Imagine your elderly father is in an aged care home. It's Friday afternoon, and he's run out of his regular Pharmaceutical Benefits Scheme ( PBS ) blood pressure medication and he can't get an appointment with the GP.
Currently, the registered nurse (RN) at the aged care home can assess his blood pressure to see if it's stable, and administer medication prescribed by a doctor. But the RN cannot issue a new prescription.
From October 1, this will change.
That's because new legislation has been passed to allow specially qualified RNs to prescribe a range of medicines.
The key change is that these can be subsidised through the PBS. Here's why that matters, and what it means for you.
Wait, can't nurses already prescribe?
Yes, some nurses can.
Nurse practitioners have prescribed medicines in Australia for more than 20 years .
But nurse practitioners are different from the newly designated RN prescribers.
Nurse practitioners are registered nurses who have completed extra university study - a masters degree - to be able to perform additional duties. They can conduct advanced health assessments, order diagnostic tests, diagnose and independently treat acute and chronic health conditions.
Nurse practitioners can also independently prescribe medicine, meaning they don't need to be supervised by a doctor.
Designated RN prescribers are registered nurses who have done specialist units of postgraduate study and are authorised to prescribe certain medicines. From October, the scope of these nurses will expand to PBS drugs.
But designated RN prescribers cannot prescribe independently - they must collaborate on prescribing with a doctor or nurse practitioner. The difference is the doctor or nurse practitioner doesn't need to see the patient each time.
The categories of medicines RN prescribers will be able to prescribe are:
- common over-the-counter and pharmacist-only medicines (schedule 2 and 3)
- prescription medicines (schedule 4)
- certain controlled medicines (schedule 8) that require additional safeguards and monitoring.
These new rules came into effect in September 2025.
So, what's changed?
The main change is that designated RN prescribers will, from October, be allowed to prescribe PBS medicines.
Until the new legislation was passed on July 2, designated RN prescribers were allowed to prescribe medication, but their patients couldn't access PBS subsidies.
Under the PBS, patients only pay a co-payment - which is capped at A$25 and $7.70 for concession card holders - rather than the full private price.
For people taking several medicines, this can mean saving hundreds or even thousands of dollars in out-of-pocket costs.
For example, a person taking three long-term prescription medicines would pay up to $900 per year in PBS co-payments. The private cost can be far higher, especially for newer medicines .
But when designated RN prescribing was first introduced last year, there was no guarantee it would cover PBS-subsided medicine.
So this new legislation is a key change to make sure patients don't pay extra for medicines when they see a designated RN prescriber.
How will registered nurses qualify?
Not every RN will be able to prescribe.
Designated RN prescribers must:
- have significant experience as an RN (equivalent to three years full-time in the last six years)
- complete approved postgraduate study
- undertake six months of clinical mentorship with a doctor or nurse practitioner
- be formally endorsed by the Nursing and Midwifery Board of Australia.
Their education focuses on how to assess patients, identify health problems, prescribe medicines, and advise patients on how to use medicines safely and effectively.
The first graduates of these accredited courses have graduated, with more completing in the second half of 2026 .
Who will this benefit?
People in residential aged care, palliative care and those in rural and remote communities may be among the first to notice a difference. These are settings where access to doctors and nurse practitioners can be very limited and cause delays in getting the right medication.
Those accessing mental health services and managing chronic diseases may also benefit, because these conditions often need regular reviews and medication adjustments.
Expanding prescribing to qualified RNs may make it easier to access care closer to home, when it's needed.
For example, imagine someone who has asthma who works and lives on a remote farm.
When their symptoms flare, they go to an urgent care centre, where an RN prescriber identifies that their inhaler treatment needs adjusting. The nurse can write a new script, meaning they avoid waiting days for a GP appointment or even a visit to emergency.
What still needs to be sorted out?
It's still not clear which PBS medicines nurses will be able to prescribe.
However, access is expected to be limited to medicines that match a nurse's education, experience and area of practice, helping ensure prescribing remains safe while the new model is rolled out.
State and territory laws still need to be updated, particularly in relation to controlled medicines such as opioids, before designated RN prescribing can commence .
There are still questions about how individual health services will implement the changes: which medicines they will allow qualified nurses to prescribe, who will provide clinical oversight and mentorship, and how monitoring will work to ensure patient safety.
And there are questions about the workforce.
Will RN prescribers be located in places where the most serious delays in treatment exist? Will there be incentives to encourage them to work rurally? Will health services have support to release nurses for education and mentorship?
The bottom line for patients
This reform is not about replacing doctors or nurse practitioners. It aims to make health care more equitable and affordable.
If implemented well, it should mean patients face fewer delays in starting treatment, renewing scripts, and responding to health conditions when changes emerge.
Marie Gerdtz is affiliated with La Trobe University where she is employed as Professor of Nursing and Midwifery and holds the position of Dean of the School of Nursing and Midwifery.
