Medication reviews via telehealth to better protect Australians

17 April 2020

 

Australians will be better supported to avoid medicine-related harm during the COVID-19 pandemic following the announcement that pharmacists will able to undertake a MedsCheck, Diabetes MedsCheck, Home Medicines Review or Residential Medication Management Review via telehealth.

 

In a move that has been strongly supported by the Pharmaceutical Society of Australia (PSA), the Government announced today that in response to the COVID-19 pandemic, where a patient has been identified as eligible, according to the relevant program rules medication reviews can take place via video or teleconference from 21 April 2020.

 

PSA National President, Associate Professor Chris Freeman said this measure to allow medicine reviews via telehealth will ensure those most vulnerable in the community were able to remain isolated but still receive vitally important medicine reviews.

 

“Throughout the entire COVID-19 pandemic, pharmacists are adapting and innovating to ensure they continue to provide the best healthcare for their communities,” he said.

 

“Allowing medicine reviews via telehealth whether it be on videoconference or teleconference is a commonsense decision made by the Government to ensure Australians continue to receive the support and medicine safety information they need without the risk of contracting COVID-19.

 

“This announcement also helps reduce the risk to pharmacists, who now no longer need to deliver essential comprehensive medication reviews face to face and run the risk of getting contracting COVID-19 themselves.”

 

A/Prof Freeman said while PSA welcomes this announcement he will continue to work with the Government and other healthcare professionals to improve medicine safety in the community, particularly around Home Medicine Review (HMR) follow-ups.

 

“Currently pharmacists can provide just one HMR per patient every 24 months with similar restrictions imposed on RMMR and MedsCheck programs and I am calling on the Government to allow pharmacists to be able to perform additional follow-ups as clinically necessary,” he said.

 

“As medicines experts it is essential that pharmacists are able to properly review patient’s medications as well as provide advice to other members of the health care team to ensure the safe and quality use of medicines for the elderly,” he said.

 

“In a time where so much attention is given to managing the immediate COVID-19 pandemic, we must also not lose sight on the importance of chronic disease management and the safe and quality use of medicines”

 

“Medicine-related problems lead to 250,000 hospital admissions each year costing $1.4 billion annually. Patients who take more than one medicine are at risk of problems associated with their medicines and medication review services are vitally important in identifying these issues.

 

For further information please visit the dedicated PSA COVID-19 Webpage.

 

Media contact: PSA media: 0487 922 176

 

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National President’s Message: COVID-19 Update

14 April 2020

 

I know that Easter for many of you was spent on the frontline, working to address this COVID-19 crisis that is enveloping us. I know that for many of us, COVID-19 is consuming not only our personal lives but our work lives.

 

There has been some good news in the last few days with some promising developments. Physical distancing, testing and quarantine measures are consolidating the flattening of the curve, with a rise in cases of about 2 per cent overall cases. This is a call for real hope and real aspiration.

 

PSA has been working over Easter to address the issues affecting you, and the policy and regulatory changes that have been made by State or Territory and Commonwealth Governments continues to change the health landscape which we work in.

 

Digital Image Prescriptions

 

I am getting an enormous amount of feedback, concern and frustration from you all on the issue of digital image prescriptions and the increasing confusion, workload and stress that this measure is causing.

 

Many of you from all around Australia are being left in a quandary and are stuck in the middle between the federal legislative instrument and the state and territory regulations. This is causing profession-wide confusion, greater workload and more administration at an already frantically busy time.

 

There is particular confusion given the Australian Government factsheets did not effectively communicate that state and territory regulatory changes were required prior to supplying of medicines under this arrangement become lawful.

 

Victoria and WA are currently the only jurisdictions where supply under this PBS special arrangement can be lawfully made at present. NSW has announced digital image prescription arrangements which will commence this Friday (17 April). These states have shown terrific leadership in this case and all other states and territories should follow suit with a matter of urgency.

 

I have made representations about this issue with both the Department of Health and Minister of Health’s office. I have made it clear that it is unacceptable that pharmacists are expected to break the law to provide patients with their medicines. GPs are heeding Commonwealth advice that they can send prescriptions electronically without forwarding a hard copy with the legislation in the states playing catching up.

 

PSA is working with the state and territory governments to accelerate this as quickly as possible in a way to minimise the additional burden this has caused you all. We understand what the Government is attempting to do in keeping the community safe – but this has to be done in a way that does not expose pharmacists to professional risks from being forced to break the law.

 

Personal Protective Equipment (PPE)

 

I was pleased to see the Australian Government announce last week that it will distribute 500,000 masks to pharmacy workers.

 

This is a good start as there has been significant and increasing demand for face masks and personal protective equipment for pharmacists working on the frontline face-to-face with patients. But we must ensure that pharmacists, like other frontline health workers, receive the adequate protection they need to care for their patients.

