New RACGP Chair speaks out against expansion of pharmacy vaccinations in NSW

Amanda Lyons

29/10/2018 12:35:33 PM

The RACGP’s new Chair, Associate Professor Charlotte Hespe, has criticised the NSW Government’s decision to let pharmacists provide more vaccines over fears it will fragment primary care.

NSW has decided to expand pharmacists’ ability to administer vaccines in the state, but GPs are concerned this will result in fragmentation of patient care.
NSW has decided to expand pharmacists’ ability to administer vaccines in the state, but GPs are concerned this will result in fragmentation of patient 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.
NSW Deputy Premier John Barilaro said the move, which brings NSW into line with the Northern Territory, Queensland and South Australia, will help to improve access for people seeking vaccinations.
‘People tell us access to a GP can be difficult at times, whether you live in the city, country or on the coast, so expanding pharmacy vaccinations gives people more choice,’ Minister Barilaro said.
But new Chair of the RACGP Board Associate Professor Charlotte Hespe is concerned this decision will undermine continuity and quality of patient care, especially if it is implemented without rigorous processes in place.

Associate Professor Charlotte Hespe believes that vaccines are best delivered by GPs.

‘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.’
Associate Professor Hespe has found there are already communication issues between pharmacists who administer vaccines and a patient’s regular GP.
‘Our experience of the pharmacists doing [vaccinations] so far is that from their perspective, they see a need, they do it, but they’re not understanding that they’re part of a bigger team,’ she said.
She is also concerned 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.
‘It means the opportunity for extending care to the other things that we do – we always try to add value as we’re doing it – so those opportunities won’t be there,’ Associate Professor Hespe said.
‘This is easy work for GPs. This is not complex multi-morbid care, but it fits into making sure that people have one health record with all of the things that are important, communicated around the framework of safety and quality.’
In the end, Associate Professor Hespe wants to ensure that NSW is not simply following the example of other states and territories, but making the best decisions in terms of patient care.
‘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 Pharmacy Vaccinations

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ST   30/10/2018 9:21:57 PM

If pharmacists want to administer vaccines and do so safely and if nurses want to prescribe medications safely- they should apply to do a degree in medicine and fulfil all its necessary requirements.

Sue McDonald   30/10/2018 10:59:42 PM

I find it is already fragmenting care as patients can't remember what they had and when.This then necessitates a visit to the Immunisation Register adding another layer of time wasting bureaucracy. How can you be an all encompassing GP when so much time is spent chasing for data because basic information is no longer in your own records.

Soma   4/11/2018 11:59:59 AM

Maybe gp’s should join the pharmacy guild to get things done!