New ZealandHPCA Act · Scopes of practice

Scopes of Practice Under the HPCA Act: What Working Within Your Scope Means

A plain-English explainer for every practitioner registered under the Health Practitioners Competence Assurance Act 2003: what a scope is in law, how it is set and changed, what conditions do, what really happens if you practise outside it, and how to handle the grey areas before they become a complaint.

Reviewed October 2026 against the HPCA Act 2003 and guidance from the Ministry of Health, Medical Council, Nursing Council, Midwifery Council, Pharmacy Council, Dental Council, Paramedic Council, Physiotherapy Board and Psychologists Board

Sections 8, 11, 21 and 22 explainedScopes across 9 professionsConditions and the registerGrey-area scenarios

Short answer: Under the HPCA Act, your scope of practice is the set of health services your responsible authority has authorised you to perform, subject to any conditions it has added. Each authority describes its profession's scopes by notice under section 11, and section 8 says you may practise only with a current practising certificate and only within your scope and its conditions. Stepping outside your scope, or ignoring a condition, is a ground for discipline under section 100, and performing a restricted activity outside scope is a criminal offence with a fine of up to $30,000.

Key takeaways

"Scope of practice" has two legal meanings: the services that make up a profession (described in a notice under s 11) and the services you personally are authorised to perform (granted under s 21, with conditions under s 22).
Scope and competence are different tests. Your scope is the legal outer limit; your competence, training and setting decide what you can safely do inside it.
Section 8 itself creates no criminal offence. The consequences of working outside scope run through discipline (s 100), competence processes and practising certificate decisions, plus offences under s 7 (titles) and s 9 (restricted activities).
Conditions can be added at registration, when your APC is issued, after a competence review, when a recertification or competence programme is not completed, during an investigation, or by the Tribunal for up to three years.
Scopes change. Nursing, midwifery, pharmacy, paramedicine and medicine (with physician associates from 1 October 2026) have all issued new or amended notices since 2024, so check the current notice for your profession, not the one you trained under.
Before taking on anything new, check three things: is it inside your scope and conditions, are you competent to do it here, and does your employer authorise it.

What a scope of practice is in law

Every registered health practitioner in Aotearoa holds a scope of practice. It is the legal foundation for almost everything else your responsible authority does: registration, your annual practising certificate (APC), recertification, competence reviews and discipline. Our fitness to practise overview explains how complaints and concerns move through the system. This page goes one level deeper, into the legal concept that those processes test you against.

Section 5 of the HPCA Act defines "scope of practice" in two parts, and most confusion comes from mixing them up:

Meaning 1 · the profession

The services that make up a profession

Any health service that forms part of a health profession and is currently described in a notice under section 11. These are the scopes you see named in a Gazette notice, such as "Registered Nurse", "Pharmacist Prescriber" or "Vocational scope: Emergency medicine".

Meaning 2 · you

The services you may perform

One or more of those health services that you personally are permitted to perform under an authorisation granted under section 21, subject to any conditions the authority has imposed. This is the scope printed against your name on the register.

The Medical Council puts the practical effect simply: the professional services a doctor can perform in New Zealand are defined by the scope of practice. The same is true for a dental hygienist, a midwife or a psychologist. Your scope is not a job description and it is not your employer's policy. It is a legal authorisation from your regulator, and it travels with you from job to job.

It also reaches beyond hands-on care. The Medical Council's scopes notices describe the practice of medicine as going wider than clinical medicine, to include teaching, research and medical or health management. A doctor in a management or teaching role is still practising within a scope, and the same logic applies in other professions: if your role draws on your professional knowledge in a way that affects patients, check what your scope says about it.

The sections that do the work

You do not need to read the whole Act, but a handful of sections decide how scope works day to day. This table pulls them together in the order you are likely to meet them.

