A residential care facility (RCF) should appoint a medicines governance committee (also referred to as a Medicines Advisory Committee). The medicines governance committee is responsible for approving and overseeing the governance of medicines held at the RCF, including:
RCFs can obtain medicines in the following ways:
Residents may be administered medicines that have been prescribed, dispensed on prescription and labelled for the individual by a pharmacy, including those in a dose administration aid (DAA). Note that these medicines belong to the resident.
Medicines must only be used by the resident for whom they were supplied and not shared or given to other residents. The RCF acts as the resident’s agent in managing these medicines.
The RCF medicines governance committee must ensure policies are in place that outline requirements for the safe and secure storage of a resident’s medicines and prevent risk of loss and misuse.
Schedule 4 and 8 urgent use medicines, or stock medicines held by an RCF generally, may only be obtained if listed on the NSW Health approved list (see below under Urgent use medicines). Any request for additional medicines must be approved by the medicines governance committee and approval sought from NSW Health. Schedule 2 and 3 medicines for nurse initiated use must also be approved by the medicines governance committee.
Urgent use medicines must:
Facilities must have arrangements for after hours supply where required.
Urgent use medicines may only be administered by:
Once a resident’s own dispensed medicine is received, urgent use stock must be withdrawn from use and returned to storage.
RCFs may hold oseltamivir in accordance with the Authority for oseltamivir.
Key requirements include that oseltamivir:
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Schedule 2, 3 and 4 medicines, including those packed in a DAA, must be stored out of public access in:
Medicine refrigerators do not need to be locked if located out of public access.
Storage areas must remain locked when not in immediate use. Keys must be kept separate from other facility keys and carried by the registered nurse in charge of the ward, or their registered nurse delegate.
Residents assessed as capable of self administration may hold a key to their own bedside drawer that stores their medicines. These medicines must not be accessible to other residents or visitors. Resident keys must not open other residents’ drawers.
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The national residential medication chart, when it complies with the requirements of section 41(5) of the National Health (Pharmaceutical Benefits) Regulations 2017 (Cth), is a valid prescription for prescribing, dispensing, and claiming PBS payments. This medication chart may be in a paper or electronic format.
Authorised practitioners such as medical practitioners, nurse practitioners may use the paper NRMC as a prescription provided it includes:
Any dose that could be considered dangerous or unusual must be clearly identified by underlining the dose and initialling the prescription in the margin.
Additional requirements apply when the following medicines are ordered on a RMC:
These medicines must also be prescribed on one of the following:
For computer‑generated (hand‑signed) prescriptions, the prescriber must include the following in their own handwriting:
For Schedule 8 medicines, the prescriber must also include in their own handwriting:
Pharmacists may dispense medicines from a paper NRMC as this has been permitted under an exemption to the form of prescription requirements in the Poisons and Therapeutic Goods Regulation 2008.
For each supply, the pharmacist must record on the duplicate NRMC:
When a medicine is supplied for the final time, the medicine order must be marked ‘CANCELLED’.
The duplicate copy must be retained at the pharmacy for 2 years from the date of last supply.
Prescribers may now use an electronic National Residential Medication Chart (eNRMC) instead of a paper RCF medication chart, as permitted in the National Health (Transitional Electronic National Residential Medication Chart) Special Arrangement 2025.
In NSW, an exemption under the Poisons and Therapeutic Goods Act 1966 has been issued to support the use of eNRMCs under this arrangement.
Approved eNRMC systems, as listed in the Electronic National Residential Medication Charts (eNRMC) – Conformance status tracker, can be used for:
This applies during the transition period, which ends on 31 December 2026.
After this date only eNRMC systems that fully meet all technical and legislative requirements will be permitted for prescribing and dispensing.
More information and resources are available on Electronic National Residential Medication Chart (eNRMC) collection.
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RCFs must have policies and procedures in place to ensure safe administration of medicines.
Administration of medicines by residents or RCF staff should be guided by the Medication management in residential aged care facilities – guiding principles.
S8 medicines may only be administered by a registered nurse or a prescriber.
Each time an S8 medicine is administered to a resident, a witness must be present. The witness must be one of the following:
The witness must be present for the entire process, including:
Where possible, medicines should be administered before residents leave the facility and after they return.
If a dose is required during an outing, medicines must be supplied in the original, fully labelled pack dispensed by a pharmacist.
Medicines must not be repacked into unlabelled containers.
Medicines no longer in use for the resident for whom it was dispensed must not be kept for administration to another resident. These should be sent back to the pharmacy for disposal in the Return of Unwanted Medicines (RUM) bin.
Arrangements should be made with the supplying pharmacist for the return of general prescription and non-prescription medicines.
Where a nursing home is maintaining a record of S4D medicine in a drug register, any unwanted S4D medicines should be destroyed in a similar manner to that for S8 medicines.
Where no register record is being maintained, the S4D medicine may be returned to the supplying pharmacy for disposal.
S8 medicines must be destroyed on the premises of the RCF under the supervision of the retail pharmacist that supplied the S8 medicine. For more information see Destruction of S8 medicines.