 

While the advice from Government regarding PPE has not changed, I will continue to work with the Government on your behalf to ensure there is adequate supply of personal protective equipment when it is needed for you all throughout this pandemic.

 

I understand some of you are having difficulties sourcing the PPE through your PHNs. If you are please let me know and we will follow up with the PHNs for you.

 

Therapeutic substitution

 

I am frustrated to report that work on the therapeutic substitution arrangements recently forshadowed by the Health Minister are not progressing well.

 

The Australian Government’s current proposed model involves a protocol being issued by the TGA to instruct pharmacists on how they should respond to every shortage.

 

This is not workable and is unacceptable to us. Being able to substitute strength and dose is well within a pharmacists’ skills and knowledge. In fact, it treats pharmacists with contempt at the time when we are providing vital healthcare to our communities. We will be providing you, our members with information later this week, and we may urge you to contact your local members to discuss this issue with them.

 

In a profession where we are accountable for making complex medicine safety decisions, it is inconceivable that the Government would see the need to advise pharmacists that 2 X 20 mg tablet equals one 40mg tablet.

 

We have long called for a Chief Pharmacist to be located within the Commonwealth Department of Health. A pharmacist, like the Chief Medical Officer and Chief Nurse who would be there fighting for the role of pharmacists in this pandemic. We will again make this call, so we know that pharmacists will have a voice, and that medicines policy advice comes from medicines experts – pharmacists.

 

Pharmacy closures

 

I have heard of pharmacies being forced to close due to isolation requirements for staff in NSW and West Australia. Pharmacists, who come into contact with a member of the public who is COVID-19 positive, are unlikely to be considered close contacts and therefore not likely to need to self-isolate for 14 days.

 

However, should a staff member become COVID-19 positive it is highly likely that anyone who has worked with them would be considered close contact during the period of working together and would need to self-isolate. In some small pharmacies this could mean your entire workforce would need to isolate.

 

If pharmacies are forced to close, particularly in a rural or remote area, there are serious implications for medicine supply, particularly if other staff are unavailable.

 

It is therefore essential that you either separate your workforce of if that is not possible, introduce additional measures to protect your team including additional restrictions on the number of patients in your pharmacy.

 

Pharmacy Interns

 

I have had a number of pharmacy interns contact me in regards to concerns about completing their required hours should they have to go into quarantine or self-isolation, and I know this is currently the case for a small number of interns across the country. While the Pharmacy Board’s response to this issue indicates that they may consider options for supervision, I am recommending that they do more to assist interns affected by COVID-19.

 

Simply put, there must be a relaxation of the supervised hours requirements for pharmacy interns and representatives of the PSA will meet with the Pharmacy Board this week and we will strenuously put the case for relaxation of the supervised hours requirements. Until this is dealt with and dealt with quickly, I am concerned that this will put undue stress on our pharmacy interns and exacerbate anxiety and stress at this time.

 

I will also stress that the Pharmacy Board should make representation to the Commonwealth as their agents for public safety to waive the fees of all pharmacists for re-registration in 2020.

 

Webinar COVID-19: Pharmacy layout and protection

 

Last Wednesday, I was joined by Associate Professor Alistair Reid, who as well as being Australia’s only rheumatologist and infectious disease physician, delivered valuable insights on treating COVID-19 in immunocompromised patients, medicines supply issues and herd immunity. His comments were supremely practical and, if you missed it, I encourage you to watch the recording here.

 

This week’s webinar to be held tomorrow night from 7.30pm-8.30pm will focus on the best way to set up your pharmacy or pharmacy practice to accommodate the changes and new ways of working to protect you, your staff and your patients during COVID-19. I will be joined by Queensland Branch President Chris Campbell to answer your questions on these topics. You can register for the webinar here.

 

Volunteer your expertise

 

I know that significant expertise lies in our membership and a large number of you work in a variety of practice settings. I would like to encourage you to offer your expertise to your fellow pharmacists by joining our COVID-19 pharmacy register where you can lead and be involved in creating resources and tools for your fellow pharmacists in tackling the COVID-19 pandemic. We will be establishing the sign-up to this register in the coming week, so stay tuned, if you can’t wait, feel free to email me or the membership team with your area of interest.

 

Stay up-to-date

 

I am pleased to tell you that visits to our dedicated COVID-19 website have more than doubled over the past month. The site is continually updated with the latest information that you need to be supported while you care for the community during the COVID-19 crisis. There are series of FAQs on the website and can be found here.

 

Please contact our team or myself for support, feedback or any inquiries you may have at membership@psa.org.au.

 

As we move into a more stable period of our pandemic response, I am confident that the profession will continue to serve the community with compassion, care and professionalism that has been evident from the moment that the pandemic started.

