‘Once again, the pharmacy sector is picking up the slack.’

Temporary arrangements now allow GPs to send digital copies of scripts directly to a patient’s pharmacy of choice, but does this impose an onerous workload and financial burden on community pharmacies?

The Federal Department of Health has recently announced new interim arrangements whereby patients can get a digital copy of a prescription from their GP directly sent to their pharmacy of choice via email, fax or text message and the medication delivered to their door.

S8 and S4D medicines are excluded from this arrangement.

Welcomed by the RACGP, the announcement followed closely after the government acted on calls to expand GP telehealth to all patients.

“This is a vital part of the puzzle to enable GPs to continue providing the same quality care to their patients via telehealth as they do face-to-face,” said RACGP president Dr Harry Nespolon.

“It means patients with a variety of health conditions can get a prescription from their GP sent to their pharmacy of choice and the medicine can be delivered.”

However while there is a legislative instrument at a Federal level that allows for e-prescribing – where the paper prescription is no longer required – this has not yet been rolled out at state and territory level.

Additionally the Department of Health is still working with software providers to upgrade clinical software so that it supports electronic prescribing, with the system anticipated to be up and running by May 2020.

Therefore paper scripts still need to be provided after the GP has sent in a digital copy, such as a photo or PDF of the prescription, by email, fax or text message.

This special arrangement has led to a dramatic increase in workload for pharmacies, highlights PSA national president, Associate Professor Chris Freeman.

“I’ve heard reports that anywhere between 60—80% of a pharmacy’s script load is coming by fax or email from the GP practice. That poses problems about securing the physical script at a later date,” he told AJP.

There are further issues with how the pharmacy is able to collect or have those scripts delivered.

While the Federal Government advises prescribers to send the pharmacy the paper script as soon as possible, where possible, “GPs are expecting the pharmacies to manage coming to pick up the scripts or supply funds themselves to have the scripts posted,” said A/Prof Freeman.

In some cases there has been a “complete lack of clarity” on where the script should be sent, with some patients being given the digital copy of the script.

Under the special arrangement, prescribers are only allowed to send the copy or digital image of the legal prescription to the pharmacist of the patient’s choice, a spokesperson for the Department of Health confirmed to AJP.

The interim changes are also having a trickle-down effect on the pharmacy’s cash flow, particularly if medications have to be dispensed as script owing.

“This is increasing the cost of doing business for pharmacies. There is a significantly larger amount of work for them to do in the process than before, with little financial support being given to pharmacies even with the recent announcements,” A/Prof Freeman said.

“Community pharmacies should be receiving additional remuneration to make sure they’re able to adapt to the changes in the sector.”

He called on the government to implement e-prescribing as soon as possible, and in the meantime encouraged pharmacies to communicate with local medical centres about how they want the prescription process managed.

In early meetings the PSA reportedly flagged that there would be a flow-down effect in initiating the telehealth model of care, and there would have to be real thought provided on how pharmacies would manage.

“Unfortunately this hasn’t been thought out. Even though this had to be implemented urgently, all intended and unintended consequences need to be seen through,” said A/Prof Freeman.

“Once again we see the pharmacy sector picking up the slack.”

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