WA expands scope of pharmacist-administered vaccinations

End the exclusion: Pharmacist access to the MBS one step closer

The Pharmaceutical Society of Australia (PSA) has called on the Medicare Benefits Schedule (MBS) Review Taskforce to increase the role of pharmacists to address the healthcare needs of all Australians.

 

In its submissions to the taskforce reference groups, PSA focused on inclusion of pharmacist services on the MBS to ensure pharmacists are no longer excluded from the rest of the allied healthcare workforce in the delivery of consultation based services upon referral from a general practitioner.

 

PSA’s recommendations stem from its two key reports Medicine Safety: Take Care and Pharmacists in 2023. Both reports advocate for empowering pharmacists to do more than the current healthcare system allows by harnessing their skills and expertise as medicine experts. It is PSA’s firm view that pharmacists must be involved in the care of patients whenever medicines are part of their health management plan, and particularly in the context of chronic disease management.

 

PSA National President Dr Chris Freeman said although the Allied Health Reference Group recommended this action in February following previous PSA submissions, there is still more work to be done. These recommendations out for consultation must make their way to the Minister for Health’s office and once and for all cease the exclusion of pharmacist access to the Medicare Benefits Schedule.

 

“PSA has advocated over many years to develop funding models to reflect pharmacists’ extensive expertise and contribution to Australia’s health. Pharmacists have been calling for access to the MBS to reflect their skills, training and experience for longer than many of us can remember.

 

“While this recommendation now exists, it is focused on long-term implementation. Given the rate of medicine-related harm being experienced by Australians and the potential for pharmacists to contribute to medicine safety and quality use of medicines, it is critical that the implementation of this recommendation is not delayed,” Dr Freeman said.

 

The inclusion of pharmacists in allied healthcare teams is particularly important for vulnerable population groups including Aboriginal and Torres Strait Islander people.

 

In writing to the Aboriginal and Torres Strait Islander Health Reference Group, PSA noted the current issues relating to medication adherence. Pharmacists can make a significant contribution to support adherence through the provision of medicine information, assessing each person’s needs and tailoring solutions accordingly.

 

Pharmacists also have a key role to play in mental health care teams. PSA supports recommendations from the Mental Health Reference Group to encourage coordinated support for patients with chronic and mental illnesses and access to mental health services in residential aged care.

 

PSA believes that pharmacists should have a role in delivering care as part of a mental health care plan, particularly where medication forms part of the patient’s treatment plan. This is particularly relevant for mental health care services in residential aged care.

 

“We look forward to continuing to work with the groups involved in the MBS Review as they undertake their consultation on these recommendations, and then working with the Minister for Health to make these recommendations a reality,” Dr Freeman said.

 

 

Media contact:   Carly Lusk, Public Affairs Officer – 0487 922 176

 

Friday 14 June 2019

New principles for pharmacists to deliver safer and high quality pharmacy services

Open Letter to Royal Australian College of General Practitioners

18 April 2019

 

I am writing to object to the egregious assertions made in the RACGP’s submission to the Pharmacy Board of Australia – ‘Pharmacist Prescribing’ and the public statements that your President, Dr Harry Nespolon, has made against pharmacists, our role in healthcare, and the future role of pharmacists with regard to Collaborative Prescribing.

 

The RACGP submission to the Pharmacy Board of Australia makes several unfounded and prejudiced statements in relation to pharmacists being able to prescribe.

 

Statements such as the “the provision of medical services by health professionals lacking the necessary medical training or registration is an inappropriate and unsustainable solution to address the health needs of Australians and that pharmacists simple do not have the healthcare training required to safely deliver healthcare services” are inflammatory, disrespectful and ignore the five years of university and clinical training undertaken by pharmacists, in addition to ongoing regulated continuing professional development similar to other health professionals.

 

Indeed, pharmacists have the greatest level of clinical training regarding medicines compared to any other health professional. Indisputably, pharmacists are the medicines experts.