Health Practitioners Competence Assurance Act 2003, version as at 6 June 2026.
Section	What it says	What it means for you
s 5	Defines scope of practice in two parts: the profession's services, and the services an individual is authorised to perform, subject to conditions	Your personal scope can be narrower than the profession's scope because of conditions
s 7	Only registered practitioners may use protected names, titles and descriptions or claim to practise as that kind of practitioner	Claiming a title you are not registered for is an offence (fine up to $10,000)
s 8	You must hold a current practising certificate to practise, and must not perform a health service from your profession's scopes unless your scope permits it and you follow its conditions	The core "work within scope" rule, with exceptions for emergencies, training and authority-ordered assessments
s 9	Certain activities are restricted to practitioners whose scope permits them	Performing a restricted activity outside scope is an offence (fine up to $30,000)
ss 11 and 12	Each authority must describe its profession in scopes by notice, and prescribe the qualifications for each scope	The Gazette notice is the authoritative statement of what each scope covers
ss 21 and 22	The authority authorises a scope (or a changed scope) and states the services you may perform and any conditions	This is your personal authorisation; changes need a fresh decision
ss 27, 29 and 32	Listed concerns, including failure to comply with a condition, send an APC application to the authority for decision; conditions can be added when it is issued; your scope is endorsed on the certificate	Breaching conditions can affect your next APC; your APC shows your scope
ss 38, 39 and 43	After a competence review, during one, or when a programme is not completed, the authority can add conditions or alter your scope	Competence and recertification issues are dealt with through your scope, not as punishment
s 69	Conditions or suspension while conduct is investigated or prosecuted	Interim conditions can apply before any finding is made
ss 100 and 101	Grounds for discipline and the Tribunal's penalties	Practising outside scope, without an APC or in breach of conditions are each a separate ground
s 106	Appeals against authority decisions	Conditions and declined scope changes can be appealed to the District Court within 20 working days

How scopes are set: Gazette notices

Section 11 requires each responsible authority to describe the contents of its profession, by notice, in terms of one or more scopes of practice. A scope can be described by reference to a commonly understood name, an area of science or learning, the tasks commonly performed, or the illnesses or conditions diagnosed, treated or managed. Section 12 then requires the authority to prescribe the qualification or qualifications for every scope.

These notices are published in the New Zealand Gazette and carry legal force. The Act already requires authorities to consult people likely to be affected before issuing a notice: the Nursing Council, for example, consulted the sector in late 2025 before approving its new registered nurse prescriber scope.

Because scopes are set by notice rather than by the Act itself, they change more often than many practitioners realise. These recent changes show how active the area is:

6 April 2017

Broadened nurse practitioner scope takes effect, removing the requirement for nurse practitioners to register in a specific area of practice.

1 November 2024

Medical Council's current scopes notice for the practice of medicine comes into force, replacing the 2023 notice. It has been amended several times since, most recently in March 2026.

20 January 2025

Updated enrolled nurse and registered nurse scopes take effect (gazetted 12 November 2024). The new standards of competence apply to continuing competence audits from 1 April 2025 and for all other purposes from 1 January 2026.

17 April 2025

Paramedic Council notice sets out the general paramedic scope and the critical care, extended care and intensive care paramedic endorsements.

1 February 2026

Midwifery Scope of Practice and Qualifications Notice 2026 takes effect, replacing all earlier midwifery scope notices.

10 September 2026

Pharmacy Council amendment notice takes effect, updating overseas pathways and adding qualifications for UK-trained pharmacist prescribers.

1 October 2026

Medical Council begins regulating physician associates, under a scopes notice for physician associate practice that came into force on 27 July 2026 and sets out provisional and general scopes.

Proposed law changes

The Health Practitioners Competence Assurance Amendment Bill (287-1) would require authorities to consult practitioner and patient representatives and seek public views before issuing a scope notice, let the Minister direct authorities on scopes, and create a review committee for complaints about declined scope changes and conditions. It is a bill, not law, and it lapsed when Parliament was dissolved on 1 October 2026 ahead of the 7 November election; the new Parliament can reinstate it. We cover it in detail in our guide to the HPCA Amendment Bill.

Scopes across the professions

There are 18 responsible authorities, and each has built its scopes differently. Some professions have one broad scope; others layer general, specialist and training scopes. This comparison covers the largest groups and a cross-section of allied professions, using each authority's current notice or scope page.

