Nurse practitioners

Nurse practitioners are some of the most senior clinical nurses in our health care system with advanced qualifications and extensive experience. We have over 50 nurse practitioners in the ACT. They work in many different areas across our health system and can:

  • diagnose and manage illnesses
  • prescribe medicines
  • request testing, such as blood tests and x-rays
  • refer patients to other health professionals

The nurse practitioner role is grounded in the nursing profession’s values, knowledge, theories, and practice. They provide innovative and flexible health care delivery that complements other health care providers.

You might have been treated by a nurse practitioner at a hospital, Walk-in Centre or in the community. We’re increasing the numbers of nurse practitioners in the ACT so everyone can have better access to safe, effective, and affordable health care.

Watch this video to learn more about nurse practitioners 

Current consultation 

The ACT Office of the CNMO is leading a consultation on legislative changes required to enable nurse practitioner authorisations in the Territory. Consultations are open until close of business 25 February 2022.

A paper has been prepared for the consultation.

You can respond to the questions asked in the consultation paper by taking our online survey or uploading your response in the area designated within the online survey.

Provide your responses to the consultation here.

Supporting documentation referred to in the consultation can be found in the More Information section below.

Meet some of our ACT nurse practitioners

Juliane Samara

Juliane Samara has worked in many different settings across the ACT and is now working in the Specialist Palliative Aged Care (PEACE) service at Clare Holland House. Juliane and her team work with residential aged care facility staff, families, residents and GPs to plan and deliver symptom management and provide end of life care. Juliane gives presentations at conferences and education days, and is involved on national committees, professional organisations and hospital working groups.

Chris Helms

Chris Helms began nursing after volunteering with nurses and public health workers in the Dominican Republic and Mexico. Since then he’s worked in many different settings, including in a remote Aboriginal community using his advanced knowledge and skills as a nurse practitioner. He has since opened his own private practice in Canberra where his patients benefit from his holistic and person-centred care.

Lan Wu

Lan Wu arrived in Australia in 2008 where she studied nursing and began her impressive career by specialising in alcohol and other drugs. She has worked extensively in QLD while gaining further qualifications to become a nurse practitioner and psychotherapist. She is currently working in her private practice in Canberra where she treats patients who need support for drug and alcohol issues.

nurse

Nurse Practitioner, Maria Bayani began nursing in the Philippines which took her to many different countries before she settled in Australia. It was her dream to become a nurse practitioner as she loves the advanced scope of work, and using her experience and scientific knowledge to help patients. She is now seeing patients at the Tuggeranong Walk-in Centre. The five Walk-in Centres across Canberra have a nurse practitioner as the clinical leader. The nurse practitioners work with advance practice nurses seeing patients every day of the year for free treatment of non-life-threatening illness and injuries.

Endorsement

Registered nurses can be endorsed as nurse practitioners by the Nursing and Midwifery Board of Australia if they have additional qualifications and specific expertise that meet the nurse practitioner endorsement standards.

Find out more about nurse practitioners’ scope of practice and how to gain endorsement from the following resources on the Nursing and Midwifery Board of Australia website:

Further education

There are many universities offering the Master of Nursing (Nurse Practitioner) across Australia, including online options. All degrees are at the master’s level and have universal admission requirements, which are:

  • registration as a registered nurse
  • a minimum of 2 years’ full time equivalent as a registered nurse in a specified clinical field
  • a minimum of 2 years’ full time equivalent advanced practice in that same clinical field
  • a postgraduate qualification (graduate certificate or graduate diploma) in a clinical field

Individual courses may have more requirements, and all are accredited by the Australian Nursing and Midwifery Accreditation Council. A list of universities offering the Master of Nursing (Nurse Practitioner) degree is available on the Australian Health Practitioner Agency website.

Governance arrangements

The ACT Government reviewed the governance arrangements for nurse practitioners in the ACT in 2017. Findings from the review highlighted the value of nurse-led models of healthcare and the need to update the existing nurse practitioner governance arrangements in the ACT.