 

Sincerely,

Associate Professor Chris Freeman
National President
Pharmaceutical Society of Australia

Queenslanders to be better protected during COVID-19

11 April 2020

 

Queenslanders will be better protected by pharmacists during the COVID-19 pandemic with increased access to vaccines and essential medicines following a number of announcements made by the Queensland Government today, many of them not yet seen in other states and territories.

 

In a move that has been welcomed by the Pharmaceutical Society of Australia (PSA), pharmacists will be able to supply an alternative suitable medicine to a patient if supplies of a usual medicine are unavailable, once enacted under protocols currently under development by the Therapeutic Goods Administration (TGA) for prescribed Schedule 4 restricted drugs.

 

Patients will also be able to receive a maximum PBS quantity or pack size without a prescription, where the pharmacist is satisfied there is immediate need, usually a months’ supply for most medicines.

 

PSA Queensland President Chris Campbell congratulated the Queensland Government for making these necessary changes that will assist pharmacists in providing necessary care to their patients and the community.

 

“PSA fully supports and thanks the Queensland Government for this common-sense approach that will provide certainty to patients who cannot access their medicines due to the impact of COVID-19 or might be worried about a certain medicine being out of stock, “he said.

 

“Queensland is the first state or territory to enable pharmacists to implement the TGA therapeutic substitution protocols when they are released, which is one of many measures the Government, through pharmacists are tackling the growing issue of medicines shortage around Australia.

 

“Dispensing therapeutic substitutions to patients is well within the current skillset of every pharmacist in Queensland and it is very important we continue to work with the Government and TGA to ensure there is as little bureaucratic red tape as possible and patient care and safety are paramount.

 

“As the peak national body for pharmacists, PSA has called for and worked with the Queensland Government to give pharmacists more scope to ensure patients continue to receive essential medicines and these changes are a good step forward.”

 

The Queensland Government also announced that pharmacists will be able to administer the meningococcal vaccine to children aged 10 and older (previously 16 and older) as well as allowing Queensland pharmacists to be the first pharmacists in Australia to provide the Pneumococcal vaccination, adding to the growing number of immunisations provided by pharmacists in Queensland.

 

Mr Campbell said as part of these announcements by the Health Minister Steven Miles, community pharmacists will also be able to administer the COVID 19 vaccination when it is available, another Australian first.

 

“This forward thinking plan will allow the most rapid uptake of COVID 19 immunisation possible, leveraging off the wide network of pharmacists in the state and will help to rapidly protect Queenslanders and will save lives,” he said.

 

“Pharmacists are on the front line of health care and are doing a tremendous job of supporting the community during the COVID crisis.

 

“We are seeing more and more patients get the influenza shot this year in pharmacy than ever before, last year over 2 million influenza vaccinations were provided by pharmacists, this year with the improvement in access from 10 years and older in QLD people are quite rightly choosing to be Immunised.”

 

PSA will continue to work closely with the Department of Health and Queensland Government to support pharmacists during the COVID-19 pandemic. Resources can be found through the PSA COVID-19 web page: www-dev/coronavirus

 

PSA contact: Chris Campbell PSA QLD President 0401 704 097

 

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People in the ACT better protected following vaccination announcement

8 April 2020

 

Families with children aged 10 and older will today be able to access the influenza vaccination through community pharmacy. This means more members of the ACT Community can access vital influenza vaccinations prior to the flu season, through their local professional pharmacist.

 

The Pharmaceutical Society of Australia (PSA) has welcomed decisions by the ACT Government to: lower the age of influenza vaccination in community Pharmacy to 10 years old; remove the restriction on administering the influenza vaccination to a person who is pregnant; and for the first time to enable trained pharmacists in the ACT to administer measles, mumps and rubella (MMR) vaccines to people aged 16 and older.

 

PSA ACT Branch President Renae Beardmore said this announcement is timely given the ongoing threat of COVID-19 leading into the flu season and also brings the ACT in-line with other states and territories.

 

“At a time when our health care system is under extreme pressure due to COVID-19, increasing options for more people in the ACT to access vaccinations is vital,” Ms Beardmore said.

 

“The decision to lower the age to 10 years and older for the influenza vaccine will protect younger children and make it more convenient for families, improving rates of immunisation across the ACT.

 

“Pharmacists are more accessible to the community than any other health provider and combined with the trust consumers have in the profession, these changes will allow pharmacists to make a greater contribution to increasing immunity across the ACT.

 

Ms Beardmore commended the Government’s decision to allow pharmacists to protect more people in the ACT from influenza and other vaccine-preventable diseases.

 

“As the peak national body for pharmacists, PSA has advocated for many years, including most recently in PSA’s 2020-21 ACT pre-budget submission, to allow pharmacists to deliver more vaccinations to a wider range of patients.

 

“PSA will continue to work closely with the ACT Government to remove barriers which restrict pharmacists from administering other vaccines to better protect the community.”