Current scope notices and scope pages of each authority, checked October 2026.
Authority	Scopes	Worth knowing
Medical Council (doctors)	Provisional general; general; provisional vocational; vocational (specialist scopes from anaesthesia to vascular surgery); special purpose (seven, including locum tenens, research, teleradiology and pandemic or disaster)	General scope allows work in any area of medicine. Vocational scope recognises a specialist who can work independently. Provisional scopes require approved supervision.
Medical Council (physician associates)	Provisional; general	Regulated from 1 October 2026. The provisional scope covers the initial period of registration (up to 36 months, in a Council-approved position under approved supervision); the general scope is for those who have completed it. Both require onsite supervision to be available.
Nursing Council	Enrolled nurse; registered nurse; nurse practitioner	Registered nurses can be authorised to prescribe some medicines within their area of practice and level of competence. A new RN prescriber scope has been approved but not yet implemented.
Midwifery Council	One midwifery scope	Covers care for people preparing for pregnancy, pregnant, birthing and postpartum, and for their pēpi up to six weeks, including prescribing within the midwife's own level of education and expertise.
Pharmacy Council	Intern pharmacist; pharmacist; pharmacist prescriber	Pharmacist and pharmacist prescriber can be held together; intern and pharmacist cannot. Prescribers are not the primary diagnostician.
Dental Council	Scopes for dentists and dental specialists, dental therapists, dental hygienists, oral health therapists, orthodontic auxiliaries, dental technicians and clinical dental technicians	Dental therapists have a general scope for children and adolescents up to age 18 and a separate adult care scope, which is practised under a dentist's direct clinical supervision or clinical guidance.
Paramedic Council	General paramedic, with critical care, extended care and intensive care paramedic endorsements	The intensive care endorsement is closed: applications close 18 months after the notice was signed on 17 April 2025, which falls in October 2026. Intensive care paramedics cannot provide drug-assisted (rapid sequence) intubation.
Physiotherapy Board	Physiotherapist (general); advanced practice physiotherapist; specialist	Advanced practice and specialist physiotherapists practise beyond the general scope in a specified vocational area.
Psychologists Board	Psychologist (general); intern and trainee psychologist (special purpose); clinical, counselling, educational psychologist and neuropsychologist (vocational)	Every scope is practised within the individual's area and level of expertise.

Three patterns stand out. First, a broad scope is not a licence to do everything inside it: the psychology notice, the enrolled nurse scope and the midwifery scope all tie practice to the individual's own education and competence. Second, specialist titles are scope-bound. The Dental Council reminds practitioners that you must not present yourself as a dental specialist unless you are registered in that specialty's scope. Third, temporary scopes are temporary: the Medical Council's special purpose registration does not lead to general or vocational registration, and entry ends after a fixed period.

Nursing: what changed and what is coming

Nursing has seen the biggest shift. The registered nurse scope that took effect on 20 January 2025 states that registered nurses are responsible and accountable for directing and delegating to members of the healthcare team and provide support and guidance to enrolled nurses. The enrolled nurse scope describes enrolled nurses as accountable and responsible for their nursing practice, working across the life span in all settings, consistent with their education and assessed competence, and says they must work with access to, and seek when appropriate, guidance from a registered nurse.

Next, the Nursing Council has approved a new registered nurse prescriber scope and a revised nurse practitioner scope after consulting in late 2025. It then consulted on the standards of competence and prescribed qualifications for both, with submissions closing on 7 September 2026. No start date had been announced when we checked. Until the new scope is gazetted and in force, the current registered nurse scope applies, under which the Council authorises suitably educated registered nurses to prescribe some medicines. Our Nursing Council recertification guide covers what each scope means for continuing competence.

Reading your own scope, and why competence is a separate test

Your scope is recorded in three places. Section 32 requires it to be endorsed on your practising certificate. It appears on your authority's public register, which anyone can search. And the full wording sits in the Gazette notice for your scope, which is where you check what the words on your certificate actually cover.

The Medical Council's register shows a doctor's name, qualifications, scope of practice and any conditions on their practice. The Nursing Council notes that not every condition appears on the public register, and that employers can contact the Council for details. If your scope carries a condition, assume colleagues, employers and patients may be able to see it, and make sure your own understanding of it is exact.

Legal question

Competent but outside scope

A registered nurse trained overseas to perform a procedure that is not part of the New Zealand registered nurse scope cannot rely on that skill here. A general scope doctor who has learned a procedure the Council ties to particular vocational scopes cannot simply start offering it. Skill does not create legal authority.

