Senate backs RN prescribing reform – what could it mean for aged care?

The Senate Community Affairs Legislation Committee has recommended the passage of the Health Legislation Amendment (Prescribing of Pharmaceutical Benefits) Bill 2025, paving the way for designated registered nurses to prescribe medicines under the Pharmaceutical Benefits Scheme (PBS) from July 2026.

The recommendation follows an inquiry that received 47 submissions from nursing organisations, medical associations, state governments, consumer groups and individuals.

The Australian College of Nursing welcomed the Committee’s unanimous position.

“This is the most significant recognition of nursing’s role in Australia’s health system in a generation,” said ACN Chief Executive Officer, Adjunct Professor Kathryn Zeitz FACN.

“Designated registered nurse prescribing will strengthen the health system by easing workforce pressures and building the long-term capacity and sustainability our communities urgently need. We congratulate the Committee on its decisive recommendation.”

If passed by the Senate, the Bill would allow endorsed nurse prescribers to access PBS subsidies, meaning patients could receive rebates for nurse-prescribed medicines.

“This bill is a win for health equity,” said Adjunct Professor Zeitz. “Nurses operate across most healthcare settings, and this means their patients will be able to access prescriptions in a timely and equitable way.”

“Nurses have been pushing for this reform for over a decade. The evidence shows nurse prescribing improves patient outcomes, increases satisfaction with care, and reduces the burden on our hospitals and GPs. Today’s recommendation brings us one step closer to making that a reality for every Australian.”

Where aged care fits

The reform does not give prescribing rights to all registered nurses. It creates a pathway for designated RNs who complete additional qualifications and operate under prescribing agreements with authorised health practitioners.

For aged care, the question is practical rather than symbolic.

In residential facilities, delays in accessing prescriptions are common, particularly after hours or in areas with limited GP coverage. Adjustments to pain management, infection treatment or palliative care medications can hinge on doctor availability. A qualified RN prescriber working within an approved scope could shorten that wait.

In rural and regional services, where visiting GPs are stretched, the impact could be more noticeable.

But several details remain unresolved.

“As yet, there is no funding mechanism to enable RN prescribing in aged care and primary care settings,” Adjunct Professor Zeitz said.

That matters. Without funding clarity, providers would need to absorb training costs, restructure rosters and strengthen clinical governance frameworks before prescribing roles could be embedded in day-to-day operations.

There is also uncertainty around which medicines designated RN prescribers will be authorised to prescribe under PBS rules.

“We are also concerned that nurses are already undertaking study to become RN prescribers, even though the Pharmaceutical Benefits Advisory Committee and Health Minister are yet to declare which medications designated RN prescribers may prescribe,” said Adjunct Professor Zeitz. “We would like clarity around when these decisions will be finalised.”

Accessing prescribing nurses

If the legislation passes, aged care providers would not be limited to employing prescribing RNs directly. In principle, they could engage designated RN prescribers through primary care clinics, shared regional arrangements or contracted services, similar to existing nurse practitioner models.

Whether that becomes common practice will depend on funding structures, indemnity arrangements and local workforce supply.

For now, the reform creates a pathway rather than an immediate shift in medication management. The scale of change inside aged care will depend on how quickly the secondary settings, medicine lists and funding arrangements are finalised.