Pharmacists had to circumvent law to provide care

Pharmacists were “neglected” by legislators in the response to the COVID-19 pandemic, says one stakeholder

The Pharmaceutical Society of Australia’s submission to the Senate Select Committee on the Governments response to COVID-19 highlights problems faced by pharmacists during the pandemic, the organisation says.

PSA says that pharmacy was neglected by legislators and left out of key policy responses during the pandemic.

The key issues highlighted in the submission centre around medicines shortages, digital image prescribing, regulatory confusion between the Commonwealth and State jurisdictions and the challenges with medicine shortages.

PSA National President Associate Professor Chris Freeman said the findings in the submission also examined the “extraordinary strength and purpose” pharmacists demonstrated in supporting Australians under unparalleled pressure and community panic.

“Community pharmacists remained open throughout the entire pandemic to deliver health care and meet the needs of patients, carers and the public,” Dr Freeman says.

“It is disappointing that pharmacists were not always fully consulted when policy and implementation decisions were being made, including those affecting the pharmacy profession.

“There were even cases when the law had to be circumvented in order to provide the care expected by patients due to disparities between State and Federal legislation.

“It is necessary to raise concerns and provide recommendations to ensure the Government is prepared for a potential second wave of COVID-19 as well as future public health emergencies.”

In the submission, PSA provided 15 recommendations including ensuring adequate supply of personal protection, invoking systematic medicine supply restrictions in a timely manner and providing clear public heath messaging.

Dr Freeman said that while PSA acknowledges the Australian Government’s rapid and decisive response that helped Australia contain the pandemic, this does not mean that there were not lessons to be learnt for the future.

“I have no doubt that legislative changes and decisions made by the Government contributed to lower infection rates in the global context however there were challenges in some policies and decisions made that had a negative impact on pharmacists.

“In putting forward this submission I hope the good work of pharmacists under extreme pressure during the COVID-19 pandemic is recognised and our recommendations lead to positive change going forward that will help pharmacists support patients and all Australians.”

Dr Freeman’s words echo recent comments from PSA Queensland Branch President, Shane MacDonald, about similar concerns highlighted in another submission, to the Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee inquiry into the Queensland Government’s health response to COVID-19.

The PSA’s full submission can be accessed here.

The recommendations are:

Recommendation 1: National and local pandemic planning must incorporate the ability to invoke systematic medicine supply restrictions in a timely manner to support equity of access to all Australians.

Recommendation 2: Limitations on supply of medicines implemented during a public health emergency must be supported by legislation to enable pharmacists to enforce those restrictions and help ensure continuation of equitable supply for all Australians.

Recommendation 3: The Pharmaceutical Benefits Scheme Continued Dispensing initiative which was expanded during recent public health emergencies, including the COVID-19 pandemic, should be enabled on a permanent basis to support continuity of patient care.

Recommendation 4: The current therapeutic substitution arrangements implemented through the Serious Shortage Medicine Substitution Notice should be reviewed with a view to allowing pharmacists to supply an alternative medicine, in place of a medicine in shortage, in accordance with professional judgement and contemporary therapeutic guidelines.

Recommendation 5: Provisions should be in place to cease the issuing of prescriptions for medicines with directions to dispense multiple repeats at one time during a public health emergency, particularly when restrictions have been enforced for international and/or local travel.

Recommendation 6: The Australian Government must provide adequate and ongoing quantities of personal protective equipment stock for use by pharmacists and pharmacy staff recognising their critical public health role.

Recommendation 7: Supplies of personal protective equipment for community pharmacies should be distributed through pharmaceutical wholesalers known as the Community Service Obligation Distributors.

Recommendation 8: As essential health workers during a pandemic or other public health emergency, support for pharmacists must be prioritised to ensure pharmacist delivered services continue through that declared period.

Recommendation 9: The Australian Government must provide clearer public health messaging that people known or suspected of being infected with a communicable disease must not enter community pharmacy premises. Such patients should be supported by providing immediate access to telehealth pharmacist consultations and acknowledgement that any medicines or advice that they need to obtain from their local pharmacy can be done without leaving their home.

Recommendation 10: The Australian Government should allocate funding for patient consultation services delivered by pharmacists.

Recommendation 11: The arrangement that allows pharmacists to deliver medication management review services via telehealth should continue beyond the pandemic with appropriate quality controls.

Recommendation 12: The Australian Government should provide leadership and support through the Council of Australian Governments and Health Ministers to ensure national uniformity and harmonisation in therapeutic goods legislation across all jurisdictions.

Recommendation 13: A Commonwealth Chief Pharmacist must be appointed urgently to enable the design and coordination of consistent and rapid implementation of relevant measures during public health emergencies and to provide strategic national leadership in improving an overall medicine safety and quality use of medicines agenda for Australia.

Recommendation 14: The role of the pharmacist in regularly distributing public health messages and implementing measures to enable equitable availability of medicines and other healthcare resources must be appropriately recognised and remunerated by the Australian Government.

Recommendation 15: Pharmacists as essential frontline healthcare service providers must be equipped with information on public health messages and changes to legislation as early as possible prior to implementation in order to maximise their ability to deliver on the Australian Government’s objectives.

Recommendation 16: Contemporary and permanent legislation must be enacted in all jurisdictions to protect pharmacists and other healthcare workers from physical violence and verbal abuse.

Recommendation 17: Businesses providing essential services during a pandemic must be adequately supported and, in particular, the unique circumstances of and impact on community pharmacy operations must be accommodated.

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