 

PSA Contact: Angela Drayton: 0419 241 344

 

Download media release

National President’s Message: COVID-19 Update

7 April 2020

 

I know that some pharmacists are nearly at breaking point. The concern that keeps me up at night is that this is only the start, and that our workforce unlike any other health worker, has over the past six weeks endured panic buying, hoarding and during the midst of all of this attempting to deliver the same level of healthcare that we always have.

 

I also know that you, working with your local teams and doctors have been fixing the challenges associated with the implementation of image-based prescribing, where doctors can send you an email, fax or text of a copy of the prescription. I know this has been challenging with a lack of information about what to do. We, like you have been frustrated about this, and will continue to work through these challenges so that you can work in safety, and patients can stay at home.

 

I know that the lead-up to the Easter break is frantically busy in pharmacy. While the busyness will still be there, this year Easter will be different from any year before – both professionally and at home.

 

I know many of you are all already exhausted and are working endlessly in a constantly changing and challenging work environment. Fatigue is getting to a point where the initial acute response and energy that was required from us all in our workplaces is taking a toll.

 

Taking care of yourself and managing your mental health and psychological well-being during this time is as important as managing your physical health.

 

If you can, I urge you to please try to take some time out over the Easter break to try to recharge and connect with those most important to you. If you can’t take the time out this long weekend, look for opportunities to do so as soon as possible as this pandemic will be ongoing for a while.

 

It is important to reach out to colleagues and those close to you if you are struggling psychologically as well as utilising the Pharmacists’ Support Service and other mental health support systems. This is not a sprint; it’s a marathon.

 

Medicine reviews: the need for follow-up visits and telehealth

 

We continue to work with the Department of Health and the Minister for Health on ensuring that medicine management reviews can be performed through telehealth arrangements.

 

I would like to thank Minister Hunt and the Department for the positive approach to addressing this issue. We are of the view that these services remain critical in the COVID-19 pandemic.

 

In addition to telehealth, PSA has been strongly advocating for the introduction of follow-up visits for HMRs and RMMRs enacting the recommendations from the interim report from the Royal Commission on Aged Care Safety and Quality.

 

As you will know, it is not possible to solve all medicine safety problems for most people in a single intervention or review. COVID-19 has amplified the need to introduce this as soon as possible to ensure that medicine-related harm does not magnify because of the pandemic.

 

Some problems take multiple reviews to address. Other problems may not emerge until more significant problems have been sorted.

 

Follow-up visits provides an opportunity for pharmacists to deliver subsequent consultations based on an individual patient’s circumstances and clinical need. The timeline for and need for follow up should be determined at the time of the initial review.

 

I believe there is real merit in also reviewing and removing the caps on Medscheck services at this point to allow more consultations to be conducted, including by telehealth, to enable pharmacists to check-in on people at home to ensure that they are using their medicines appropriately.

 

Customer abuse

 

We have been hearing from our members concerning reports about physical assaults on you and your staff.

 

This is unacceptable. This is not okay. This sort of the behaviour from members of the public is reprehensible and it is important that you are all safe in your workplace.

 

Australia’s leaders have appropriately declared zero tolerance of any abusive behaviour towards you and other health professionals on the front line of this pandemic.

 

The Western Australian Government, though the advocacy of health professional peak bodies including the PSA, has passed legislation which means people who threaten or abuse pharmacists and other health professionals will face up to 10 years jail. PSA is writing to all State and Territory governments to mirror these laws. PSA wants to send a clear message for pharmacists to the community, threats and abuse are unacceptable.

 

I am heartened to hear reports of police supporting you when there are reports of violence of abuse and I encourage you to contact them when you need to.

 

I want to thank all of you for being professional and not accepting unacceptable behaviour while protecting Australian’s medicine supply through enforcing limits as people try to unnecessarily stockpile.

 

COVID-19: Health system update

 

With international and state border quarantine measures now in place for the foreseeable future, suppressing COVID-19 transmission is now focussed on introducing measures to better detect community transmission.

 

Most jurisdictions are now revising their testing criteria for COVID-19 to include much broader groups of people with coronavirus symptoms such as workers with community contact in their role, vulnerable people and older Australians. You should be familiar with the testing criteria in your area and the locations where testing is available. We know that this does shift over time, and the best place to understand the details of testing is here.

 

The use of masks remains a vexed issue. Personal Protective Equipment is not in surplus supply. That is why the recommendations for the use of face masks in the general community remains unchanged at this stage, that is reserved for those at high risk such as immunocompromised, suspected contact and need to leave the house for any reason. Individuals may choose to use cloth or masks made of other materials as recommended by the WHO.

 

We will continue to follow Australian advice when it comes to PPE, though individual pharmacists should choose the measures that they believe give them an appropriate level of comfort especially if close contact with patients is present.