 

The ageing population, increasing incidence of chronic disease, advances in medicines and health technologies, rising health care costs, evolving health service delivery models, and a need for a responsive health workforce are all factors which have contributed to health practitioners, other than medical practitioners, to be authorised to prescribe within their scope of practice. The RACGP should be well aware that Australia’s healthcare system rates poorly on access and equity, an issue Australian pharmacists are all too familiar with, given the rising out of pockets costs that are prevalent in accessing general practice and general practitioners.

 

These factors, in addition to the alarming incidence of medication-related harm, the availability and access to pharmacist care and our medicines’ expertise all add to the need for pharmacists to be able to do more in our health system, including prescribing, just as dentists, midwives, nurse practitioners, optometrists and podiatrists are able to in Australia.

 

We must recognise and acknowledge that pharmacists already prescribe medicines. As much as the RACGP might like to rewrite history, and to dismiss the vital role that pharmacists in the community play, consumers and pharmacists know that the care that they deliver benefits patients and our healthcare system. Pharmacists already make clinical assessment and diagnoses within their scope of practice and prescribe lower-risk medicines. The Pharmacist Only Medicines schedule, which allows a pharmacist to assess the clinical needs of the patient, make an assessment, communicate and discuss that assessment with the patient and allows them (based on the risk of the medicine) to supply that medicine as well. In this context based on the risk profile of the medicine, pharmacists do both – prescribe and dispense. This vital primary care function of triage and referral, may result in the pharmacist referring the patient to a General Practitioner for additional assessment, without the provision of a medication and with no out of pocket expense to the patient.

 

The PSA has been very clear about the separation of prescribing and dispensing functions according to the risk profile of the medicine. In addition, we believe that where the independent decision is made to initiate a schedule four or eight medicine, that this should be separated from the dispensing activity. Within a collaborative prescribing agreement between a pharmacist and a general practitioner that the pharmacist, pharmacists should be able to adjust the doses of prescribed medicines to reach treatment targets, to extend the life of a prescription and to order any necessary tests to monitor the safety of the medicine. This role should be able to be performed across sectors, within the hospital, within general practice and importantly because of the accessibility of community pharmacists, within community pharmacy – but again, within a collaborative care agreement.

 

The outrageous statement “that patients will be exposed to unnecessary risk, including increased incidences of medication misadventure” disregards the fact that there is already an enormous issue around medication-related harm in Australia, many of these medicines prescribed by general practitioners.

 

PSA’s report Medicine Safety: Take Care 2019 revealed the enormity of the issue of medication-related harm and its cost to our economy. The report found there were 250,000 hospital submissions annually as a result of medication-related problems with an additional 400,000 presentations to emergency departments due to medicine misuse costing $1.4 billion annually.

 

Three in five hospital discharge summaries, where pharmacists were not involved in their preparation, had at least one medication error and over 90 per cent of patients have at least one medication-related problem post-discharge from hospital.

 

The evidence is clear, pharmacists have significant potential to reduce the number of medication-related hospital admission and adverse medication events in Australia but are prevented from doing so due to barriers in fulfilling our scope of practice. As experts in medicines, pharmacists can identify medicines that are causing harm and reduce adverse events through monitoring, frequency of patient contact, and through our expertise and knowledge of how medicines interact.

 

RACGP’s statement that “the business needs of a pharmacy may be prioritised over the needs of patients” blatantly disregards the fact that GPs themselves work in a business that provides services that have their own potential conflicts of interests. All health professionals are subject to professional standards codes and guidelines which demand health professionals place the health and welfare of patients ahead of any other interest. In this context pharmacists are no different to general practitioners.

 

PSA has stated that clear risk frameworks would need to be put in place for any model for pharmacists’ prescribing to avoid business needs being prioritised over patients. Pharmacists should not be considered any different in the provision of health services to other health professionals.

 

PSA has argued that collaborative prescribing should be designed so that the pharmacist and the medical practitioner support each other. They are complementary roles that would be designed to actually address the safety concerns of patients in an already fragmented care system. PSA believes pharmacists, medical practitioners, other allied health professionals and consumers should all work together as part of a wider health care team for the benefit of patients.

