RACGP backs NACCHO’s pharmacy concerns

Morgan Liotta

16/02/2023 6:23:18 PM

Both organisations warn that Aboriginal and Torres Strait Islander people’s care will be compromised by pharmacist prescribers.

Aboriginal person receiving medication
The college has pledged full support of NACCHO’s concerns of the proposed expansion of pharmacy scope of practice in Aboriginal and Torres Strait Islander communities.

The National Aboriginal Community Controlled Health Organisation (NACCHO) has called for a comprehensive and transparent evaluation of expanding scope of practice for private sector pharmacists, in the wake of ongoing Pharmacy Guild efforts for autonomous prescribing rights.
Several state and territory governments have already committed to pilot programs of independent pharmacy prescribing in various guises, but NACCHO CEO Pat Turner believes the push threatens to erode the quality of primary healthcare provided to Aboriginal and Torres Strait Islander people.
‘These trials threaten to further fragment care for priority conditions such as otitis media and hearing loss, hepatitis management, and further exacerbate the crisis in antimicrobial resistance seen in many Aboriginal and Torres Strait Islander patients,’ she said.
‘Whilst there has been years of consultations and various taskforces and committees reviewing scope of practices and access to care for patients, including the recent Medicare Strengthening Taskforce, which had representation of a range of clinicians involved in delivering primary healthcare, the same cannot be said of this pursuit by private pharmacy.’
RACGP President Dr Nicole Higgins told newsGP the college echoes NACCHO’s concerns about pharmacy overreach.
‘Allowing expanded scope of pharmacy practice will unequivocally compromise quality care that GPs and Aboriginal Health Workers provide, because patient care is more effectively and safely delivered within general practice and ACCHOs,’ she said.
The North Queensland Pharmacy Scope of Practice Pilot has been strongly opposed by the RACGP and NACCHO, as well as other medical organisations, since it was first floated in early 2022. Despite these reservations, Queensland Health Minister Yvette D’arth confirmed that the pilot would proceed at a Pharmacy Guild event later that year.
Part of the concern lies in the fact that North Queensland has a high population of Aboriginal and Torres Strait Islander people, with many having complex healthcare needs for comorbidities, requiring holistic and coordinated care – a point raised by Ms Turner.
‘Expanded scope trials are being conducted in areas with large numbers of Aboriginal and Torres Strait Islander patients,’ she said.
‘[But] the expanded scope proposed for pharmacists is clearly “out of scope” with current practice, as it requires changes to legislation, and a minimum of an additional year of education for pharmacists to perform activities such as prescribing.’
Antimicrobial resistance – a phenomenon doctors have said will likely get worse with pharmacy prescribing – is also recognised as a growing concern among Aboriginal and Torres Strait Islander communities, to the point where NACCHO has launched a program aimed at improving antimicrobial stewardship to help tackle the issue in the tropical north of Australia.
It is another reason why Dr Higgins, who lives and practises in Mackay, is opposed to the pilot.
‘NACCHO has warned that the Queensland expanded scope of practice pilot threatens to further exacerbate issues with antimicrobial resistance seen in many Aboriginal and Torres Strait Islander patients, and fragment care for patients with serious conditions, including hearing loss,’ she said.
‘The RACGP backs these calls.’
Rather than expanding pharmacists’ scope of practice to prescribe independently, both the RACGP and NACCHO have promoted integrated care teams of GPs, nurses and pharmacists all working under the one roof.
‘Our community controlled health services [ACCHOs] are the Australian leaders in coordinated, multidisciplinary primary healthcare,’ NACCHO Chair Donnella Mills said.
‘ACCHOs currently employ three nurses or Aboriginal and Torres Strait Islander health workers for every one GP and have developed effective models for integrating pharmacists within primary healthcare teams.
‘This coordinated multidisciplinary primary healthcare is improving access and quality of care.’
Dr Higgins said the college will continue to stand by ACCHOs and support community needs for priority patient groups such as Aboriginal and Torres Strait Islander people and those living in rural and remote areas.
‘We want to work together with community pharmacists as a team for our patients, but the Pharmacy Guild’s push for retail pharmacy prescribing is not supported by the medical community,’ she said.
‘While pharmacists dispense medicines, they don’t have the training required to diagnose patients or fulfil ongoing therapeutic relationships – which is particularly valuable in rural and remote communities.’
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