To prescribe, or not to prescribe….

medicines meds shortages prescription rx

Questions are increasingly being asked about the likelihood of pharmacists having limited powers to prescribe, and Guild leaders endorse the possibility

The issue of pharmacist’s being able to prescribe medicines is back on the public agenda following the release of a recent AHPRA discussion paper, and comments from Pharmacy Guild leaders backing calls for regulatory changes. 

The Pharmacy Board of Australia released a discussion paper on pharmacist prescribing just before the APP2019 Conference early this month.

In it, the Board said: “A well-trained pharmacist workforce with expertise in medicines management with the ability to prescribe has the potential to facilitate safe and improved access to medicines for all Australians.”

“Non-medical prescribing may contribute to the delivery of sustainable, responsive and affordable access to medicines. It may reduce costs, increase access, and improve outcomes for patients without compromising safety and quality”.

George Tambassis, national president of the Pharmacy Guild of Australia told AJP that prescribing was the next crucial step for the profession to expand its scope of practice.

He advocated first gaining rights to prescribing for conditions such as urinary tract infections (UTIs), that can be handled via a Q&A protocol and don’t require pathology tests.

“We could easily follow the protocol just as well as a doctor, you could do the consultation in a pharmacy and the patient will get a proper therapeutic outcome straight away.” 

“That would be an easy area to start with, but our long-term strategy is to see people trained through the Universities as full-scope prescribers, autonomous prescribers that can cover areas such as UTIs and others – and then upskill the pharmacists already out in the workforce.”

The Board discussion paper prompted a predictable response from General Practice leaders, with RACGP president Dr Harry Nespolon telling GP newspaper Medical Republic that it had failed to make a case for why pharmacists should prescribe in the first place.

“It doesn’t answer that fundamental question,” he said. “The vast majority of Australians can access a GP within 24 hours. It’s a solution looking for a problem.”

Dr Nespolon said the Board’s comments indicated prescribing was not within pharmacy’s remit.

“It says pharmacists who want to prescribe will need a significant amount of upskilling, so the report admits that prescribing is way out of their scope of practice.”

“Then there’s this real issue about being both a prescriber and a supplier.”

The Board is seeking public and stakeholder feedback on the potential for pharmacist prescribing. The closing date for submissions is 15 April 2019. 

Click here to read the full Board discussion paper



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  1. John Wilks

    I agree with the Dr. The prescribing and supplying facilities must always be separate. An independent eye of surveillance is essential to the QUM.

    However prescribing (under direction) has a vital capacity to improve compliance, reduce surgery visits and unburden doctors both in the domestic setting when a HMR is conducted and in the hospital setting

    The latter wastes vast amounts of CMO time, slows discharges and adds to bed block.

    • Jarrod McMaugh

      It’s interesting that people see prescribing and dispensing as occurring at the same time if a pharmacist has accreditation to prescribe.

      In Victoria, the definition of prescribing is specifically to direct a person to receive a service from another professional….

      • Gavin Mingay

        In the case of a late-night or remote pharmacy, it would be ideal for the pharmacist to both prescribe and dispense. For example, a case of shingles or a skin infection, where immediate treatment is very important, what would be wrong with doing both?

        As the bloke on the fantastic Optus ad says – “both…”

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