Prescribing nurses will number over 30,000 by 2004
For the first time specially trained nurses will be allowed to write prescriptions for a wide range of drugs, including antibiotics for infections.
The move is the latest step in a drive by ministers to expand the role of nurses.
The creation of independent nurse prescribers is designed in part to relieve pressure on hard-pressed GPs, who can be freed up to concentrate on more complex problems.
By September 2001, more than 22,000 district nurses, health visitors and practice nurses had been trained to prescribe from a limited list including laxatives, aspirin and paracetamol.
Ministers announced in May 2001 that the scheme would be expanded and a further 130 medicines added to the list of available prescriptions.
The government has allocated £10m to train 10,000 nurses with the extended list by 2004.
They will be able to prescribe treatments for:
They will also be allowed to prescribe nine common antibiotics for conditions such as lower urinary tract infections in women, the skin conditions impetigo and acne and the ear condition otitis externa.
In addition, there are plans for nurses to take responsibility for the long-term management of patients with chronic conditions such as asthma, diabetes, heart disease and mental illness - but only provided they follow an individual treatment plan devised by a doctor.
Announcing the new powers, the government's Chief nursing officer Sarah Mullally said: "Over the last few years, nurses and health visitors have demonstrated that they are safe, careful and professional prescribers.
"Their prescribing has largely substituted for GPs' prescribing and early research tells us that patients believe they benefit from their nurse's prescribing."
Nurses want more
The Royal College of Nursing has welcomed the extension of nurse prescribing.
However, Mark Jones, RCN primary care policy advisor, said the powers did not go far enough.
He told BBC News Online: "We believe that nurses who are suitably qualified and competent should be able to prescribe anything they need for the care of their patients from the whole British National Formulary."
Mr Jones said the limits of the new scheme would particularly impact on nurses who worked in hospitals, and who were keen to take control of drug regimes for patients to take on their discharge, and to move into specialist areas such as the prescription of immuno-suppressant drugs.
He said nurses would also like to take responsibility for developing drug programmes for diabetic patients without having to consult a doctor first.
He said: "The challenge for nurses is to prove that they are high quality, safe and competent prescribers and that they can take responsibility for additional items."
Doctors keen
The British Medical Association is in favour of an expanded role for nurses.
It put forward proposals earlier this year for nurses not only take on new prescribing powers, but also to offer advice and minor forms of treatment.
Only patients needing help for more complex conditions, or a referral to a consultant, would need to see the GP.
However, the Medicines Commission, which advises ministers on prescribing issues, has expressed concern that the 37 days training that nurses will receive is inadequate.