Recommendations from the report which are being implemented include:

  • normalising the role of nurse practitioners in the ACT in line with other health professionals, with the clinical governance arrangements for nurse practitioners being the responsibility of employers.
  • making sure all employers have robust clinical governance systems in place for all health professionals (including nurse practitioners) working in the service.
  • amending the ACT legislation and policy barriers that relate to nurse practitioner practice, to allow them to work to their full potential.

In response, the Office of the Chief Nursing and Midwifery Officer has begun a body of work for the ACT that includes:

  • Surveying the nurse practitioner workforce and consulting with key stakeholders about the current nurse practitioner workforce, their employers and their clinical practice
  • evaluating previous recommendations from research and reports on the role of nurse practitioners
  • creating a database of legislation and policy relating to current and future nurse practitioner clinical practice
  • developing a suite of frequently asked questions and other useful resources for nurse practitioners and their employers
  • reviewing the existing nurse practitioner credentialing processes in the ACT public sector, and developing an overarching framework for credentialing public and private sector nurse practitioners
  • analysing the barriers of nurse practitioners working to their full scope of clinical practice, with recommendations for legislative and policy changes presented to the Minister for Health.

More information

To find out more about nurse practitioners:

Reports, Papers and Frameworks

Frequently Asked Questions

Frequently Asked Questions for Health Consumers

This information is for people who see a nurse practitioner (NP) in the Australian Capital Territory (ACT). The ACT Office of the Chief Nursing and Midwifery Officer (ACT OCNMO) will update this information if things change. 

Download the frequently asked questions for Health Consumers

What is a nurse practitioner (NP)?

Nurse practitioners are expert registered nurses (RNs). The title ‘nurse practitioner’ means the RN has extensive experience and education. They can:

  • assess and diagnose medical conditions
  • prescribe medicines
  • request and interpret tests (e.g. imaging tests such as X-rays and ultrasounds, blood tests)
  • make referrals to a medical and/or allied health specialists.

You can check whether your NP is registered by checking the national register. To find or request more information about NPs, you can visit:

What does an NP do?

Nurse practitioners work in many different areas, including diabetes, palliative care, wound care, mental health, walk-in centres, and aged care. They may work in their own stand-alone clinics, or work within larger healthcare teams. They work in both the public and private health sectors. 

Each NP has unique skills and expertise. For example, some can perform procedures like skin checks and stiches, and others are excellent at helping you take care of long-term health conditions. If you’re unsure if your NP can do something for you – just ask them! They will be more than happy to give you helpful advice.

Can NPs write medical certificates in the ACT?

Medical certificates and sick certificates are two different documents.

NPs in the ACT can issue a sick certificate for people who are unwell and cannot go to work.  NPs cannot provide a medical certificate because it can only be written by registered medical practitioners. There is no limit on the number of days an NP can write a sick certificate for, it depends on your illness and the NP employer’s policies.

Can NPs fill out my workers’ compensation, Comcare or driver’s license medical paperwork?

NPs can assess, diagnose, and treat many work-related injuries. However, under ACT law, workers’ compensation and Comcare certificates must be completed by a medical practitioner (doctor).

NPs can assess a person’s fitness to drive. However, under ACT law driver’s license medical forms must be completed by a medical practitioner.

Can NPs prescribe medicines subsidised by the government?

Many medicines are subsidised by the government through the Pharmaceutical Benefits Scheme (PBS). Generally, inpatient medicines and those supplied by public hospitals in the ACT are subsidised by the ACT government. Many medicines that are dispensed in community pharmacies are subsidised by the PBS.

Private sector

NPs working in private health services can write prescriptions for specific medicines that are covered by the PBS. Generally, any medicine listed on the PBS website will be subsidised if prescribed by a doctor. If a medicine prescribed by an NP does not attract a PBS subsidy, you will need to pay the full cost of that medicine. The costs of private medicines will not contribute to your safety net threshold. 

