parameters of Practice - to identify the prescribing rights being requested:
  4. Justification//benefits/advantages/costs and risks
  5. Indicative list of prescription medicines/classes of medicines
  6. Competencies and education
  7. Ongoing monitoring of competence and client safety
  8. Consultation
  9. It was agreed that the template should make it clear that any group should have the support of the relevant registering body.
  10. The template would be in 'draft' for 12 months with the intent to review in 12 months following some experience.
  11. Agreed: that NPAC will send a letter to all the health professional registering bodies informing them of the establishment of NPAC and the future distribution of a template for applications.

ITEM 7 - "Standing Orders" (Dependent Prescribing Rights)

  1. There was a discussion about "standing orders" and the current process of creating regulations that will clarify dependent prescribing rights. NPAC discussed the potential for the use of standing orders to be a more effective way of improving access to the administration and supply of medicines than the extension of independent prescribing rights through the NPAC process. It was agreed that NPAC will send a letter to the Minister advising that the 'standing orders' regulations be accelerated. This letter is to be reviewed by NPAC before being sent.

Points to be held over for the next meeting

  1. The mechanism of scheduling medicines, and the need to update the schedules - how can this happen. 25. A process of monitoring the impact of new prescribers and how a budget should be set aside for this. 26. The draft child health and aged care regulations (if these are available).

The meeting closed at 4.20 pm

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