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Health practitioners are traditionally reluctant to make mandatory notifications for various reasons, says the Pharmacy Council of NSW

Reasons pharmacists may be reluctant to make a notification include fear of becoming part of a drawn out legal process, a perception that they are “dobbing in their peers”, or breaking the trust of their patient.

“It can be a challenging dilemma,” says the Pharmacy Council of NSW.

However the council reminds pharmacists that under the Health Practitioner Regulation National Law (NSW), health practitioners (including pharmacists), their employers as well as education providers must tell AHPRA if they have formed a belief that a practitioner has behaved in a way that constitutes notifiable conduct.

Currently, notifiable conduct by a registered health practitioner includes:

  • practising while intoxicated by alcohol or drugs
  • sexual misconduct in the practice of the profession
  • placing the public at risk of substantial harm because of an impairment (health issue), or
  • placing the public at risk because of a significant departure from accepted professional standards.

The council refers to a recent case involving a pharmacist in a difficult situation, with a medical practitioner attempting to self-prescribe diazepam.

The medical practitioner had reportedly used a family member’s name on the prescription, and as the pharmacist asked questions about the prescription and the patient’s history, the medical practitioner’s behaviour alerted suspicion, prompting the pharmacist to check the AHPRA register.

The pharmacist subsequently discovered there were conditions on this medical practitioner’s registration which did not allow them to prescribe this medication. Following this, a mandatory notification was made.

The pharmacist was initially reluctant to make the notification due to a perception that they would become further involved in the matter. However, discussion with another colleague helped to dispel that concern.

“Most of the time a mandatory notification does not require the practitioner making the notification to provide any further correspondence to the regulatory authority, but for more serious matters, further information may be sought,” says the council.

“By making the notification, the medical practitioner was able to be directed to an appropriate pathway to resolve their issues. Remediation is the more common outcome for these matters, as the aim is to bring the medical practitioner back up to a level where they can practise again.”

However pharmacy and medical groups have criticised the inclusion of the clause “placing the public at risk of substantial harm because of an impairment (health issue)” as notifiable conduct.

“Mandatory reporting undermines the health and wellbeing of doctors,” said former AMA president Dr Gannon.

“It is a tragic reality that doctors are at greater risk of suicidal ideation and death by suicide. This year we have lost several colleagues to suicide. The AMA has identified that mandatory reporting is a major barrier to doctors accessing the care they need.”

“Mandatory reporting does potentially create a barrier to pharmacists seeking medical treatment and the existence of mandatory reporting can create a lack of trust between a pharmacist and their treating clinician,” Kay Dunkley, Executive Officer of the Pharmacists’ Support Service, told AJP last year.

“Mandatory reporting is important to protect the public from impaired practitioners but at the same time it should not be a deterrent to health professionals seeking treatment for their own medical conditions.”

At the April COAG Health Council meeting this year, health ministers unanimously agreed to change mandatory reporting requirements so registered health professionals can seek appropriate treatment for impairments, including mental health.

“Ministers agreed to a nationally consistent approach to mandatory reporting which will be drafted and proposes exemptions from the reporting of notifiable conduct by treating practitioners (noting Western Australia’s current arrangements are retained) and subject to other jurisdictional formal approval in certain circumstances,” the COAG Health Council’s communique stated.

“The legislation will include strong protection for patients and will remove barriers for registered health professionals to seek appropriate treatment.

“The legislation will specifically include a requirement to report past, present and the risk of future sexual misconduct and a requirement to report current and the risk of future instances of intoxication at work and practice outside of accepted standards.”

There were 373 notifications lodged with AHPRA about pharmacists in 2016/17, according to AHPRA’s annual report for the year to 30 June 2017.

The report revealed 1.8% of pharmacists had notifications made about them during the year.

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