Public sector

NPs working in community-based settings can write prescriptions for specific medicines that are covered by the PBS. NPs working in ACT public hospitals or in co-located outpatient departments cannot write prescriptions for medicines covered by the PBS. Any prescriptions written by an NP working in ACT public hospitals or co-located outpatient departments that are filled in community-based pharmacies will be at the full, private costs of those medicines. Medicines prescribed by public sector NPs for inpatients in public hospitals, or supplied in community-based clinics (e.g. walk-in centres) are subsidised by ACT Government.

Can NPs request tests that are subsidised by the government?

Many blood and imaging tests (e.g. x-rays and ultrasounds) requested by NPs are subsidised by the government through hospitals or Medicare. Generally, inpatient testing and those tests performed by public hospitals are subsidised by ACT Government. Many tests that are performed in community-based laboratories or imaging services are subsidised by Medicare.

Private sector

NPs working in the private sector can request diagnostic tests that attract a Medicare subsidy. 

Blood Tests: Generally, any blood test that attracts a subsidy when requested by a doctor will be subsidised when requested by an NP. 

Imaging: Not all imaging tests requested by an NP in the private sector will be subsidised by Medicare. If an NP requests these imaging tests they will attract a subsidy. If you choose to see an NP for any other imaging tests you will have to pay the full private cost of those imaging tests.  The costs of private imaging examinations will not contribute to your safety net threshold.

Public sector

Imaging and pathology examinations that are requested by NPs that are completed in ACT public hospitals or health centres, are subsidised by ACT government.

Who do I contact if I have a concern about the care an NP has provided?

Nurse Practitioners, like other regulated health practitioners, are responsible for the care they provide. They must follow national standards and guidelines. If you have a concern about the care an NP has provided, it is always best to first raise your concerns with the NP involved. If you do not feel comfortable doing so, then you can contact any of the following for assistance:

  1. the NP’s employer
  2. ACT Human Rights Commission,
  3. Australian Health Practitioner Regulation Agency.
Frequently Asked Questions for Employers

These FAQs are written for nurse practitioner (NP) employers in the Australian Capital Territory (ACT). It’s recommended you review the FAQs designed for nurse practitioners and health consumers for further information. 

The ACT Office of the Chief Nursing and Midwifery Officer (ACT OCNMO) will update this information from time to time, as legislation and/or policy evolves in the ACT. 

Download the frequently asked questions for Employers

What is a nurse practitioner (NP)?

Nurse practitioners are expert registered nurses (RN) that are endorsed by the national nursing regulator, the Nursing and Midwifery Board of Australia (NMBA). The title ‘nurse practitioner’ is protected by law and signifies the RN has extensive clinical experience and education. They can work independently within their roles to:

  • assess and diagnose medical conditions
  • prescribe medicines
  • request and interpret tests (e.g. imaging tests such as X-rays and ultrasounds, as well as blood tests)
  • make referrals to a medical and/or allied health specialists.

You are able to identify whether your NP holds the NMBA endorsement by checking the national register. To find or request more information about NPs, we recommend you visit ACT Health's webpage or contact the Australian College of Nurse Practitioners

What does an NP do?

Nurse practitioners work in many different areas, including specialty care (e.g. diabetes, palliative care, wound care, and mental health) to generalist care (e.g. walk-in centre, aged care, or primary healthcare NP). They may work as individual health providers with their own stand-alone clinics, or work within larger healthcare teams. They work in both the public and private health sectors. 

Each NP has skills and expertise that are unique, and supplement those skills by collaborating with other health professionals to ensure you get the best possible care. For example, some can perform procedures like skin checks and suturing, whereas others are excellent at case management and the care of long-term health conditions. If you’re unsure if your NP can do something for you – just ask them! They will be more than happy to provide you with helpful advice.

What do I need to know about hiring an NP?