 

Pharmacists have long identified and referred patients to doctors to help manage chronic disease and believe that any future collaborative prescribing model would strengthen and enhance these partnerships.

 

It is essential that all health professionals work together for the benefit of patients as part of health team and PSA is disappointed that RACGP has chosen to diminish the role of pharmacists and their role as a trusted, patient-focused health care professional rather than work together towards fostering relationships and models of care that will greater benefit all Australians.

 

Yours Sincerely,

Dr Chris Freeman

National President

Pharmacist-administered vaccination age lowered in the Australian Capital Territory

Pharmacists will be able to protect more Canberrans against vaccine-preventable diseases, ACT Health announced today in a move welcomed by the Pharmaceutical Society of Australia (PSA).

 

Pharmacists will be able to vaccinate more people following ACT Health’s announcement to lower the minimum age of pharmacist-administered vaccinations to 16 years.

 

ACT PSA Branch President, Renae Beardmore, congratulated ACT Health for allowing pharmacists to vaccinate more Canberrans.

 

“Allowing trained pharmacists to administer vaccines will significantly increase the immunisation rates within the community and reduce the incidence of vaccine-preventable diseases.

 

“The administration of vaccines by pharmacists complements the excellent work done by GPs, nurses, Indigenous Health Workers and other healthcare professionals. This change will increase immunisation and positively impact people’s health in the ACT.”

“As the peak body for pharmacists, PSA has advocated for many years to allow pharmacists to deliver more vaccinations to a wider range of patients and will continue to work closely with ACT Health to achieve this.”

 

Ms Beardmore commended Minister Fitzharris and ACT Health for making use of pharmacists’ expertise and training to better protect the community against vaccine-preventable diseases.

 

Media contact:   Michellé Mabille, Marketing and Communications Manager – 0487 922 176

Supporting collaborative prescribing to improve safe and effective use of medicines

The Pharmaceutical Society of Australia (PSA) supports collaborative prescribing of medicines by pharmacists to improve Australians’ access to safe and effective healthcare, in its response to the Pharmacy Board of Australia’s Public discussion paper on pharmacist prescribing.

 

PSA National President Dr Chris Freeman said PSA had advocated for collaborative pharmacist prescribing and recognised the work that had already been done to develop this role.

 

“PSA supports collaborative prescribing of medicines by pharmacists within a framework that allows them to practise to the full extent of their expertise,” Dr Freeman said.

 

“Pharmacists have more clinical training in medicines than any other health professional, they already perform clinical assessment and diagnosis within their scope of practice and prescribe other scheduled medicines. These activities are within the national competency framework for pharmacists.

 

“Prescribing Schedule 4 medicines is a logical next step and continuation of pharmacists’ role in medicines management.

 

“As stated in our Pharmacists in 2023 report, we are committed to enabling pharmacists to practise to their full scope by advocating for expanded roles and new opportunities in prescribing, consistent with their recognised competency framework.”

 

One of the actions for change outlined in Pharmacists in 2023 is to Facilitate pharmacist prescribing within a collaborative care model.

 

PSA surveyed pharmacists, interns and students to inform its response to the Pharmacy Board. Ninety-four per cent of respondents agreed pharmacists are already well placed to prescribe under a structured prescribing arrangement or under supervision.

 

The majority of respondents said they would prescribe under the proposed models, with 56% saying they planned to prescribe under a structured prescribing arrangement as soon as it was implemented.

 

In its submission to the Pharmacy Board, PSA outlined the core principles that must underpin pharmacist prescribing, including:

• Safety and wellbeing of the patient are fundamental priorities
• Patients are supported to receive patient-centred care in a timely manner
• Pharmacist prescribers have professional accountability and responsibility to patients as well as other members of the healthcare team
• The pharmacist prescriber works as a member of a collaborative care team with shared responsibility and implements highest standards of communication with patients and other team members
• Separation of prescribing and dispensing functions in a risk based framework.