Professional judgement

Inside scope but outside competence

A general scope doctor may legally work in any area of medicine, but a doctor with no recent obstetric experience should not cover a labour ward alone. The scope permits it; competence, training and the setting do not.

Both matter. The first is a legal question your authority answers. The second is a professional judgement you make every shift, and your code of conduct expects you to make it honestly. Our comparison of codes of conduct across the professions shows how each authority words that duty.

Conditions on scope of practice

A condition narrows your personal scope. The Medical Council describes a condition as a legal requirement that a doctor must do something or cannot do something. Under section 22(3), conditions are those the authority considers necessary to ensure you practise competently, and the Act gives examples:

Supervision or oversight

Practising only under supervision, or under the oversight of a named person or role.

Task restrictions

Not performing specified tasks, or performing them only in specified circumstances.

Capacity or setting

Practising only in a stated capacity, or only in association with nominated people.

Time limits

Practising only for a stated period.

Further learning

Gaining further qualifications or experience.

Public safety

Any other condition the authority believes on reasonable grounds is necessary to protect public safety.

Not every condition is a sign of trouble. Many are routine. The Nursing Council uses conditions to describe the area a nurse may work in, linked to their pre-registration education, such as a condition allowing a nurse to practise in general and obstetric nursing, and the registered nurse scope notes that conditions can limit some nurses to a specific area of practice. Provisional and special purpose scopes come with supervision built in. Others follow a concern.

When conditions can be imposed

Health Practitioners Competence Assurance Act 2003.
Route	Trigger	What can happen
Registration or change of scope (ss 21, 22)	Your qualifications or experience do not fully match the scope	Scope authorised with conditions; the authority must tell you first if it plans to depart from the scope you applied for (s 20)
Practising certificate (s 29)	The authority needs to be satisfied you meet the required standard of competence	Conditions added or varied when your APC is issued
After a competence review (s 38)	You appear not to meet the required standard	Conditions, a competence programme, an examination or assessment, or counselling
During a competence review (s 39)	Reasonable grounds to believe you pose a risk of serious harm	Interim conditions, altered scope or suspension, after you have been told why and given a chance to respond
Programme not completed (s 43)	You do not meet the requirements of a competence or recertification programme	Altered scope, added conditions or suspension until you meet them; not itself a ground for discipline
Conduct investigation (s 69)	Conduct under investigation or prosecution casts doubt on the appropriateness of your practice	Conditions or suspension until the matter ends
Tribunal penalty (s 101)	A disciplinary charge is proved	Conditions on practice for up to three years, including on employment and supervision

The recertification route is the one most practitioners never expect. If you do not complete your authority's recertification programme, section 43 lets the authority change your scope or add conditions until you do. That is why a shortfall in CPD hours or a missing portfolio item is more than an administrative problem. Our recertification portfolio audit checklist helps you avoid it.

Living with a condition

Read the exact wording, keep a copy, and tell every employer and locum agency. Breaching a condition is its own ground for discipline under s 100(1)(f), and under s 27 a failure to comply with a condition is one of the concerns that takes your APC application out of routine processing and sends it to the authority for decision. If a condition no longer fits your practice, apply to have it varied or removed rather than working around it. A decision to impose or vary conditions can be appealed to the District Court within 20 working days of being notified.

Practising outside scope: what actually happens

It is often assumed that practising outside scope is "an offence under section 8". It is not quite that. Section 8 sets the rule but does not itself create a criminal offence. The consequences come through four other routes, and which one applies depends on what you did.

$30,000maximum fine for a restricted activity performed outside scope (s 9)

$10,000maximum fine for falsely claiming a protected title (s 7)

3 yearsmaximum Tribunal suspension, or conditions, under s 101

Health Practitioners Competence Assurance Act 2003, ss 7, 9, 100 and 101.

1. Discipline

Section 100(1) lists the grounds on which the Health Practitioners Disciplinary Tribunal can penalise a practitioner. Three are about scope: practising without a current practising certificate (s 100(1)(d)), performing a health service from your profession's scopes that your own scope does not permit (s 100(1)(e)), and failing to observe conditions in your scope (s 100(1)(f)). Notice too that professional misconduct under s 100(1)(a) is judged as malpractice or negligence "in relation to the scope of practice" you held at the time. Your scope is the yardstick for misconduct as well.