 

I, of course, will keep you informed if the advice from the Government changes in regards to face masks.

 

In the interim keeping the high level of adherence to hand hygiene. Physical distancing and screening out at-risk patients.

 

Vaccinations

 

Many of you have contacted me and PSA seeking advice on the risk of COVID-19 transmission during vaccination. The best thing you can do to keep yourself and your patients as safe as possible is a strong initial screening process.

 

Many medical practices and pharmacies have automated booking and reminder systems so if you haven’t done this already, please add these warnings ASAP. You can set them up upon the patient booking and also in the reminder emails/texts to patients.

 

The other measure you can take is to ensure clear signage is displayed throughout the pharmacy about these risk and precautions

 

Use this as an opportunity to remind your patients of the physical distancing when they are in the pharmacy especially during their 15 mins observation period as well as hand hygiene and cough etiquette. Providing access to hand sanitiser on the way in and at stations in your pharmacy is essential.

 

As it is not an aerosol-generating procedure current advice for primary care is that immunisation presents a low risk of transmission to the healthcare provider. Where PPE is in such short supply, the use of masks are not currently recommended.

 

As the risk of community exposure increases public health agencies are reviewing their recommendations. I will keep you informed of evolving advice from the Chief Medical Officer. And of course, if a staff member is unwell we would ask them to follow advice and not attend work.

 

To find out the advice from your particular state or territory health department you can access information here.

 

Pharmacy shutdowns due to COVID-19

 

In most pharmacy environments, it is likely most of your work colleagues would be considered a close contact if you were to become COVID-19 positive. For most pharmacists in Australia this could threaten the ability of your workplace or business to continue operating.

 

We have already seen a handful of community pharmacies have to temporarily close after a positive COVID-19 result, as well as seen reports of some hospital staffing challenges following need to self-isolate groups of health practitioners.

 

As an essential community services, whether that be in a community pharmacy, hospital or other health setting, it is important pharmacists have contingencies which ensure their patients have access to ongoing pharmacist care and access to medicines.

 

Common contingencies include:

  • Separating pharmacists and pharmacy staff into discrete teams who do not work with each other during COVID-19 (e.g. ‘Team A’ and ‘Team B’). Handover between these teams should be minimal and done remotely if possible.
  • Discussion with colleagues in nearby pharmacies to identify possible options to support continuity of care if your business has to temporarily suspend operations
  • Undertaking activities such as medicine review, medicine counselling or administrative tasks where possible from self-isolation if you are well enough to do so
  • Minimising physical and longer consultations with patients unless necessary to do so.

 

There are also government measures that need to be seriously addressed to support community pharmacy as an essential workplace.

 

The Government’s JobKeeper package should be extended to all community pharmacies across the country to ensure they remain open, appropriately staffed and safe.

 

The JobKeeper package as announced by the Government necessitating a 30% reduction in revenue, simply does not address the increased cost of keeping community pharmacies open in this dire time.

 

I was also heartened to see the Rural Pharmacy Network of Australia (RPNA) suggest a rural guarantee for Australian community pharmacies. This suggestion, as a temporary supplement to the Rural Pharmacy Maintenance Allowance, is sensible.

 

Keeping unwell patients out of your pharmacy

 

It’s becoming well-known that the best defence our community has against COVID-19 is physical distancing. This means keeping potential cases outside of health care settings and environments not designed to assess and manage people who are potentially coronavirus-positive.

 

Patients should not be coming into a pharmacy if they have any of the possible COVID-19 symptoms: particularly fever, cough, sore throat or shortness of breath.

 

People presenting with these symptoms should be supported outside the pharmacy through contactless means (such as telephone, car window-drop, home delivery or post) and also referred to the coronavirus hotline for further guidance as appropriate.

 

Much like other providers of essential services, signage and screening of people at the entrances to premises can help achieve this.

 

While community pharmacies are generally exempt from public gathering limits, physical distancing should be observed at all times – that being maintaining 1.5m distances as far as practical between all people at all times – staff and patients included.

 

Therapeutic substitution

 

Last week the Australian Government announced it will implement changes to allow pharmacists to substitute dose strengths or forms of medicines without prior approval from the prescribing doctor, if a medicine is unavailable at the time of dispensing.

 

We continue to work through this measure in a meaningful way with the Department of Health, through the Therapeutic Goods Administration.

 

I want to make sure that red tape is removed from this process and that bureaucratic approvals are removed from the end goal which is to ensure your patients get the medicine they need at the dose they need. I will keep you informed of progress in this area.

 

These substitutions are well-within the existing skillset of every pharmacist within Australia and are well-overdue, but they must not be mired in unnecessary bureaucracy and approvals.

 

A pharmacist can substitute 2 x 20mg of a molecule to make 40mg, we don’t need bureaucrats to tell us we can do it.