There are over 50 different specialty areas in which NPs practice[1]. Data published by the NMBA indicate there are just over 2100 NPs nation-wide[2], and emergency NPs are the most common specialty[3]. Approximately 75 per cent of endorsed NPs currently work in the public sector.  You may be fortunate and find a candidate immediately. However, many employers find their applicant pool is insufficient, or advertised positions generate interest from highly capable NPs in differing specialty areas who want to expand their roles into a new area of practice. Therefore, to attract the right candidate, we recommend you consider (as appropriate) the following:

  • Include a statement in job advertisements that “experience in [a specific specialty area] is highly desirable, but not required for the right candidate who is willing to expand their practice through mentoring and a supportive work environment”, or
  • Grow your own NP by supporting existing registered nursing staff into the NP role.

If a candidate does not have experience in the advertised area of practice, you need to carefully review the NP’s capability and the time required to expand their practice to meet job requirements. You will also need to consider how applicable credentialing processes will be used to protect the public and facilitate the NP’s growth into the role. Generally, this process can take anywhere from three months to one year, depending on the requirements of the role and the NP’s existing scope of practice. You should therefore decide if you have enough support in the workplace to help the candidate successfully transition. 

NPs are able to independently expand their knowledge and skills into new areas, using the NMBA’s Decision-Making Framework for Nursing and MidwiferyA good way of expanding the NP’s practice is by starting them in their scope of practice comfort zone, with a mutually-agreed upon plan, milestones and timelines for expanding practice into different facets of their new practice area. This plan should include appropriate review and oversight by the employer and an experienced clinician mentor, who should be a medical practitioner or nurse practitioner. 

Potential candidates can be screened for their NP endorsement on the register of practitioners, which is maintained by the Australian Health Practitioner Regulation Agency (AHPRA). It’s important to note the NMBA no longer issues physical registration and endorsement certificates.  The online register is the single point of truth relating to whether nurses are registered and/or are endorsed with the NMBA, and whether they have conditions or undertakings on their practice.

What key skills should NPs have after endorsement?

All newly-endorsed NPs should be able to independently perform the following key skills within their scope of practice:

  • completing and documenting a comprehensive history and physical assessment
  • formulating a differential diagnosis
  • autonomously prescribing medicines using principles aligning with the Quality Use of Medicines
  • autonomously and judiciously requesting and interpreting reports arising from diagnostic examinations
  • independently determining the limits of their competence
  • collaborating with other health professionals through written referral and appropriate communication.

In addition, many NPs will have advanced specialty knowledge within a specific area of practise.  As with other health professionals, there may be a transition period of up to six to 12 months while the newly-endorsed NP enters clinical practice. 

What do I need to know to help an RN become an NP?

Whether you’re helping an RN develop into an NP role, or helping an NP expand their practice into your desired role, there are a few key things you should know: 

Developing RNs into the NP Role

An RN must demonstrate 5000 hours working at an advanced level of practice in the previous six years, and have successfully completed a Master’s degree from an accredited Australian university before they are able to demonstrate the registration standard required for endorsement by the NMBA. In order to gain entry to an Australian Master of Nurse Practitioner program the RN must demonstrate the following:

  • current registration as a RN
  • a postgraduate qualification (Graduate Certificate or Graduate Diploma) in a clinical field relevant to the RN’s intended clinical field
  • a minimum of two years’ full time equivalent (FTE) as an RN in a specified clinical field
  • a minimum of two years’ FTE working at an advanced level of practice in that same clinical field

The determination of an advanced level of practice does not relate solely to, or require the ability to undertake technical procedural skills (e.g. suturing, plastering, insertion of contraceptive devices, etc.)  

The demonstration of advanced practice requires the nurse demonstrate a high level of nursing practice across five domains: clinical care, optimising health systems, education, research and leadership. The ADVANCE Tool can assist nurses and employers determine if the RN is working at an advanced level of practice. If not, it highlights areas for future professional development.  Once enrolled in a Master of Nurse Practitioner course, the student should expect to graduate in 2-3 years, depending on the program and their progress.

