As of Sunday 1 September, Victorian endorsed midwives in all areas of practice are now able to prescribe relevant medicines within the scope of their professional practice without being constrained by the formulary.
As of March 2024, Nursing and Midwifery Board of Australia (NMBA) figures show there are 197 endorsed midwives in Victoria who are authorised to administer, obtain, possess, prescribe, sell or supply schedule 2,3,4 and 8 medicines.
These midwives are authorised under section 13(1)(bc) of the Drugs, Poisons and Controlled Substances (Supply by Midwives) Act 2012 and under section 94 of the Health Practitioner Regulation National Law (the National Law).
What is the formulary, and why was it removed?
For over a decade, Victoria was one of the only states, along with Tasmania, that limited endorsed midwives to prescribing via a medicine list (or a formulary).
Whilst the NMBA initially developed a prescribing formulary in 2010, they ceased publishing this in 2019. In the absence of an alternative, Victorian endorsed midwives were forced to use an outdated, unnecessarily restrictive formulary that was last updated in 2012 and no longer conformed to best practice or new evidence. Simply, midwives were constrained in the medicines that they could prescribe.
During early 2024, therefore, the Department of Health sought feedback on the prescribing arrangements for endorsed midwives in Victoria, with a view to updating them. Consultation was sought from key stakeholders including endorsed midwives, chief nurse midwifery officers, privately practising midwives and the ANMF (Vic Branch), as well as peak bodies, medical colleges, education providers and health services.
These stakeholders were provided with three options:
- Remove the formulary and allow endorsed midwives to prescribe within scope of practice.
- Update the Victorian formulary and establish a process to enable routine updates.
- Keep the status quo.
Overwhelmingly, the stakeholders supported option 1: remove the formulary and allow the prescription of medications within the scope of practice.
ANMF would like to thank those midwifery members who participated in the development of the Branch submission through responding to the survey questions and participating in online forums.
Support for midwives to prescribe within scope of practice
In terms of supports to ensure that endorsed midwives can prescribe within their scope of practice, stakeholders including the ANMF highlighted, among other things, the importance of:
- continuing professional development (CPD) and education
- ensuring the Australian College of Midwives guidelines are regularly updated, providing written examples of common clinical situations, and
- providing low/no cost access to the Clinician’s Health Channel, the Australian Therapeutic Guidelines and Australian Medicines Handbook.
ANMF looks forward to seeing all public sector health services reviewing and implementing their systems to ensure that their currently employed midwives who have an endorsement can use it. The opportunity for endorsed midwives to work to full scope can only improve the overall outcomes for women and neonates, and for the midwives’ professional satisfaction. It is a true retention and recruitment strategy for many.
Is there something in the 2024-2028 public sector EBA about endorsed midwives?
Yes. From 1 June 2025, there will be a new endorsed midwife allowance payable (clause 32A.2), aligned to the graduate diploma qualification allowance.
Importantly, this new allowance is in addition to receipt of any existing qualification allowance.
When the access period for the new Agreement opens, ANMF recommends all members vote YES: anmfvic.asn.au/voteyes.