 

It is important to note that these changes have not yet come into effect. Specific details of the changes are yet to be released and I will continue to work with the Government on this commitment.

 

COVID-19 webinar

 

Tomorrow night we’ll be continuing our COVID-19 Webinar series, this time the third webinar in our series will focus on what pharmacists in both hospital and community settings can do to support immunocompromised patients.

 

These are the patients who have the potential to be greatly affected by medicines supply, and are most at risk for developing infection. And, in the case of chemotherapy patients, we’re seeing more of them be initiated on, and managed through, community pharmacy.

 

I’ll be joined by Australia’s only dual infectious disease and rheumatologist physician, Associate Professor Alistair Reid, who is eminently qualified to answer all your questions about both infection control and supporting your patients. If you would like to join us please register here.

 

Stay up-to-date

 

I encourage you to go to visit our dedicated COVID-19 website which is continually updated with the latest information that you need to be supported while you care for the community during the COVID-19 crisis. There are a series of FAQs on the website and can be found here.

 

Please contact our team or myself for support, feedback or any inquiries you may have at membership@psa.org.au.

 

In closing, I want to wish you and your loved ones the very best over this long weekend. From all of us @YourPSA, we wish you to be safe and to thank you again for all your support and for all the essential work you do as pharmacists.

 

Sincerely,

Associate Professor Chris Freeman
National President
Pharmaceutical Society of Australia

ACT Government extend emergency dispensing for pharmacists

The ACT Government has today made an announcement to extend the special authority for emergency supply of medicines without a prescription in a move that has been welcomed by the Pharmaceutical Society of Australia (PSA).

 

Patients will be able to receive a maximum PBS quantity or pack size, usually a months’ supply, until at least June 30 2020 without a prescription, where the pharmacist is satisfied there is immediate need.

 

The medicine must have been previously prescribed and be for the continuation of current essential treatment.

 

PSA ACT President Renae Beardmore congratulated the ACT Government for extending the emergency supply rules.

 

“PSA fully supports and thanks the ACT Government for this very sensible approach which will ensure patients in the ACT have continued access to essential medicines during the COVID-19 pandemic” she said.

 

“General Practitioners across the ACT are under extreme pressure and this measure provides certainty to patients who are unable to access their usual prescriber due to COVID-19.”

 

“As the peak national body for pharmacists, PSA has called for and worked with the ACT Government to allow the continuation of emergency dispensing that was put in place during the recent bushfire crisis to be extended during the COVID-19 pandemic.

 

This will ensure patients and members of the community continue to gain access to much needed medicines.”

 

PSA will continue to work closely with ACT Health to support pharmacists during the COVID-19 pandemic.

 

Resources can be found through the PSA COVID-19 web page: www-dev/coronavirus

 

PSA contact: Angela Drayton: ACT PSA Territory Manager: 0419 241 344

 

Download media release

National President’s Message: COVID-19 Update

1 April 2020

 

The past week has been tough for everyone. Tough for Australians who have lost their jobs. Tough for families who need to keep distance from their loved ones. Tough for pharmacists and their teams working extended hours with little rest to support the health needs of Australians. And I know that number of you already feel like you’re at breaking point.

 

I am so proud at how pharmacists everywhere are adapting, innovating and providing inspiration to their colleagues while caring for their community.

 

These are just some of the extraordinary measures pharmacists are undertaking to ensure they continue to provide a safe environment for them, their staff and the best healthcare for their communities.

 

As another week of unprecedented challenges looms, in today’s message I have detailed just some of the changes and issues that have arisen this past week.

 

Job Keeper announcement

 

The Prime Minister and Treasurer yesterday announced a once in a lifetime $130bn package to support the income of Australian employees during COVID-19.  At first glance, the majority of pharmacists and pharmacy staff would not be eligible for this payment as the businesses must have revenue projected to decline >30% year-on-year to be eligible.

 

The initial surge in demand for community pharmacy will mean it’s unlikely you might see a >30% decline in revenue. PSA is very conscious that this might change as the pandemic develops and there may be dips in revenue, particularly in discretionary front-of-pharmacy spending.

 

This will occur at a time when costs of providing essential pharmacist services to the community are significantly higher due to PPE, cleaning requirements and the need to adopt to alternative medicine delivery models.

 

PSA is engaging the Treasury and the ATO to see if there are some specific concessions which can be made for pharmacy. In all the daily conversations I have had with bureaucrats and elected officials, it’s clear the Government is very aware of the immense challenges pharmacists face and try to work towards access to measures which provide stability for pharmacists, their employers and most importantly the community during the COVID-19 pandemic.

 

Expanded Continued Dispensing during COVID-19: ensuring continuity of access to essential medicines.