If a charge is proved, the Tribunal can cancel registration, suspend it for up to three years, impose conditions for up to three years, censure, fine up to $30,000 and order costs. Our guide to Professional Conduct Committees explains the investigation stage that usually comes before a charge.

2. Restricted activities: a criminal offence

Section 9 lets the Government restrict activities that risk serious or permanent harm if performed by the wrong people. Only a practitioner whose scope permits the activity may perform it, or say they are willing to. The Ministry of Health lists five restricted activities:

Surgical or operative procedures below the gingival margin or the surface of the skin, mucous membranes or teeth.
Clinical procedures involved in the insertion and maintenance of fixed and removable orthodontic, and oral and maxillofacial prosthetic, appliances.
Prescribing enteral or parenteral nutrition given by tube into the gut or through a central venous catheter.
Prescribing ophthalmic, optical or ophthalmic medical devices for remedial or cosmetic purposes, including to correct a defect of sight.
Applying high-velocity, low-amplitude manipulative techniques to cervical spinal joints.

Your scope does not need to name the activity, but the Ministry's guidance is that it must cover or clearly include it. Contravening s 9 carries a fine of up to $30,000. The Ministry of Health says breaches will be investigated by the Ministry and may be prosecuted, and a registered practitioner acting outside scope may also face proceedings from their authority.

3. Competence and practising certificate decisions

Work outside scope often reveals a competence gap. The authority can review your competence and order conditions or a programme under s 38, act in the interim under s 39 if there is a risk of serious harm, and take conditions into account when deciding your next APC.

4. An HDC complaint

If a patient complains, the Health and Disability Commissioner looks at the care against the Code of Rights. Right 4(2) gives every consumer the right to services that comply with legal, professional, ethical and other relevant standards, so care given outside your scope is very hard to defend. Our practitioner's guide to the Code of Rights covers the standards HDC applies.

The three exceptions

Sections 8(3) and 9(5) both allow work outside scope in three situations: an emergency; a course of training or instruction (for restricted activities, only under the control of a practitioner whose scope covers the activity); and an examination, assessment or competence review your authority requires or orders. The exception is for a genuine emergency. It is not a way to cover routine gaps in a roster.

Related courseProfessionalism in Practice for Health PractitionersPlaces scope, conditions, APC declarations and competence review inside the wider picture of how NZ regulators define and enforce professionalism.3 hours (estimated) · NZ$139 · certificate on completion View course

Grey areas: where scope questions really come up

Few practitioners deliberately step outside their scope. The risk lies in situations that feel normal at the time. These are the ones regulators and the Ministry have actually written guidance on.

Delegation and standing orders

Delegation does not transfer a scope. Whoever takes on a task must be permitted to do it and competent to do it. The registered nurse scope makes registered nurses responsible and accountable for directing and delegating to members of the healthcare team. The enrolled nurse scope makes enrolled nurses accountable and responsible for their nursing practice, so an enrolled nurse who accepts a task they are not educated or competent for cannot rely on having been asked.

Standing orders follow the same logic. The Ministry of Health's standing order guidelines let medical practitioners, dentists, nurse practitioners and optometrists issue standing orders so that other named people working under the order can supply or administer specified medicines without an individual prescription. Issuers may act only within their own scope and expertise, the people working under the order must be competent to judge whether it applies and to give the medicine, and the issuer must review their competence at least once a year. A standing order permits, but never requires, someone to act. It cannot be used to write prescriptions for a pharmacy.

Extended practice and new skills

Learning a new skill does not widen your scope on its own. Where an authority wants a skill to be practised only by those with specific training, it usually builds that into a scope, an endorsement or a condition. The Medical Council's policy on general scope doctors performing tumescent liposuction is a clear example: the extension is granted as a condition on the doctor's scope, only to doctors meeting set criteria, with ongoing peer review and audit. The Physiotherapy Board's advanced practice and specialist scopes and the Paramedic Council's endorsements do the same job for those professions.

Prescribing is a common area of extended practice, and it is moving. Midwives prescribe within the midwifery scope; pharmacist prescribers, registered nurses with prescribing authorisation and nurse practitioners prescribe within their scopes; and a 2026 Cabinet paper published by the Ministry of Health proposes designated prescribing authority for paramedics who complete the required training, expected to start with extended care paramedics and limited to a specified list of medicines, with the Paramedic Council setting scope, training and supervision requirements. That proposal is not yet in force.

