‘This is purely about money making from a pharmacist perspective’

The new RACGP Chair has criticised expanded pharmacy vaccinations in NSW, but the Guild NSW president says pulling the ‘money making’ card is hypocrisy

New Chair of the Royal Australian College of General Practitioners (RACGP), Associate Professor Charlotte Hespe, has criticised the NSW Government’s decision to let pharmacists provide more vaccines over fears it will fragment primary care.

The NSW Government announced last week that pharmacists in the state will be able to provide vaccines to people aged 16 years and older for a wider range of infectious diseases, including rubella, diphtheria and measles from January 2019.

A/Prof Hespe said she is concerned this decision will undermine continuity and quality of patient care.

“In and of itself, I don’t have a problem [with pharmacist-conducted vaccinations] with the proper guidelines and the proper training that they might be able to deliver a vaccine,” she told newsGP.

“But I have a real problem in that it is being delivered outside the systems that we’re trying to set up for people to improve long-term safety and quality of care.

“We need to have an integrated care system with everybody communicating and ensuring that what is being done is in the best interest of that patient, at that time. It’s not just about, ‘Oh you’re here, let’s give you a vaccine’, because perhaps the patient has had it done already, or they may actually require a different one, there’s all sorts of issues.”

A/Prof Hespe also shared concerns that pharmacist-administered vaccines may prevent patients from having regular contact with their GPs that can also help in terms of treating other ongoing health issues.

“We need to ask, what are we wanting to achieve by putting services into pharmacy?” she said.

“This is purely about money making from a pharmacist perspective, and not about improving the patient care we’re providing. From my perspective it’s actually undermining a whole lot of the good work that we’ve been trying to do in terms of providing a better integrated care experience within that framework of quality and safety.”

NSW Guild president David Heffernan congratulated A/Prof Hespe on her new position and invited her to visit a pharmacy with him so he could “address her concerns”.

“Because in the real world, pharmacists and GPs and have a good relationship, but in the media sphere it just seems to be something that isn’t representative of the real world,” said Mr Heffernan.

“This isn’t about the RACGP or the Guild. This is about patients. Let’s work together.”

In regards to her comments that pharmacist vaccination is purely about money making, Mr Heffernan responded: “Absolutely not. This is about removing some regulation that stops pharmacists from practising to their full scope of practice.

“Perhaps she should advocate for GPs to take eftpos machines out of practices before she makes jabs at pharmacy doing it for money.”

PSA NSW president Professor Peter Carroll said it is “disappointing” to see the RACGP make comments around “fragmented care” and assumptions about the expansion of immunisation by pharmacists in NSW.

“Immunisation by accredited pharmacists complements the excellent work done by GPs,” said Professor Carroll.

“However, there are many patients who do not visit a GP regularly, or simply do not have a GP.

A study of NSW pharmacists administering influenza vaccines from April to May 2016 showed that 15% of those people vaccinated had never received a flu vaccine before. In addition, 43% of people vaccinated were in the 18 to 49-year-old age group, a group with traditionally low overall influenza vaccination rates.

“Expanding pharmacist-administered vaccination to include dTpa and MMR complements vaccination currently provided through general practice by providing the opportunity for eligible patients who do not have a GP, or do not see their GP regularly, to be vaccinated.

“This change is important as it will facilitate greater access to vaccination for patients and improve immunisation rates and herd immunity within the community, for example:

  • family members and carers who will have close contact with babies in their first weeks of life will be able to access dTpa vaccinations from the pharmacist and be vaccinated against whooping cough.
  • measles outbreaks occur in some communities from time to time as a result of unvaccinated travellers or visitors importing the disease from overseas. Allowing pharmacists to vaccinate people against measles will increase herd immunity and reduce the incidence of these outbreaks.

“International and national research has shown that accredited pharmacists can provide safe immunisations with positive health outcomes, and there are rigorous processes in place to ensure that patients receive the highest quality care of care.

“Pharmacists administering approved vaccinations will also be required to use the Australian Immunisation Register to assess patient eligibility as well as report details of patient immunisation – the same system used by other health care professionals.

“Pharmacists are front line health care professionals and are often the first point of call for patients. Any integrated care model must include pharmacists.”

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1 Comment

  1. B Lee

    Just sharing one of my experience with GPs: I had very mild-to-none itchy(only sometimes) rash for around 2 weeks and at that time I had absolutely no idea.
    Went to three different GPs at different suburbs.

    All three of them had the same reaction: saw my rash, “hmm I am not sure. Here is your prescription( 3 different doctors gave me 3 different prescriptions: corticosteroid cream, lyclear and keflex). See how you go and come back if it does not work”.
    I asked “What do you think it is? It is itchy but not severely, but it is not painful”
    GPs: No idea. Just see how you go and come back if it does not work
    Me: So you don’t know?
    GPs: Well I think it is (3 different doctors had 3 different diagnosis: eczema, scabies and cellulities).
    Me: Can I have swab or something to make sure it is what you think it is?
    GPs: No, this is clinical diagnosis so it won’t be necessary.

    I used all of them but none of them gave me a relief. Asked my last GP and insisted to get a referral to a skin specialist.

    Booked for a skin specialist. He saw my rash, explained all symptoms, and he goes, “Yep, that is acne”
    Gave me minocycline 50mg 1 tablet daily – Rash went away after.

    If this is what RACGPs “define” patient care, I will strongly discourage all my patient from now on, to get close relationship with GPs. As a health care professional, I would be extremely concerned with patient health.

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