 

The Health Minister this morning announced an expansion to Continued Dispensing – Emergency measures which will see Australians able to access any PBS/RPBS medicine (excluding S100 medicines) in an emergency without a prescription.

 

This is an extension of the funding arrangements announced earlier this year in response to the bushfire crisis. It is a measure that I have been in constant communication with the Government about over the past couple of months and I welcome this announcement.

 

In the past week, Western Australia, NSW, Victoria, South Australian, Tasmania and ACT governments have all moved to ensure continuity of access to medicines through expanded emergency supply provisions (for PBS and non-PBS medicines). I understand all other jurisdictions are also rapidly undertaking regulatory work needed to enable access to this initiative.

 

These measures provide sensible and pragmatic options to continue essential medicines if prescribers are unexpectedly unavailable or consumers are unexpectedly isolated at home.

 

It is vitally important the profession is judicious in their use of these provisions. Professional guidelines, state regulatory instruments and Continued Dispensing Program Rules govern the scope and limitations of this service. Patients can only access this initiative when it is impractical for them to access a prescription from their regular doctor – and they can only access each PBS/RPBS medicine once in a 12-month period via this initiative.

 

An Addendum to the Continued Dispensing Guidelines will shortly be published on PSA’s website, along with FAQs and other supporting resources.

 

Therapeutic Substitution

 

The Australian Government also announced today it will implement changes to allow pharmacists to substitute dose strengths or forms of medicines without prior approval from the prescribing doctor, if a medicine is unavailable at the time of dispensing.

 

The changes, which I have been working on with the Government and Department of Health over recent months, will allow a pharmacist to dispense different strengths of a product (such as two 20mg tablets in place of a 40mg tablet), or a different dose form of the same medicine (such as a capsule instead of a tablet).

 

Specific details have not yet been released, but the Commonwealth has advised the changes will be implemented through the Scheduling Policy Framework and Poisons Standard, with implementation by States and Territories and the Government through the TGA.

 

I strongly supports this announcement and will continue to work with the Government on this commitment and potential expansion of these substitution measures. I will provide guidance to members in my weekly messages to you on this common sense initiative as more information becomes available.

 

Infection control: Protecting yourself, your colleagues and your community

 

I’ve heard from many of you regarding your concerns on how to protect you and your colleagues from transmission of COVID-19 in your workplace.  This has seen many pharmacists work to develop changes to their work environments, including innovative adjustments to workflow, such as one way customer flow, limiting patient numbers in your pharmacy or closing premises for brief periods for cleaning and breaks.

 

Hand hygiene and social distancing remain the most significant protection against COVID-19, and as far as possible pharmacists should be working with their colleagues and patients to maintain these protections at all times.

 

As the influenza season approaches, concerns regarding how vaccinations can be safely administered by pharmacists during a phase of COVID-19 community transmission has increased.

 

At this stage, PSA’s advice remains that vaccination proceeds, but that pharmacists perform appropriate close contact measures such as measuring a surgical mask at least, along with using gloves and hand sanitiser. This includes not vaccinating anyone with fever or cold and flu like symptoms.

 

Limits on medicines

 

The introduction of these limits have been particularly difficult for pharmacists, particularly in the face of consumer aggression and abuse at imposing restrictions on the volumes of medicines they can access.

 

While some lines are starting to return towards normal stock levels with wholesalers, it is vital these limits continue to be enforced.  This will ensure our medicine supply chain will withstand the pressures thrown at it during the COVID-19 pandemic.

 

Where multiple months’ supply of medicines are requested, particularly by people who are self-isolating, pharmacists should encourage other options such as medicine delivery services.

 

Evidence requirements for supply of salbutamol as a Pharmacist Only Medicine

 

An amendment to the SUSMP last week provided legal backing to the announcement pharmacists require evidence of medical diagnosis of a respiratory condition or dispensing history for salbutamol MDI to legally supply salbutamol MDI as a Pharmacist Only Medicine (Schedule 3).

 

Members have reported this measure has been generally well received by those with long-standing conditions such as COPD, bronchiectasis and chronic asthma in providing confidence in being able to access vital medicines. I have also received reports about aggression and confusion from some people seeking salbutamol who were unaware of this change.

 

Anecdotally, members have reported to me that this evidence change has identified a large number of consumers who appear to be self-managing respiratory symptoms with salbutamol at a frequency suggestive of the need for medical review for an undiagnosed condition.

 

It is important these people receive an appropriate diagnosis and therapy in the early stages of the COVID-19 pandemic as we know COVID-19 infection outcomes for people with respiratory conditions are more severe than those for the general population.

 

FAQs and resources on this issue are available on the PSA COVID-19 website.

 

Immunisation Webinar – Covid-19: Your Immunisation Questions Answered.

