Proposed new legislation will strengthen the role of nurse practitioners in the Australian Capital Territory enabling them to certify cause of death certificates.
New legislation has been introduced to give nurse practitioners (NPs), endorsed by the Nursing and Midwifery Board of Australia (NMBA), the legal practice authority to issue cause of death certificates and witness non-written health directions.
The Nurse Practitioners Legislation Amendment Bill 2025 will enable NPs in the ACT to work to their full scope of practice, recognising their advanced training and expertise, especially those who work in hospice, palliative care, or residential aged care facilities.
If the legislation is passed in the Legislative Assembly, the ACT will be the first jurisdiction in Australia to enable endorsed NPs this expanded scope, providing more comprehensive end of life care.
The reforms would ensure the skills of NPs were fully utilised, improving access to timely, high-quality healthcare for Canberrans, said ACT Health Minister Rachel Stephen-Smith.
“Enabling the legal practice authority for nurse practitioners to issue cause of death certificates, where they were responsible for the care of the person and within 48 hours of the person’s death supports families during a difficult time and helps them to finalise legal affairs more quickly.”
The change removes the need for a medical officer’s involvement where a nurse practitioner has the capacity to undertake the role.
Non-written health directions
The reforms will also allow NPs to witness non-written health directions, alongside doctors and other health professionals.
“Expanding the role of nurse practitioners in witnessing these directions will make the process more accessible and efficient,” said Minister Stephen-Smith.
“This change would enable a non-written health direction to be witnessed by two health professionals, as long as one of those health professionals is either a doctor or a nurse practitioner.”
The Australian College of Nurse Practitioners (ACNP) lauded the legislative changes as a landmark moment for healthcare in Australia.
“By empowering nurse practitioners to work to their full scope, the ACT government is ensuring families receive timely, person-centred care when they need it most,” said ACNP ACT Chapter lead Tim Keun.
“Granting NPs who are often directly involved in a person’s final hours, the authority to complete death certificates provides clarity and closure for families and carers and supports continuity of care.
“These reforms reflect contemporary healthcare needs and set a benchmark for other jurisdictions to follow.”
The changes align with the National Nurse Practitioner Workforce Plan, which advocates for NPs to work to their full scope of practice.
Recent legislation has enabled NPs in the ACT to legally undertake key roles in the voluntary assisted dying process and to prescribe medical termination of pregnancy in accordance with the Therapeutic Goods Administration changes.
Further work in the ACT is underway to enable NPs to conduct fitness to drive medical assessments and complete documentation such as work capacity certificates for initial workers’ compensation claims.
