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Concern over use of interns in North Queensland pharmacy pilot


Jolyon Attwooll


29/03/2023 4:45:39 PM

Pharmacy interns could be diagnosing and prescribing as soon as March 2024 – a move that will pose ‘further dangers,’ a local GP has warned.

Pharmacist
Pharmacy interns will be able to study in a second wave of training for the pilot due to begin later this year.

A move to include interns in the North Queensland pharmacy prescribing pilot has the potential to further increase the risk patients face when utilising the service, GPs have warned.
 
The likely use of pharmacy interns in the North Queensland Community Pharmacy Scope of Practice Pilot was flagged last week in a speech made by Pharmacy Guild President Professor Trent Twomey at the Australian Pharmacy Professional Conference.

According to the Guild President, pharmacy interns will be able to study in a second wave of training for the pilot due to begin later this year.

Internships normally take place after graduation as part of a process towards general registration, which allows pharmacists to practice unsupervised. 
 
‘This means by March 2024, interns working in the pilot area will be able to assist patients with prescribing for everyday health conditions and chronic disease management,’ Professor Twomey said in a speech that has also been published on the Pharmacy Guild website.
 
The Guild this week also stated that 175 community pharmacists have signed up to train for the pilot through the Queensland University of Technology, with a second cohort ‘close to reaching capacity’.
 
Dr Aileen Traves, a Cairns-based GP who has long advocated against the pilot, warned that including interns is likely to exacerbate patient risks – an issue the college has raised frequently.
  
‘Proposing to use the least experienced community pharmacy interns in this prescribing trial poses further dangers to the public, as these pharmacists will lack clinical experience and be expected to work well outside their safe scope of practice,’ Dr Traves told newsGP.
 
Another Queensland-based GP, Dr Liesel Whyte, described the move as ‘seriously concerning’ and said the ‘trial’ is actually trialling ‘how close one can get to the sun without getting burnt’. 

Dr Traves also says she is concerned about the capacity of pharmacists to cope with the extra workload.
 
‘There are already workforce shortages in the pharmacy sector, and employee pharmacists are also expressing their concerns and starting to leave the profession as a result of the increased expectations without additional support,’ she said.
 
‘The pharmacy prescribing trial will mean patients paying an out-of-pocket cost of $25–55 to access healthcare and advice they currently receive for free.
 
‘These costs to patients will be equivalent to what many people are paying out of pocket to see a qualified GP.
 
‘Specialist GPs have at least 12–13 years training to be able to diagnose. Pharmacists are experts in medications but are not trained in diagnosis, and doctors have repeatedly raised concerns that our pharmacist colleagues are not adequately trained in diagnosis to take on this workload.’
 
In further comments to delegates, Professor Twomey said GPs are ‘refusing to bulk bull’, as well as ‘deserting regional, rural and remote areas in droves’.
 
Dr Traves strongly contested the remarks.
 
‘Firstly, GPs are not “refusing” to bulk bill,’ she said. ‘They are absolutely no longer able to cover the costs to keep the practice doors open due to the lack of investment of successive governments in general practice.
 
‘The fact that funding for general practice has effectively been frozen for a decade while the costs of paying staff, rent, electricity and all the consumables have risen along with everything else means GPs are increasingly unable to cover the costs relying on bulk billing alone.’
 
She warned patients to be wary of involvement in the pilot.
 
‘We implore patients to think carefully about where they seek healthcare, and to still see their GP if they have ongoing concerns that are not addressed after paying to participate in this experiment,’ Dr Traves said.
 
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Dr James Scandrett Brown   30/03/2023 6:14:24 AM

Commence a campaign for universal general practice dispensing. From overseas experience it is valued by patients and rewarding.


Dr Greg Saville   30/03/2023 9:35:25 AM

This is a drug trial. I assume it has ethics approval. If so, I haven’t heard anything about this.

Another thing, reading the comments in the AJP (the pharmacy trade rag) shows the rank and file pharmacists seriously unhappy about this scope overreach and the additional stress, work and potential negligence claims this will entail. All the while the Guild is complaining about pharmacist burnout.