A new setting, employer or role

Moving jobs can change what your scope allows. Doctors in provisional general, provisional vocational or special purpose scopes must apply for a variation before changing work location, employer, supervisor or level of appointment, and must wait for approval. The Medical Council warns that time worked in breach will not count towards general or vocational registration. The Dental Council says areas of dental therapy not covered in a practitioner's training should not be undertaken until they have completed appropriate training. Even in a broad scope, a move from a ward to the community, or from adults to children, is a moment to check competence before you start.

Telehealth across borders

The Medical Council's 2023 statement on telehealth says any doctor providing telehealth to patients in New Zealand should be registered with the Council and hold a current practising certificate, and it expects doctors based overseas to comply with the statement too. The standard of care should match an in-person consultation within the limits of the modality, and telehealth should not be used for potentially serious or high-risk conditions that need a physical examination. If you are registered with another authority, check its own guidance on telehealth.

AI and digital tools

An AI tool does not extend your scope or move responsibility. The Medical Council's March 2026 guidance says "AI is not a substitute for your clinical judgement, and you remain responsible for all your clinical decisions and actions." It expects doctors to use AI only where they are competent to interpret its output, to make sure patients know when AI is being used in their care, and to get informed consent before an AI scribe records a consultation. Nurses should also read our guide to the Nursing Council AI declaration.

Aesthetics and cosmetic procedures

This is a live area of risk. The Medical Council's statement on cosmetic procedures (2017) sets expectations on training, skill, advertising and consent. In August 2025 the Council consulted on a tighter model that would sort procedures into three categories, require doctors outside surgery and dermatology to obtain an approved extension of scope recorded on the register before starting, limit general scope doctors to low-complexity procedures, and bar provisional general doctors from cosmetic work. Consultation closed on 24 September 2025 and no decision had been published when we checked in October 2026. Treat it as a signal of direction, not a current rule, and check the Council's site before expanding cosmetic work.

Emergencies and good Samaritan care

The emergency exception in s 8(3) and s 9(5) protects you when you act outside scope in a genuine emergency, such as assisting at a roadside collision. It does not authorise planned work outside scope because no one else is available. If an "emergency" happens regularly, it is a staffing problem to escalate, not a scope exception to rely on.

Related courseWorking Within Your Scope of PracticeWorks through out-of-scope requests, delegation, standing orders, telehealth and role creep with scenarios, and how to plan a legitimate extension of practice.3 hours (estimated) · NZ$139 · certificate on completion View course

Changing, adding or extending a scope

Under section 21 the authority can authorise a changed scope, which may add services, cancel or vary conditions, or add new ones. Until it does, your current scope is the limit. Each authority has its own forms, but the process follows a common pattern:

Read the notice for the scope you want
Check the Gazette description and the prescribed qualifications under s 12. For a vocational medical scope, that usually means a fellowship from a recognised college; for pharmacist prescriber, a specified postgraduate qualification.
Map your evidence
Collect qualifications, supervised practice, logbooks, references and CPD records. Build any gap into your professional development plan; our PDP examples show how to frame goals.
Apply on the right form
The Medical Council uses COS4 to move to the general scope, COS5 to move from provisional vocational to vocational, and COS1, COS2 or COS7 for variations to provisional and special purpose scopes, all through myMCNZ.
Allow time
The Medical Council asks for at least 20 working days for variations, longer if there are disclosures or concerns. If the authority proposes to depart from what you applied for, s 20 requires it to tell you first.
Do not start until it is authorised
A new or changed scope takes effect when the authority decides it, and you will usually receive a new practising certificate. Starting early is practising outside scope.
Update your recertification plan
A new scope can bring different recertification requirements. Check your authority's programme, for example the Medical Council, Pharmacy Council, Dental Council, Midwifery Council or allied health requirements.

If the authority declines a change of scope, or imposes conditions you disagree with, you can appeal to the District Court within 20 working days of being notified. A judge can extend that time.

Self-check before you take on something new

Run through these before accepting a new task, role, contract or setting. If any answer is "no" or "not sure", stop and check with your authority, your professional body or your indemnity provider before you start.

