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Pharmacists call for ‘self-determined’ scope
Pharmacists would be allowed to autonomously prescribe all Schedule 4 and 8 medicines if a new plan from the nation’s leading pharmacy bodies is adopted.
‘We need to be putting patient safety first – not profits over patients,’ says the RACGP President.
Peak pharmacy groups have joined forces to step up their push for prescribing rights, issuing a joint plan to empower pharmacists to prescribe medicines autonomously.
The proposal put forward includes an enhanced role for ‘endorsed pharmacist prescribers’, along with patient access to Pharmaceutical Benefits Scheme (PBS) subsidies for medicines prescribed by pharmacists.
However, the RACGP warns of the dangers that come with the proposal, including the risk to patients as well as a potential for conflicts of interest.
The model was detailed in an open submission to the Pharmacy Board of Australia by the Joint Pharmacy Organisations (JPO), which comprises Advanced Pharmacy Australia, the Pharmacy Guild of Australia, and the Pharmaceutical Society of Australia.
It comes just weeks after the Pharmacy Board announced it had begun work to establish an endorsement for scheduled medicines for pharmacists, ‘supporting a consistent, safe, and nationally coordinated approach to pharmacist prescribing’.
The JPO proposal centres on autonomous prescribing: ‘where a health professional undertakes prescribing of any scheduled medicine within their individual, self-determined, documented and authorised scope of practice, based on completion of an accredited training course’.
This, it states, will be delivered in appropriate collaborative relationships with the patient and all other members of the healthcare team.
‘The Joint Pharmacy Organisations’ submission, which should be adopted by the Pharmacy Board in full, would enable qualified pharmacists to administer, obtain, possess, prescribe, sell, supply or use Schedule 2, 3, 4, and 8 medicines after completing an approved course,’ it stated.
The pharmacy organisations also called for collaboration with governments to ensure patients can access their PBS subsidies for medicines prescribed by endorsed pharmacists – ‘removing financial barriers and improving equity in healthcare’.
But RACGP President Dr Michael Wright, who last week met with the Pharmacy Board where the topic was raised, expressed concerns about the proposal.
‘There was lots of conversation, as well as at a roundtable discussion with the Pharmacy Board, around possible education planning, but I do have some real concerns here,’ he told newsGP.
‘There seemed to be a lack of understanding about the potential risks associated to expanding prescribing to all medications.
‘I was particularly concerned about the lack of regard for the dangers of S8 medications; also, for the dangers of fragmentation and the confusion caused by multiple people potentially providing similar types of care.
‘Also, there was acknowledgement, but little discussion about how to deal with the thorny issue of conflict of interest that pharmacists face in profiting from the sale of medications they would prescribe.’
Dr Wright said ‘we need to be putting patient safety first – not profits over patients’.
‘We’ve seen the dangers of putting profits over patients in the telehealth space, and we have to make sure that this doesn’t happen through this pharmacy prescribing process,’ he said.
Behind the pharmacist push is the view that enabling pharmacists to prescribe autonomously will improve access to timely care, reduce pressure on general practice and emergency departments, and ‘enhance continuity of care through integrated, patient-centred services’.
The submission also points to the role this could play in addressing the maldistribution of GPs across the country, particularly impacting rural, regional, and remote areas.
Pharmacy Guild of Australia National President Professor Trent Twomey said pharmacists are ready to do more.
‘Expanding the range of services provided in pharmacy, in line with pharmacists’ skills, training and experience will reduce GP wait times and non-urgent visits to the emergency room’, he said.
‘Nationally endorsed pharmacist prescribing will improve access to treatment, relieve pressure on doctors and hospitals, and deliver better value for taxpayers.’
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