Supporting existing NPs into a new role

NPs who are endorsed by the NMBA may use the Decision-Making Framework for Nursing and Midwifery to help make practice decisions relating to their intended scope of practice. In addition, the Nurse Practitioner Clinical Learning and Teaching Framework uses the concept of “metaspecialties”[4] to help guide the development of clinical learning and teaching goals for NPs wanting to expand into different areas of clinical practice. Ultimately, scope of practice is jointly determined by the NP, their employer, and the intended requirements of the role. An NP going into a different area of practice must determine, in collaboration with their employer, what additional education, training, and clinical governance will be required to safely expand their clinical scope of practice.

What funding models support NP positions?

There are two primary funding models that support NP positions: public or private funding. Both funding models benefit from a needs assessment, development of a relevant business case, and consideration of supporting outcomes measures that will promote growth and long-term sustainability of NP roles. 

Public sector

It’s highly recommended public health services explore the advantages and disadvantages of ‘Block Funding’ vs ‘Activity Based Funding’ (ABF) using Tier 2 Non-Admitted Services for NP roles. Currently, the use of ABF funding to support NP roles in outpatient clinics would appear to better support the growth and sustainability of the NP workforce in the public sector. 

Public sector NPs are not eligible for a Medicare provider number. This may create unique issues for NPs in the ACT public sector, as employers will need to identify funding mechanisms that enable NPs to freely undertake core activities required of their roles. These core activities include: requesting diagnostic pathology and imaging, prescribing medicines, and referring to medical specialist and allied health services to their full scope of practice. It is critical public employers identify how these core activities will be funded and facilitated, to appropriately enable their NP workforce.

Private sector

Eligible NPs working in the private sector may obtain a Medicare provider number and use the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) to help subsidise the cost of care provision. The MBS and PBS work to subsidise the costs of performing the core activities discussed above. Importantly, to be eligible for MBS and PBS support the NP is required to demonstrate one of four types of collaborative arrangements. Nurse practitioners working in the private sector, who do not use MBS or PBS subsidies in their clinical practice, are not required to demonstrate a collaborative arrangement.

Occasionally there are additional funding pools in the primary healthcare sector, including through non-governmental organisations and primary health networks when there are demonstrable gaps in service provision. 

What clinical governance supports are needed for NP practice?

Generally, the clinical governance requirements for NPs are no different than for medical practitioners or other regulated health practitioners. If you are working with a new NP, or an NP expanding their practice into a new area, they will likely need more mentorship and/or supervision than an experienced NP. However, there are a few key governance considerations that may be relevant, depending on the NP’s intended scope and context of practice:

  • How can credentialing be used to not only protect the public, but assure the NP can work to their full scope of practice with minimal inefficiency?
  • How does ACT legislation uniquely impact upon the NP’s practice authority and their employed role? 
  • What referral and consultation pathways can patients and health professionals use to access the NP’s services and vice versa?
  • How will care escalation occur, and how might this be different from other regulated health practitioners within the health service?
  • How will peer review occur and what nurse-sensitive outcomes measures should be used to measure performance?
  • What level of private indemnity insurance does the NP require given the requirements of the employed role?

What is the standard NP salary?

This depends on whether the NP is employed in the public or private health sectors. The public sector has Enterprise Agreements that determine an employed NP’s salary and work conditions in the ACT. Minimum work conditions for nurses employed in the private sector have been established by the Fair Work Commission through the Nurses Award 2010

Employers should note salary rates listed in the Award are far below that of public sector enterprise agreements. NPs in the private sector must determine their own salaries in negotiation with employers. 

Can NPs write medical certificates in the ACT?

Medical certificates and sick certificates are two different documents.

