Introduction
Prescribing medicines is a core responsibility of doctors, nurse practitioners, dentists and some allied health professionals in Western Australia (WA). The process is regulated by national legislation, the Therapeutic Goods Act 1989, and statespecific guidelines issued by the Western Australian Department of Health and the Medical Board of Australia. This page provides an overview of who can prescribe, the legal framework, key responsibilities, and practical steps for safe prescribing in WA.
Who Can Prescribe?
In WA the following professionals are authorised to prescribe:
- Medical practitioners doctors, including general practitioners and specialists.
- Nurse practitioners (NPs) registered nurses who have completed an endorsed NP program.
- Dentists for oral and dental related medications.
- Pharmacists under the Pharmacy Extension of Authority scheme for specific medications.
- Other allied health professionals e.g., podiatrists, optometrists, when they hold a specific prescribing endorsement.
All prescribers must be registered with the Australian Health Practitioner Regulation Agency (AHPRA) and hold a current practising certificate from the relevant national board.
Legal Framework
The main pieces of legislation governing prescribing are:
- Therapeutic Goods Act 1989 (Cth) controls the supply, advertising and prescribing of therapeutic goods.
- Health Practitioner Regulation National Law (WA) aligns WA with the national registration scheme.
- Poisons and Therapeutic Goods Act 1966 (WA) classifies medicines into Schedule 2, 3, 4, and 8 and sets statespecific restrictions.
Prescriptions must be written in accordance with the Western Australian Prescription Standards, which include legibility, required information (patient details, prescriber details, drug name, strength, dosage, quantity, and authorised signatory), and electronic prescribing guidelines.
Key Responsibilities of Prescribers
1. Patient Assessment
Before prescribing, a thorough clinical assessment is required. This includes a review of the patients medical history, current medications, allergies, renal and hepatic function, and any relevant lifestyle factors.
2. EvidenceBased Choice
Prescribers should select medicines based on current clinical guidelines (e.g., Australian Medicines Handbook, NICE guidelines) and consider nonpharmacological alternatives when appropriate.
3. Safe Supply
Only authorised medicines may be supplied. Schedule 8 (controlled) drugs require additional documentation, such as a signed authority form and adherence to the WA Controlled Substances Act.
4. Documentation
Every prescription must be recorded in the patients medical record, including the rationale for the choice, dosage, and any instructions given to the patient.
5. Patient Counseling
Patients must receive clear verbal and written information about the medication, including how to take it, possible side effects, interactions, and what to do if a dose is missed.
6. Ongoing Monitoring
Regular review of therapy is essential, especially for highrisk medicines (e.g., anticoagulants, insulin, opioids). Adjustments should be made based on therapeutic response and adverse events.
Electronic Prescribing (ePrescribing)
WA encourages the use of the ePrescribing System (ePS). Benefits include reduced transcription errors, instant pharmacy verification, and easier audit trails. To use ePS, prescribers must:
- Register with the WA Health eHealth network.
- Complete the mandatory ePS training module.
- Maintain a secure login and use digital signatures.
Electronic scripts are recognised as legally valid and can be transmitted directly to any community pharmacy that participates in the system.
Prescribing Controlled Substances
Schedule 8 medicines (e.g., opioids, benzodiazepines) are subject to stricter controls:
- Prescriptions must be written on a governmentissued Schedule 8 prescription form.
- Only one script may be issued for a 28day supply, unless otherwise authorised.
- Prescribers must retain a copy of the prescription for at least two years.
- Daily limits and total quantity are monitored through the WA Real Time Prescription Monitoring (RTPM) system.
Failure to comply can result in penalties, suspension of prescribing rights, or criminal prosecution.
Common Prescribing Issues and How to Avoid Them
Illegible Handwriting
Switch to typed or electronic scripts wherever possible.
Incomplete Information
Always include patient name, DOB, address, medication name (including formulation), dose, frequency, duration, and prescribers signature and registration number.
Drug Interactions
Use the Australian Medicines Handbook interaction checker before finalising a script.
Allergy Oversights
Check the patients allergy list in the electronic health record before prescribing.
Overprescribing Opioids
Follow the WA Opioid Prescribing Guidelines start low, assess risk, and limit duration to the minimum required.
Helpful Resources
- Western Australian Department of Health Prescribing Information
- Medical Board of Australia Guidelines for Prescribers
- Australian Medicines Handbook Online Access
- Therapeutic Goods Administration Regulatory Updates
- Pharmacy Extension of Authority Scope of Pharmacist Prescribing
Conclusion
Prescribing medicines in Western Australia is a carefully regulated activity designed to protect patient safety while ensuring access to necessary treatments. By understanding the legal framework, adhering to bestpractice guidelines, and utilising electronic tools, prescribers can minimise errors, reduce adverse events, and provide highquality care. Ongoing education, awareness of statespecific requirements, and a commitment to thorough patient communication are essential components of safe prescribing.
