What can and can’t a nurse practitioner do in Australia?

This blog is for educational purposes only and does not replace professional medical advice or diagnosis. If you have health concerns, consult an AHPRA-registered telehealth doctor or request a medical certificate online if clinically appropriate. Please note: Hola Health does not currently offer Mental Health Care Plans.

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Overview

Nurse practitioners, or NPs, are registered health professionals with advanced education and clinical training. Depending on their individual scope of practice and relevant requirements, they can assess patients, diagnose conditions, prescribe certain medicines, request some tests, and coordinate or refer care.

What an individual NP can do depends on their registration, education, clinical experience and area of practice. The Nursing and Midwifery Board of Australia (NMBA)¹ allows NPs to practice independently, while also collaborating with other health professionals.

What is a nurse practitioner?

A nurse practitioner is a registered nurse. The NMBA recognises NPs as advanced-level practitioners. This sets them apart from registered nurses. An NP has additional education, extra clinical hours, and professional responsibilities.

1. Advanced clinical education and training, including a Master’s degree
2. Endorsement by the NMBA
3. Independent clinical practice
4. Patient assessment and clinical management
5. Collaboration with other healthcare professionals

To apply for endorsement as a nurse practitioner, applicants must meet the NMBA’s requirements, which include relevant postgraduate education and the equivalent of 5,000 hours of advanced nursing practice within the previous six years.

What can a nurse practitioner do?

NPs can handle many common primary healthcare needs, as long as the care falls within their individual scope of practice.

Diagnoses and assess health conditions

NPs can take a patient’s medical history, conduct physical examinations, and assess possible diagnoses. These are recognised parts of NP practice under NMBA standards.

They can:

1. Assess symptoms
2. Perform physical examinations
3. Identify potential conditions
4. Make clinical diagnoses
5. Develop an appropriate care plan

Order pathology and diagnostic tests

NPs may request certain pathology and diagnostic imaging services where permitted and within their scope of practice.

1. Blood tests
2. Urine tests
3. Pathology
4. Imaging
5. Other clinically appropriate investigations

Prescribe medications

NPs can prescribe medicines when appropriate and within their authorized scope. However, their prescribing rights may differ from those of a GP and depend on their scope of practice and relevant Australian laws².

1. Prescribing medicines within the NP’s endorsed scope
2. PBS prescribing, for authorised NP prescribers
3. State and territory requirements
4. Situations where another clinician needs to be involved

Manage health conditions

NPs can assess and manage conditions within their scope of practice. This may include

starting, changing, continuing or ceasing appropriate clinical management or therapeutic interventions

1. Acute conditions
2. Ongoing health concerns
3. Chronic disease management
4. Preventive care
5. Follow-up care

Refer patients to other healthcare professionals

NPs can collaborate with, and refer to, other healthcare professionals. This happens when a patient needs extra expertise or care.

NPs may refer to other health professionals when clinically appropriate. Medicare rebates for the service you are referred to depend on the receiving service and the current MBS rules (eg. allied health professionals)

Provide mental health support

NPs with appropriate training can assess and support patients with some mental health concerns. However, not every NP provides specialised mental health care.

1. Mental health assessment
2. Support for conditions within scope
3. Clinical management planning
4. Follow-up
5. Referral, when specialist care is required

Provide medical certificates and other clinical documentation

Whether an NP can provide a particular certificate or other clinical document depends on the type of document, the relevant state or territory requirements, and the organisation requesting it. If you need documentation for work or another purpose, check with the relevant organisation about what forms of evidence it accepts.

What can’t a nurse practitioner do?

NPs must practice within the limits of their training, skills, authorisation and the law. According to the NMBA, scope of practice means what an individual is educated, authorised, and competent to perform.

Practice outside their scope

NPs cannot perform every task they are technically capable of doing. They need the right training, skills, authorisation, and scope of practice.

Prescribe medications outside their authorised scope

NPs can prescribe medicines within their authorised scope, but there are some limitations. Some medicines have additional restrictions under Commonwealth, state or territory requirements. Depending on the medicine and clinical circumstances, an NP may need to consult or refer to another healthcare professional.