NPs in the ACT must issue a sick certificate for employees who are unwell and cannot attend their workplace. A sick certificate serves the purpose of a statutory declaration for the patient’s employer. The reason why NPs cannot provide a medical certificate is because the law requires that ‘medical certificates’ only be written by registered medical practitioners. There is no limit on the number of days an NP can write a sick certificate, but depends on the patient’s illness and any relevant policies for your organisation.

Can NPs fill out workers’ compensation, Comcare or driver’s license medical paperwork?

NPs can assess, diagnose, and treat work-related injuries within their individual abilities and employed roles. However, under ACT law, NPs workers’ compensation and Comcare certificates must be authorised by a medical practitioner.

NPs working within their individual abilities and employed roles can assess a person’s fitness to drive. However, under ACT law, driver’s license medical forms must be authorised by a medical practitioner.

Can NPs prescribe medicines subsidised by the government?

Many medicines are subsidised by the government through public hospitals or the Pharmaceutical Benefits Scheme (PBS). Generally, inpatient medicines and those supplied by public hospitals upon discharge are subsidised by the ACT government. Many medicines that are dispensed in community pharmacies are subsidised by the PBS.

Private sector

NPs meeting requirements in the private sector, who are working within their abilities and employed roles, can obtain a prescriber number and write prescriptions that attract a PBS subsidy for specific medicines. Generally, any medicine listed on the PBS website will attract a subsidy if prescribed by a medical practitioner. The Commonwealth has determined that if a medicine prescribed by an NP does not attract a PBS subsidy, patients will need to pay the full private cost of that medicine. The cost of privately-prescribed medicines will not contribute to a patient’s safety net threshold. 

Public sector

NPs working in community-based settings can obtain a prescriber number and write prescriptions for specific medicines that are covered by the PBS. NPs working in ACT public hospitals or in co-located outpatient departments cannot write prescriptions for medicines covered by the PBS.  Prescriptions written by an NP working in public hospitals or co-located outpatient departments that are filled in community-based pharmacies will be required to pay the full, private costs of those medicines. Medicines prescribed by public sector NPs for inpatients or supplied in community-based clinics (e.g. walk-in centres) in public hospitals are subsidised by ACT Government.

Can NPs request tests that are subsidised by the government?

Many diagnostic pathology and imaging tests requested by NPs are subsidised by the government through hospitals or the Medicare Benefits Schedule (MBS). Generally, inpatient testing and those investigations performed by public hospitals are subsidised by ACT Government. Most tests that are performed in community-based laboratories or imaging services are subsidised by the Commonwealth through the MBS.

Private sector

NPs meeting requirements in the private sector, who are working within their abilities and employed roles, can apply for a provider number and request diagnostic tests that attract a MBS subsidy. Generally, any pathology testing that attracts a subsidy when requested by a medical practitioner will be subsidised when requested by an NP. In addition, NPs in the private sector are able to perform a small selection of simple basic point-of-care tests for which patients receive an MBS subsidy.

However, not all imaging tests requested by an NP in the private sector will be subsidised by the MBS. Currently, an NP requesting these imaging tests will attract an MBS subsidy. If the patient chooses to see an NP for any other imaging tests they will be required to pay the full private cost of those imaging tests, even if within the scope of practice for that NP or subsidised when requested by a medical practitioner. The costs of privately-requested imaging tests will not contribute to the patient’s safety net threshold.

Public sector

Imaging and pathology tests that are requested by publicly employed NPs, that are completed in ACT public hospitals, outpatients, or community health centres, must be subsidised through funding pools allocated by ACT Government. As NPs are not allocated Medicare provider numbers in the public sector, and because no additional funds may be raised for patients seeking care in the public sector, they are unable to request pathology or imaging tests in the private sector.

Who do I contact if I have a concern about the care my NP has provided?