 

“PSA looks forward to working with the Pharmacy Board and the wider profession to support pharmacist prescribers by establishing training and recognition requirements, enabling legislative and regulatory change, and developing a framework for collaborative prescribing across practice settings,” Dr Freeman said.

 

Media contact:   Michellé Mabille, Marketing and Communications Manager – 0487 922 176

PSA calls for greater support for pharmacists to improve Australia’s health

Following the announcement of the date of this year’s Federal Election, the Pharmaceutical Society of Australia (PSA) looks forward to working with an incoming Government to support a healthier Australia by making better use of the pharmacist workforce.

 

PSA National President Dr Chris Freeman said Australia had a world-class healthcare system, but it faced many challenges and pharmacists were well placed to increase access to care and improve patient and medicine safety.

 

“PSA looks forward to working with an incoming Government to improve medicine safety for all Australians by empowering pharmacists to better meet the needs of the community,” Dr Freeman said.

 

“Our Pharmacists in 2023 report outlines 11 key actions to improve the health of all Australians through better access to care, medicine safety and use of pharmacists’ expertise.

 

“To meet community health needs, we must ensure pharmacists can practise to their full potential, develop within a team of health professionals and have a quality agenda for the services they deliver.

 

“The public want to see pharmacists’ knowledge, and skills being put to full use. We need to remove the structural and funding barriers that are holding pharmacists back. It’s simply a waste of precious healthcare resources if we don’t have our pharmacists practicing to their full potential. It’s a disservice to patients and to the entire community to not fully utilise a ready and waiting health workforce to improve care.”

 

PSA seeks the following commitments from an incoming Government:

 

• Address the alarming rate of medicine-related harm in our health system by declaring medicine safety a National Health Priority Area (NHPA).

“Medicine-related problems cause 250,000 hospital admissions and 400,000 emergency department presentations in Australia each year, costing the healthcare system $1.4 billion annually. At least half of this harm is avoidable,” Dr Freeman said.

“Pharmacists are the stewards of medicine safety. Their primary responsibility at all times is to ensure medicines are used safely and effectively.

“Declaring medicine safety as a NHPA will provide much-needed awareness and investment.”

 

• Provide funding to embed pharmacists within healthcare teams, particularly in residential aged care facilities.

“Ninety-eight percent of people living in residential aged care facilities are taking at least one potentially inappropriate medicine,” Dr Freeman said.

“Embedding pharmacists in residential care facilities reduces the use of and harm caused by psychotropic medicines, opioids and antibiotics. We would like to see pharmacists embedded in every residential care facility in the country.”

 

• Accept the MBS Review Taskforce’s recommendations to allow pharmacists to access allied health items to provide medication management services to patients with complex care requirements.

“While GPs can include pharmacists in healthcare teams, this rarely happens because pharmacists are excluded from the list of eligible allied health providers and are therefore restricted by the current funding structures to be part of healthcare teams,” Dr Freeman said.

“Accepting the MBS Review Taskforce’s recommendations as a first step, will make better use of existing MBS services by fully harnessing the knowledge, skill and accessibility of pharmacists.”

 

• Align the incentives for pharmacists to support rural and remote communities with those of other rural and remote health practitioners.

“The seven million Australians living in rural and remote areas are more likely to have chronic conditions and poorer health outcomes than people in major cities,” Dr Freeman said.

“Pharmacists could play a much greater role in rural and remote areas, where they are often the only health provider. It’s only logical that the incentives for other health professionals to go, to stay and to be educated in the bush, should be available to pharmacists as well.”

 

• Include PSA as a signatory to the Community Pharmacy Agreement.

PSA welcomes recent commitments by the Federal Health Minister Greg Hunt that PSA will be a signatory to the 7th Community Pharmacy Agreement and from Labor’s Shadow Health Minister Catherine King to “early and inclusive” negotiations for the 7CPA.