Rules for Schedule 8 medicines differ between states and territories.

Some medicines, including certain controlled medicines, have additional prescribing restrictions that vary between states and territories. Check the current requirements that apply in the relevant jurisdiction.

For example, NSW³does not allow NPs to prescribe or supply psychostimulant medicines, while ACT NPs⁴ can prescribe some Schedule 8 medicines when they meet the relevant requirements.

This is why prescribing rules cannot be applied the same way everywhere. Check the current state, territory, and PBS requirements for the medicine involved.

Manage conditions beyond their clinical scope

If a patient’s condition is complex or outside the NP’s scope, the NP should arrange appropriate referral or work with another healthcare professional.

Perform procedures they are not trained or authorised to perform

The procedures an NP can perform depend on their training, skills, clinical role and authorisation. Not every NP is trained or authorised to perform the same procedures.

Can a nurse practitioner work independently?

Yes. Nurse practitioners can practise autonomously within their individual scope of practice. They may also collaborate or consult with other healthcare professionals when appropriate.

Nurse practitioner vs GP: What’s the difference?

Both NPs and GPs can provide clinical care. Neither is simply “better” than the other. Their training, professional pathways, scope, and areas of expertise differ.

	Nurse Practitioner	General Practitioner
Base qualification	Registered nurse with approved postgraduate education for nurse practitioner endorsement	Medical degree followed by medical registration and postgraduate general practice training
Postgraduate training	Relevant postgraduate education and advanced nursing practice experience, followed by NMBA endorsement where the requirements are met	Postgraduate general practice training through an approved pathway, with fellowship and registration requirements applying
Regulator	Nursing and Midwifery Board of Australia	Medical Board of Australia
Prescribing	Prescribing within their authorised scope and applicable Commonwealth, state and territory requirements	Prescribing within their medical scope of practice and applicable Commonwealth, state and territory requirements
Typical focus	Assessment, diagnosis and management within the NP’s scope of practice	Broad primary medical care across a wide range of health concerns

An NP may be appropriate for health concerns within their individual scope of practice. Depending on the symptoms, complexity, risk and type of care required, a person may instead need assessment by a GP, specialist or another healthcare professional.

When should you see a nurse practitioner?

NPs can help with many common health concerns, ongoing care, and conditions within their area of expertise.

An NP may be suitable for:

1. Common acute health concerns
2. Ongoing condition management
3. Medication management within scope
4. Preventive healthcare
5. Health assessments
6. Certain mental health concerns
7. Follow-up care

When should you see a GP or a specialist instead?

An NP may refer or escalate care when your symptoms, condition or healthcare needs fall outside their individual scope of practice.

1. Complex or rapidly deteriorating conditions
2. Specialist assessment, investigations or care
3. Care outside the NP’s authorised scope
4. Certain medications or procedures
5. Emergency symptoms

If symptoms are severe, rapidly worsening or potentially life-threatening, call 000. For urgent but non-life-threatening concerns, seek prompt in-person care or call Healthdirect on 1800 022 222 (ie. not all urgent issues require 000)

Do nurse practitioner consultations qualify for Medicare?

Eligible NP services can attract a Medicare rebate under the Medicare Benefits Schedule. Medicare eligibility and billing are separate from an NP’s clinical scope of practice5.

1. Medicare Benefits Schedule (MBS) item numbers apply to eligible NP services
2. Medicare rebates depend on the specific service
3. Bulk billing is a separate choice made by the provider
4. You must meet the patient eligibility rules for that item

For more detail on Medicare rebates and bulk billing for NP visits, read our guide on Nurse Practitioner Medicare rebates.

What happens if a nurse practitioner cannot provide the care you need?

If a health concern is outside an NP’s scope of practice, the NP may explain the limitation and recommend an appropriate next step, which may include referral or further assessment.

1. Referral to a GP
2. Referral to a specialist
3. Additional testing
4. Emergency care
5. Follow-up with another healthcare professional

Conclusion

Nurse practitioners are registered health professionals with advanced education and training who can assess, diagnose and manage health concerns within their individual scope of practice. Their responsibilities vary according to their education, competence, endorsement, authorisation and the requirements that apply where they practise.