Current legislation allows registered nurses or midwives who: have completed an approved education programme; have appropriate clinical experience; have registered with An Bord Altranais agus Cnáimhseachais na hÉireann (Nursing and Midwifery Board of Ireland) as a Registered Nurse Prescriber (RNP); and have authority from the health service provider who employs them to prescribe a range of medications within their scope of practice.
The HSE has put arrangements in place governing prescribing in the community by RNPs. Under these arrangements, the Primary Care Reimbursement Service (PCRS) will allocate a GMS number and provide Primary Care Reimbursement Forms to RNPs to allow them issue prescriptions to GMS patients subject to a number of criteria, including: the RNP's service area is a community setting where the RNP is working in collaboration with GPs and GMS prescriptions are normally used; the community RNP is a HSE/statutory voluntary sector employee; and the HSE Area Manager/Local Health Office (LHO) have supplied notification and authorisation to the PCRS for the community RNP to be issued with a GMS number and a Primary Care Prescription Pad.
Currently, RNPs employed in acute/specialist hospitals, mental health services, private hospitals, private nursing homes and general practice are not issued with Primary Care Prescription Pads.
Under the current arrangements/structures, the HSE cannot impose governance requirements on private organisations. Given the quality and safety requirements for patients, it is critical to maintain the integrity of the prescribing initiative in the event of extending this arrangement to private organisations.