Further expansion of pharmacists’ reach a ‘recipe for disaster’: RACGP

As the number of confirmed coronavirus cases in Victoria eclipses 1000, concerns over the potential strain on the state’s healthcare system as flu season inches closer have intensified.
 
In an attempt to reduce the burden on the healthcare system, the State Government has announced that Victorian pharmacists will be able to administer approved vaccinations outside of their normal location.
 
This means pharmacists can now leave the pharmacy and carry out vaccinations in aged care facilities and workplaces. They will also be able to administer the measles-mumps-rubella (MMR), meningococcal ACWY and whooping cough-containing vaccines to people aged 15 and older.
 
A Victorian Government spokesperson confirmed to newsGP that the changes will be permanent beyond the response phase of the pandemic.
 
But RACGP President Dr Harry Nespolon says expanding the reach of pharmacists is a ‘recipe for disaster’.
 
‘This year in particular, with the risk of COVID-19, having your immunisation done in a crowded pharmacy is not the safest place to be immunised,’ he told newsGP. ‘This is especially so if the pharmacy does not have a consulting room.
 
‘The usual requirements are the patient waits for 20 minutes after being immunised, and for most pharmacies that means waiting in a crowded dispensing area.’
 
Dr Nespolon said pharmacists do not have the medical training required to safely deliver vaccinations and respond to associated risks, such as anaphylaxis, that can very occasionally occur.
 
This could be particularly concerning since the minimum age for influenza vaccinations has been lowered from 16 to 10, with higher clinical and operational risks associated with vaccinating children and adolescents.
 
Meanwhile, pharmacies are not accredited according to the RACGP Standards to provide safe and high-quality medical care. The potentially less stringent cold-chain management outside of general practices may compromise vaccine efficacy.
 
GPs argue that investment would be better directed into general practice to ensure all Australians have access to holistic, patient-centred care provided by a GP.
 
‘GPs draw on a comprehensive patient history and are well-equipped with the training and facilities to respond promptly in the rare case that a patient responds adversely to a vaccination,’ Dr Nespolon said.
 
‘Vaccinations administered in a general practice have the additional benefit of reducing fragmentation of care, avoiding duplication of services and the potential of jeopardising a patient’s medical records.’
 
The announcement follows continued advocacy by the Pharmacy Guild of Australia to expand the powers of pharmacists, which has intensified and been leveraged since the coronavirus outbreak.
 
The Guild has also been calling for pharmacists to be able to dispense common medication without a prescription, which has since been permitted in NSW as of Tuesday 31 March. NSW pharmacies can also operate 24 hours a day.
 
Dr Nespolon previously told newsGP that it is ‘yet another example of the pharmacy sector trying to place financial gains ahead of patient care and safety’.
 
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