Red flags raised on prescribing models amid framework review

A warning has been issued over the growing adoption of non-collaborative prescribing models, with concerns that sidelining clinicians in key clinical decisions is putting patient safety at risk.

AHPRA is undertaking an overhaul of the National Prescribing Competencies Framework, originally developed in 2012 and last updated in 2021. This review follows the defunding of NPS MedicineWise in 2022, which previously oversaw this remit.

In its submission to the consultation, the Australian Medical Association (AMA) expressed concerns over the rapid rise of prescribing models that exclude medical doctors entirely.

“Fragmentation is the enemy of patient safety, and it is time that we end these dangerous experiments and focus on models that are proven to deliver high quality patient outcomes,” AMA President Dr Danielle McMullen warned.

The AMA said the revised framework downplays the importance of collaborative prescribing, where non-medical health professionals operate under medical leadership – something the Association insists is non-negotiable for safe, effective care.

“Our position is 100% clear: non-medical prescribers must work in close collaboration with medical practitioners to ensure safe, effective, and evidence-based care,” Dr McMullen said.

She pointed out that today’s patients are increasingly managing multiple complex chronic conditions that require comprehensive clinical expertise.

“Only medical doctors, who have a minimum of 10 years of training, can safely diagnose and prescribe medicines without oversight,” she said.

The AMA has warned that without a doctor involved, these expanded prescribing models threaten to prioritise convenience over clinical integrity, eroding standards of care.

“Prescribing models that don’t involve a patient’s doctor are a thin end of the wedge which could potentially result in serious harms to patients,” Dr McMullen emphasised.

The submission also flagged concerns around off-label prescribing – an area with significant clinical, ethical, and legal implications. While the AMA supports the guiding principles developed by the Council of Australian Therapeutic Advisory Groups for public hospitals, it remains especially cautious around off-label use of drugs like Ozempic.

In particular, she warned that pharmacist-led prescribing of antibiotics could accelerate antimicrobial resistance and trigger the emergence of more superbugs.

“Short-sighted solutions like pharmacist prescribing are taking Australia down the same path that other countries have followed, with their health systems delivering inferior health outcomes compared to Australia,” she said.

Changes to the framework are expected to be finalised before the end of 2025.

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