Karalyn Huxhagen takes aim at the price war and lack of state cooperation in pharmacist immunisation

Immunisation in pharmacy definitely has reached the first stage but there is more to come. In Queensland, where I live, I can immunise against influenza, whooping cough and measles and mumps. Other states differ in what pharmacists can deliver.

For our pharmacy, we are seeing a steady influx of people accessing the pharmacy as it is an easy walk in-walk out arrangement delivered by a trusted health professional. We are also experiencing an increase in corporate vaccinations by businesses who wish to protect their employees from influenza.

I live in hope that we move to the next stages of vaccination services as can be accessed in Europe e.g. travel vaccinations, and an expanded scope of practice to deliver immunisation from the Australian Immunisation Schedule.

What really disappoints me and disappoints many others, if you read the various pharmacy blog sites, are the factions that have developed within pharmacy itself.

We have the price war faction. The profession worked so hard to prove to Government, Doctors and the general public that we can deliver immunisation as a professional service. We won that battle then the price cut war started.

As a locum I work in different pharmacies which charge from $9.95 to $24.95 for this service. The pharmacist has value and has undergone extensive training to deliver this service so why are we desecrating the service we deliver by price cutting?

We are taught that we need to establish herd immunity to lessen the impact of influenza in Australia and save lives. This means there are plenty of Australians to be immunised—we do not need to cut our throats and make this business model non-viable.

The second faction is the lack of recognition of our qualifications by other Australian state health regulators.  I have encountered, as a locum, that my Queensland qualifications are not recognised in other states.

I am trained by qualified nurse trainer to the Pharmaceutical Society of Australia standards in Queensland. I undertook the Pharmacy Guild training in New South Wales. I am trained to immunise intramuscular, subcutaneous and trans dermal injections. I am trained to a qualification in anaphylaxis and first aid.

BUT when I work outside of Queensland, the other states do not recognise this qualification. I cannot immunise in the other states.

Why have we allowed this to happen? I was informed in Victoria that my qualification in Queensland is only for influenza, which is not true. I was informed that there are bridging courses which are rarely conducted, and the best advice I was given was to complete the whole Victorian course. When I looked into this further I was informed that I would require a nurse to visit the pharmacy and check my technique and procedure if I practiced in Victoria.

I have been immunising in Queensland since the beginning of the QPIP project. I have completed three nurse-led vaccination education programs. Why do I have to do this and pay the fees all over again due to the fact that I stepped over a state border! Nurse locums and agency nurses can move between states and immunise; why can’t pharmacists?

Being able to immunise in an easily accessible health facility such as a pharmacy will improve herd immunity and increase immunisation rates. We are delivering a much needed service that will lead to better health outcomes for the patient and the community. This is the basis that all pharmacy programs aim to achieve. So why have we allowed this compartmentalisation within states to occur?

Pharmacy has been very careful to develop standards for immunisation training and qualification. The universities delivering pharmacy qualifications are developing curricula to train pharmacy graduates to provide immunisation services.

How will the graduates feel if they achieve this qualification in their university state of residence and then move to another state and not be able to practice? Reading the early career pharmacy blog sites I can see that I am not the only practitioner confused and upset by this state by state compartmentalisation.

I have been a strong advocate for immunisation services within pharmacy. I have undertaken training in two states and my understanding was once the other states came on board within their own state health regulations that Immunisation would be a component of pharmacy practice that can be delivered wherever we work within Australia. To discover that this is not the case is disappointing for the profession who have proven that we can deliver these services to the betterment of our communities.

Who let this happen? Is it not enough that we have differing regulations in each state for the processing and retailing of Pharmacy Only and Pharmacist Only medications?

How can “Pharmacist Immuniser” become a qualification that is recognised in every Australian state and territory without the need to complete new practice competency standards as we cross state borders?

Karalyn Huxhagen is a community pharmacist and was 2010 Pharmaceutical Society of Australia Pharmacist of the Year. She has been named winner of the 2015 PSA Award for Quality Use of Medicines in Pain Management and is group facilitator of the Mackay Pain Support Group.