I have read the current Gazette notice for my scope, not the one I trained under.
I know every condition on my scope, in its exact wording, and I have told my employer.
My APC is current and shows the scope I am about to work in.
This task is inside my scope, and if it is a restricted activity, my scope clearly covers it.
I have recent training and experience for this task in this setting and with this patient group.
My employer has authorised me to do it, and any standing order or delegation is in writing and current.
If I am in a provisional or special purpose scope, any change of job, supervisor or setting is approved.
I know who to ask when I reach the edge of my competence on shift.

Test yourself on four situations practitioners regularly face:

A practice manager asks an enrolled nurse to work a clinic session with no registered nurse available on site or by phone. Is that within scope?

Unlikely as described. The enrolled nurse scope requires enrolled nurses to work with access to guidance from a registered nurse and to seek it when appropriate. With no access at all, the enrolled nurse should raise the issue before the session, not during it.

A general scope doctor completes a weekend course in a cosmetic procedure and wants to start offering it next month. Is the course enough?

Not necessarily. General scope allows work in any area of medicine, but some procedures are tied to particular scopes or require a Council-approved extension recorded as a condition, as with tumescent liposuction. The doctor also needs genuine competence. Check the Council's current cosmetic procedures standards first.

A pharmacist prescriber is asked to make the first diagnosis for a new patient with undifferentiated symptoms. Does the prescriber scope cover it?

No. The Pharmacy Council's notice describes pharmacist prescribers as prescribing to start, change or stop therapy and ordering and interpreting investigations, but not as the primary diagnostician. The patient should be referred for diagnosis.

A doctor in a provisional general scope is offered a post at another hospital starting next Monday. Can they simply start?

No. A change of employer, location, supervisor or level of appointment needs a variation approved by the Medical Council first, and the Council asks for at least 20 working days. Time worked in breach does not count towards general registration.

Frequently asked questions

Is practising outside my scope a criminal offence in New Zealand?

Usually not in itself. Section 8 of the HPCA Act sets the rule but creates no offence. Practising outside scope is a ground for discipline under s 100(1)(e). It becomes a criminal offence when you perform one of the five restricted activities outside scope (fine up to $30,000 under s 9) or falsely claim a protected title (fine up to $10,000 under s 7).

Where can I see my own scope and any conditions?

Your scope is endorsed on your annual practising certificate and shown on your authority's public register. The Medical Council's register lists conditions on a doctor's practice. The Nursing Council notes that not all conditions appear on its public register. The Gazette notice for your scope sets out what the scope covers in full.

Can my employer expand my scope through a policy or job description?

No. Only your responsible authority can authorise or change your scope. An employer can narrow what you do in a role, and can authorise tasks that are already inside your scope, but it cannot authorise work your scope does not permit.

Does a condition on my scope mean I am under investigation?

Not necessarily. Many conditions are routine, such as supervision in a provisional scope or a nurse's area of practice linked to their education. Conditions can also follow a competence review, an unfinished recertification programme or an investigation, so read the wording and ask your authority if you are unsure why it is there.

What is the difference between general scope and vocational scope for doctors?

Doctors in the general scope can work in any area of medicine. Vocational scope recognises a doctor as a specialist in one of the vocational scopes, such as general practice or psychiatry, and allows them to work independently. Each has a provisional version in which the doctor works under supervision approved by the Council before moving to the full scope.

Can I hold more than one scope at the same time?

Often, yes. The Medical Council registers doctors in one or more scopes of practice, and the Pharmacy Council allows the pharmacist and pharmacist prescriber scopes to be held together, although not intern pharmacist and pharmacist. Check your own authority's notice.

Can I appeal a condition or a refused change of scope?

Yes. Under s 106 you can appeal to the District Court against an authority's decision to impose or vary conditions, or to decline a change of scope. The appeal must be lodged within 20 working days of being notified, although a judge can extend that period.

Has the nurse practitioner or registered nurse prescriber scope changed?

The Nursing Council has approved a new registered nurse prescriber scope and a revised nurse practitioner scope after consulting in late 2025, and consulted on the related standards and qualifications until 7 September 2026. No start date had been announced when this page was reviewed, so the current scopes and authorisations still apply.

Primary sources

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