Sticking to the script


The Pharmacy Board has revealed its position on pharmacist prescribing, and the responses to it have been wildly divergent 

The release of the Pharmacy Board of Australia’s position statement on pharmacist prescribing has led to decidedly divergent responses from different groups within the health care sector.

The Board concluded earlier this week that under Health Practitioner Regulation National Law, there were “no regulatory barriers in place for pharmacists to be able to prescribe… within a collaborative healthcare environment, via a structured prescribing arrangement or under supervision”.

The statement also outlined that autonomous prescribing by pharmacists would require additional regulation via an endorsement for scheduled medicines.

The statement has been welcomed by both the Pharmacy Guild of Australia and the Pharmaceutical Society of Australia as outlining a way forward for collaborative prescribing, with the Guild adding that it “outlines a clear pathway and process to achieve autonomous pharmacist prescribing and the Pharmacy Guild urges the Board to proceed towards this objective in the interests of Australian healthcare consumers”.

However, the Board statement was also welcomed by the Australian Medical Association for not backing autonomous prescribing by pharmacists.

PSA national president, Dr Chris Freeman, said, “PSA is pleased that the Pharmacy Board has concluded that under the National Law there are no regulatory barriers in place for pharmacists to be able to prescribe collaboratively under two of the three models outlined in the Health Professionals Prescribing Pathway (HPPP).

“Prescribing via a ‘structured prescribing arrangement’ and ‘prescribing under supervision’ can be progressed immediately, and implementation of these models through for example, expansion of continued dispensing for chronic disease medicines can address a significant proportion of the administrative burden that community pharmacists see day to day with patients running out of their medicines.” 

Meanwhile, Pharmacy Guild of Australia national president, George Tambassis, had a somewhat different slant on the statement, emphasising that it had not ruled out autonomous prescribing.  

The Guild said the statement “outlined a clear pathway and process to achieve autonomous pharmacist prescribing and the Pharmacy Guild urges the Board to proceed towards this objective in the interests of Australian healthcare consumers”.

“Quite clearly, autonomous pharmacist prescribing would improve access to treatment options for conditions that can be managed by a pharmacist – including after hours and on weekends when access to other health care professionals is limited or non-existent,” Mr Tambassis said.  

“If pharmacist prescribing is to contribute to the delivery of sustainable, responsive and affordable access to medicines then it has to be autonomous, and we should proceed with the work required to achieve this.”

Unsurprisingly the AMA had a different view, congratulating the Pharmacy Board for not recommending autonomous prescribing.

The Board said autonomous prescribing by pharmacists would require additional regulation, changes to State and Territory legislation, and an application to the Ministerial Council, which the Board was not making, the AMA said.

It’s President, Dr Tony Bartone said the Board position was a “strong endorsement of the appropriate scope of practice of health professionals and in the best interests of patients and the community.

“Pharmacists are not doctors, and they should not be allowed to undertake autonomous prescribing,” he said.

Brett Simmonds, chair of the Pharmacy Board, said “developments leading to changes to how pharmacists further contribute to the delivery of health services requires input from a broad range of stakeholders and government and importantly, the public receiving such services.”

“The Board hopes the work it has carried out to date will facilitate stakeholders to further explore the potential role of pharmacists in prescribing that may contribute to the healthcare needs of the public”.

The Board’s position statement also includes several important considerations that would inform any development of pharmacist prescribing models in the future.

“I urge stakeholders to consider these issues, to reach a common understanding of the ways in which pharmacists can further contribute to public healthcare and to collaborate on any future proposals,” Mr Simmonds said.

 

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10 Comments

  1. Ron Batagol
    17/10/2019

    I think they’ve got the balance right. As always, collaboration is the key. Also, pharmacists are not differential diagnosticians, but with appropriate training and clearly defined & delineated clinical and legal parameters, I’ve no doubt that independent pharmacist prescribing will occur in the future

    • Philip Smith
      17/10/2019

      By prescribing do we mean we get paid for the service?
      An example I had this morning, child presents with white tongue, mother believes thrush, on inspection and asking a few question it not was not thrush.
      So the pharmacy made no money for my time with that patient. Did I just diagnose?
      Would pharmacist under financial pressure just sell it anyway?

      • Dr Phil 42
        18/10/2019

        Yes they would. It happens.
        If it is so important to pharmacists to prescribe – why not insist the script if written by one pharmacist must be dispensed by a second pharmacist.

        If pharmacists are going to take on the responsibility of doctors and the checking by a pharmacist then surely the pharmacist should similarly have a second pharmacist review the suitability of scripts.

        I have made mistakes (prescribing ear instead of eye drops) and the pharmacist picked it up. Surely this is an important safety mechanism and shouldn’t be thrown out for convenience.

        • Jarrod McMaugh
          18/10/2019

          So Dr Phil, his is the paradigm that will be implemented.

          What has me wondering is – where did everyone get the idea that there wouldn’t still be separation of dispensing and prescribing?

          It is included in every single discussion paper on the matter; something that I personally put a lot of work in to getting clarified….

  2. Good to see that the Board has some sense

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