Nurse Practitioners, like other regulated health practitioners, are responsible for the care they provide.  They adhere to national standards and guidelines. If you have a concern about the care your NP has provided, it is always best to first raise your concerns with the NP involved and follow organisational policy. If you do not feel comfortable doing so, then the following may assist:

  1. ACT Human Rights Commission
  2. Australian Health Practitioner Regulation Agency

 

[1] Helms, C., Gardner, A., & McInnes, E. (2017). Consensus on an Australian Nurse practitioner specialty framework using Delphi methodology: results from the CLLEVER 2 study. J Adv Nurs, 73(2), 433-447. https://doi.org/10.1111/jan.13109

[2] Nursing and Midwifery Board of Australia. (2021). Statistics. https://www.nursingmidwiferyboard.gov.au/About/Statistics.aspx

[3] Middleton, S., Gardner, A., Gardner, G., & Della, P. R. (2011). The status of Australian nurse practitioners: the second national census. Aust Health Rev, 35(4), 448-454. https://doi.org/10.1071/AH10987

[4] Gardner, A., Helms, C., Gardner, G., Coyer, F., & Gosby, H. (2020). Development of nurse practitioner metaspecialty clinical practice standards: A national sequential mixed methods study. Journal of Advanced Nursing, 77(3), 1453-1464. https://doi.org/10.1111/jan.14690

Frequently Asked Questions for Nurse Practitioners

These FAQs are written for nurse practitioners (NP) who are new to the Australian Capital Territory (ACT), or are newly-endorsed with the Nursing and Midwifery Board of Australia. It’s recommended you review the FAQs designed for Employers and Health Consumers for further information.

The ACT Office of the Chief Nursing and Midwifery Officer (ACT OCNMO) will update this information from time to time, as legislation and/or policy evolves in the ACT. 

We invite you to keep up-to-date with news relevant to NPs from the ACT OCNMO by signing up to our mailing list.

Download the frequently asked questions for Nurse Practitioners

What’s the difference between practice authority and scope of practice?

Practice authority refers to all the activities a profession is legislatively authorised to perform, whereas scope of practice refers to all activities an individual within that profession is both legislatively authorised to perform, and competent to do. NPs are independent and collaborative practitioners regulated by the Nursing and Midwifery Board of Australia (NMBA). Thus, you are fully responsible and accountable for your practice. An employed scope of practice is determined by yourself and your employer, as relevant to your employed role. 

What authorisation process is required for public sector NPs?

NPs working for the public sector must undergo a formal credentialing process for approval of their employed scope of practice. Credentialing committees within the ACT public sector are delegated through a legislative instrument approved by the Minister for Health through the Health Act 1993. The purpose of credentialing is to protect the public and enable full scope of practice within an individual’s employed role. 

What authorisation process is required for private sector NPs?

Regulated health practitioners working in the private sector, inclusive of NPs, are not currently required to undergo a formal credentialing process for their employed scope of practice.  However, they must still adhere to professional standards and guidelines for practice established by the NMBA, as well as local regulatory requirements. It is highly recommended that private sector employers establish contextualised credentialing processes relevant for all health practitioners, which is transparent and relevant to their context, profession, and area of practice. 

Are there any specific requirements for independent NP clinics in the private sector?

Like other private sector employers in the health industry, NPs working in stand-alone NP clinics are required to adhere to local requirements, such as work health and safety laws. It is highly recommended you use the Australian Business License and Information Service when setting up your clinic to understand your requirements. 

A unique requirement for stand-alone NP clinics in the ACT is that you must apply for an infection control license if you perform any skin penetration procedures in your clinical practice. This requirement does not apply to general practices who employ medical practitioners. 

Can NPs write medical certificates in the ACT?

Sick certificates and medical certificates are different documents.

NPs in the ACT must issue a sick certificate for employees who are unwell and cannot attend their workplace. A sick certificate serves the purpose of a statutory declaration for the patient’s employer. The reason why NPs cannot provide a medical certificate is because operational definitions in the Fair Work Act 2009 (Commonwealth) and Workers Compensation Act 1951 (ACT) require that medical certificates only be written by a registered medical practitioner. If an NP were to provide a ‘medical certificate’ it would amount to ‘holding out’, which is an offence under sections 116 and 118 of the Health Practitioner Regulation National Law 2010 (Commonwealth). There is no limit on the number of days an NP can write a sick certificate, and is dependent on the patient’s disposition and employer policy.