“PSA believes the need to preserve the accessibility of community pharmacy for the delivery of health care services such as vaccinations, medication management and minor illness care. For this reason, and as recommended by the Review of Pharmacy Remuneration and regulation, PSA must be included as a signatory in the upcoming 7CPA.”

 

“Pharmacists are among the most accessible health professionals. Every day they use their clinical training to care for patients across the country,” Dr Freeman said.

“PSA looks forward to working with an incoming Government to empower pharmacists to do more to deliver better healthcare for all Australians.”

Pharmacists will do more to improve the health of all Australians

February 13, 2019

 

In 2023 pharmacists will be the custodians of medicine safety, embedded wherever medicines are used, and more responsible and accountable for the safe and effective use of medicines, a new report reveals.

 

Pharmacists in 2023: For patients, for our profession, for Australia’s health system, developed by the Pharmaceutical Society of Australia (PSA), reveals the 11 system changes needed for healthcare evolution to deliver safety and quality improvements in the use of medicines, and better use of pharmacists to improve access to healthcare.

 

PSA National President Dr Chris Freeman launched the report today at a breakfast event in Parliament House attended by political leaders and pharmacy experts from across the country.

 

“Pharmacists in 2023 is the pharmacy profession’s response to the national medicine safety problem,” Dr Freeman said. “The report unlocks the potential for pharmacists to improve healthcare access and outcomes for Australians and reduce variability in care.”

 

PSA recently showed in its Medicine Safety: Take Care report that 250,000 people are admitted to hospital each year as a result of medicine-related problems, costing the Australian health system $1.4 billion per annum.

 

“Medicine safety should be a national priority. The report identifies the key actions needed to address this issue by unlocking more opportunities for pharmacists as the guardians of medicine safety.

 

“Pharmacists must be empowered to do more than the current system allows them to do. As the only health professionals trained with a specific focus on the effective and safe use of medicines, pharmacists must lead a culture change to embed medicine safety at every point of healthcare delivery.

 

“Rather than gazing into a crystal ball, we have laid out an ambitious agenda for change with tangible and practical actions to support all pharmacists to reach their full potential and provide more effective and efficient healthcare.

 

“All of the actions in Pharmacists in 2023 aim to ensure pharmacists practise to the full extent of their expertise, are recognised for their key role in healthcare and are remunerated appropriately.

 

“Our goal is to ensure any Australian, no matter where they live, can receive the best possible care from a pharmacist, and that pharmacists are supported to address their patients’ needs using the full extent of their training and expertise.”

 

The report is the result of two years of consultation with a wide range of pharmacy, consumer and health stakeholders.

 

For pharmacists in 2023 to address the health needs of all Australians, the report identifies 11 actions for change:

 

1. Empower and expect all pharmacists to be more responsible and accountable for medicine safety.
2. Enhance the role of community pharmacists to have a greater level of responsibility and accountability for medicines management.
3. Embed pharmacists within healthcare teams to improve decision making for the safe and effective use of medicines.
4. Facilitate pharmacist prescribing within a collaborative care model.
5. Improve pharmacist stewardship of medicine management to improve outcomes at transitions of care.
6. Utilise and build upon the accessibility of community pharmacies in primary care to improve consumer access to health services.
7. Equip the pharmacist workforce, through practitioner development, to address Australia’s existing and emerging health challenges.
8. Establish additional funding models to recognise the value and quality of pharmacist care.
9. Allow greater flexibility in funding and delivery of pharmacist care to innovate and adapt to the unique patient needs in regional, rural and remote areas.
10. Develop and maintain a research culture across the pharmacist profession to ensure a robust evidence base for existing and future pharmacist programs.
11. Embrace digital transformation to improve the quality use of medicines; support the delivery of safe, effective, and efficient healthcare; and facilitate collaborative models of care.

 

Dr Freeman said, “I now look forward to working with pharmacy leaders, other healthcare groups, consumers and government to advance the role of pharmacists in 2023 – for patients, for our profession and for Australia’s health system.”

 

Read Pharmacists in 2023

 

Media contact:
Jarryd Luke
Senior Communications Officer
0487 922 176