Leading pharmacists have expressed disappointment at doctors’ reaction to the announcement of expanded pharmacist vaccination in Victoria
And stakeholders in NSW remain disappointed at the lack of similar announcements in the country’s most populous state.
Victorian health minister Jill Hennessy announced a suite of vaccination reforms which will see pharmacists able to offer the MMR, in addition to influenza and whooping cough vaccines.
The age at which Victorians can access vaccines at pharmacies is also set to drop from 18 to 16.
At the same time, PSA released new data showing that 64% of Australians think pharmacists should be able to administer common vaccinations – such as travel vaccines, meningococcal and whooping cough vaccines – across the country.
According to Channel Nine, this has sparked a “turf war” between pharmacists and GPs.
Doctors have “major concerns” about the care of patients, says health reporter Gabriella Rogers.
“We’ll only see fragmentation of that care, which leads to less than perfect outcomes, leads to a reduction of health care to the community,” AMA president Dr Tony Bartone told Ms Rogers.
He also said that patient safety is an issue.
“You’d need the trained health professionals to deal with the scope, the entire scope of possible side-effects.”
Anthony Tassone, president of the Pharmacy Guild’s Victorian branch, expressed disappointment at these comments.
“These criticisms are a tired repetition from the ‘dial a quote’ playbook of the AMA and a legacy of obstruction, rather than working with other health professionals to achieve best outcomes for patients,” he told the AJP.
“It’s infuriating that another peak body continues and insists on questioning the competency of health professional colleagues working within their scope of practice to improve public health outcomes.
“Nonetheless, these repeated jibes won’t halt the Guild advocating for the best utilisation and recognition of pharmacists.”
He said that perceived fears of fragmentation of care – “through the lens of a doctors’ group” – do not and should not excuse delays in care, or no care at all.
“If we’re genuine about patient centred care then that must be based on the individual needs and preferences of the very patients we are treating.
“A vaccine that is competently administered within a health professional’s scope of practice is equally effective regardless of who delivers it – and if that achieves an outcome of herd immunity then surely that’s a good thing for public health.”
PSA national president Shane Jackson also called for a more collaborative approach with a focus on increasing vaccination rates.
“All we need to do is focus on what’s the best for patients,” he told the AJP.
“Pharmacists have a role to play as medicines experts and as one of the most accessible primary healthcare providers we also have a role in addressing primary care issues which include supporting patient self care, vaccinations and screening programs.
“The key point is that we should have a connected health system that supports health professionals scope of practice fulfillment.”
Vaccines are safe when given by any trained health professional including pharmacists, nurses and doctors. Let’s focus on the issue of increasing vaccination rates across the country. @PSA_National @ama_media @PharmGuildAus https://t.co/HVOvXFeLUr
— Shane Jackson (@ShaneJacks) August 13, 2018
NSW still restricted
Meanwhile in NSW, Guild branch president David Heffernan called for expanded pharmacist vaccination and expressed frustration at the lack of movement on the issue from decision-makers.
“We’ve made several representations to the Department of Health and to [NSW Health Minister] Brad Hazzard himself, and it’s basically for nothing, because last time we met with them they said they were seeking a national approach,” Mr Heffernan says.
“However it’s quite clear that the states are doing things unilaterally – just in the last fortnight we’ve had Tasmania and Victoria announcing separate things.”
Mr Heffernan and state president of the PSA Peter Carroll have both expressed their support for expanded vaccination by accredited pharmacists in NSW, and concern that the Government has not pursued the issue.
At the end of July the Tasmanian government announced a program of free meningococcal vaccines for anyone aged six weeks to 20 years. Pharmacists will be able to administer government vaccine stock to children and young people aged 10 and above.
“Tasmania came about because of an outbreak of meningococcal, and my theory is that it’s going to take something like that to get NSW Health into gear,” Mr Heffernan says.
“When I speak to politicians they’re all in favour [of expanded pharmacist vaccination], when I speak to politicians they’re all in favour, when I speak to the general community, when I speak privately to GPs, they’re in favour – though the RACGP and AMA are against it.
“But we seem to have a very apathetic ministry. And it’s not just inaction on vaccination, it’s inaction on real time monitoring as well.”
NSW Labor recently made an election promise that it would allow NSW pharmacies to provide vaccinations for the dTpa vaccine and the MMR vaccine from September 1, 2019, if elected, bringing NSW into line with South Australia, Queensland and the Northern Territory.
“But it’s a simple fact that as it stands, NSW have the most restrictions on vaccination in the country, and we’re the most populous state,” Mr Heffernan says.
While final numbers are yet to be counted, there has been more pharmacist vaccination this year than ever before, he said.
“Last year we had a horror flu season, with 3000 deaths out of the 5000 nationwide. And there’s reports on the ABC talking about regional areas where there’s a six-week wait for the doctor as GP shortages bite, so it’s quite dumbfounding.
“None of this is controversial – we’re not talking big numbers of vaccines, it’s only a small amount of the population that are going to get a booster or travel vaccination.
“But as it stands we just seem to have an apathetic, do-nothing approach in NSW.”