NPs may also authorise attendance and carers certificates for employers of patients through the statutory declaration process described above. These certificates are generally given when an employee misses work for a medical appointment, or who are well themselves but caring for an unwell family member.

Do NPs have the authority to authorise a workers’ compensation or Comcare certificate?

NPs in the ACT have the practice authority to assess, diagnose, and treat work-related injuries within their employed scope of practice. However, under the Workers Compensation Act 1951 (ACT) and Work Health and Safety Act 2011 (Commonwealth) NPs cannot authorise workers’ compensation or Comcare certificates - they must be completed by a medical practitioner working within their scope of practice.

Do NPs have the authority to perform a medical termination of pregnancy (MToP)?

Currently NPs in the ACT do not have the practice authority to prescribe a medicine for the purposes of MToP under Part 6 of the Health Act 1993 (ACT). Any health professional, other than a medical practitioner, who prescribes a medicine for the purposes of inducing a termination of pregnancy commits an offence under ACT legislation.

Do NPs have the authority to perform and authorise driver’s license medicals?

NPs in the ACT have the practice authority to assess a person’s fitness to drive within their employed scope of practice. However, under the Road Transport (Driver Licensing) Act 1999 (ACT) NPs cannot authorise paperwork required as evidence by the ACT Road Transport Authority - it must be completed by a medical practitioner.

It is important to note there is no mandatory reporting requirement for practitioners if they identify a patient is unfit to drive. However, practitioners should note they are not civilly or criminally liable for assessing a patient and reporting, in good faith, a patient who may be unfit to drive.

Do NPs have the authority to authorise a death certificate?

Current NPs in the ACT do not have the practice authority to authorise a death certificate as required by the Births, Deaths and Marriages Registration Act 1997 (ACT). Some registered nurses employed in the public sector may declare ‘life extinct’ in a person, but this is dependent upon local policy. Check with your health service for further information. The declaration of life extinct does not have the same legal ramifications as a death certificate.

Do NPs have the authority to witness a non-written health direction?

Under the Medical Treatment (Health Directions) At 2006 (ACT), NPs and other health professionals do have the practice authority to witness non-written health directions, but one of the two witnessing professionals must be a medical practitioner. A NP cannot substitute for a medical practitioner for this purpose.

What diagnostic examinations do NPs have the authority to request and/or interpret?

An NP endorsed by the NMBA can request any diagnostic pathology or imaging examination within their scope of practice. Like medical practitioners, an NP may interpret any diagnostic pathology or imaging examination within their scope of practice.

Subsidy of diagnostic pathology or imaging through the Medicare Benefits Schedule (MBS) or other funding mechanisms does not relate to an NP’s practice authority. However, an NP’s employed scope of practice may limit which diagnostic examinations an NP may request and/or interpret.

What medicines do NP have the authority to prescribe in the ACT?

An NP endorsed by the NMBA can prescribe any S2, S3, S4 or S8 medicine within their employed scope of practice, except medicines used for the purposes of inducing a medical termination of pregnancy, or Appendix D Medicines in the Medicines, Poisons and Therapeutic Goods Regulation 2008 (ACT). There are Controlled Medicines Prescribing Standards for the prescribing of controlled medicines in the ACT that all prescribers must comply with.

Do I need a separate authorisation process for patients from NSW or other jurisdictions?

Authorisation to practice is not required for patients living in different states or territories, as long as the care provided by the practitioner occurs within ACT borders. In the case of telehealth services, all practitioners must adhere to legislation and policy in the jurisdictions in which the patient resides. This is particularly important as relating to medicines, poisons and therapeutic goods acts (however named).

Page last updated on: 5 Jan 2022