 

I would like to thank so many of you for attending our COVID-19 webinar last Wednesday. We had more than 500 pharmacists attend the webinar and I would like to thank Associate Professor Charlotte Hespe who stood in for Professor Robert Booy.

 

You had some insightful questions that demonstrated the pressures that pharmacists have been under. And in response to your many questions about vaccination during COVID-19 with the upcoming influenza season, I will be running another webinar tomorrow night from 7.30pm to 8.30pm AEDT with Associate Professor Hespe on the topic of immunisations and how to vaccinate your patients safely.

 

I encourage you to register here and ask any questions you may have on immunisation and any other COVID-19 questions you are uncertain about.

 

Medicine reviews via telehealth

 

On Sunday, the Health Minister made strong announcements to support telehealth services, such as GP and psychology consultations, during the COVID-19 pandemic, declaring “As of tomorrow, we will have universal telehealth available in Australia and that “Everything which can be done by telehealth will be done by telehealth”.

 

I will continue to work with the Department of Health and the Minister for Health to ensure that medicine management programs are available to be delivered where appropriate by telehealth arrangements.

 

Now, more than ever, it is critical to minimise adverse drug outcomes in the community and aged care settings, to free hospital beds for the national response to COVID-19 and I will continue to work on this measure and keep you informed of progress.

 

Personal Protective Equipment (PPE)

 

I have been hearing from many members about the use of PPE. This includes everything from whether pharmacists and pharmacy staff should be routinely wearing PPE to how pharmacies can access PPE. These are important questions in a rapidly evolving environment and I’m keen to address these concerns as quickly as possible.

 

PSA is in the process of developing FAQs to complement existing primary care guidelines for pharmacist and pharmacy staff which will be published on the PSA COVID-19 microsite.

 

In the meantime, the Department of Health has issued interim guidance for the use of PPE, intended for practitioners in primary health care settings. Read the interim advice here.

 

To obtain PPE for your pharmacy from the National Medicines Stockpile, contact your local Primary Health Network. The contact details for all 31 PHNs can be accessed here.

 

PSA

 

Your PSA teams around the country are now predominantly in work-from-home arrangements; liaising with government agencies, supporting you on the phone, and developing resources which helps the profession to play its role in the pandemic response.

 

I am pleased this transition has been a smooth one and members continue to be able to access all member services.

 

Keep up to date

 

Our dedicated COVID-19 website is continually updated with the latest information that you need to be supported while you care for the community during the COVID-19 crisis.

 

Please contact our team or myself for support, feedback or inquiries you may have at membership@psa.org.au.

 

This is another pivotal week in Australia’s pandemic response.  One of the most important ways you can contribute to Australia’s response this week is to echo public health messages on social distancing to your patients: #StayatHome – if you are not buying essential supplies, working, exercising locally or seeking essential health care you must stay at home.

 

PSA anticipates further announcements which affect pharmacist care through this week. Your PSA will keep you up-to-date on these announcements as they happen.

 

Sincerely,

Associate Professor Chris Freeman
National President
Pharmaceutical Society of Australia

SA Government extends emergency dispensing for pharmacists

1 April 2020

 

The SA Government has made an announcement to extend the special authority for emergency supply of medicines without a prescription in a move that has been welcomed by the Pharmaceutical Society of Australia (PSA).

 

Patients will be able to receive a maximum PBS quantity or pack size without a prescription, where the pharmacist is satisfied there is immediate need, usually a months’ supply for most medicines.

 

This provision continues to be in place while the declaration of a major emergency remains in force or until advised by the SA Government.

 

The medicine must have been previously prescribed and be for the continuation of current essential treatment where it is impractical to obtain a prescription.

 

PSA SA/NT President Robyn Johns congratulated the SA Government for extending the emergency supply rules.

 

“PSA fully supports and thanks the SA Government for this very sensible approach which will support patients continued access essential medicines,” she said.

 

“GPs across SA are under extreme pressure and this measure will provide certainty to patients who cannot access their usual prescriber due to the impact of the coronavirus pandemic.”

 

“As the peak national body for pharmacists, PSA has called for and worked with the SA Government to allow the continuation of emergency dispensing that was put in place during the recent bushfire crisis to ensure patients and members of the community continue to gain access to much needed medicines.”

 

This measure is also supported the recent announcement by the Federal Government where the medicine can be supplied at PBS prices under the continued dispensing arrangements.

 

Aligned with the changes to allow community pharmacists to substitute dose strengths or forms of medicines without prior approval from the prescribing doctor, if a medicine is unavailable at the time of dispensing, pharmacists are better placed to support their communities during this pandemic.

 

Specific details on substitutions have not yet been released and the changes will be implemented through the Scheduling Policy Framework and Poisons Standard soon.

 

The arrangements in South Australia excludes certain drugs including Schedule 8, benzodiazepines, stimulants, and some medications including hydroxychloroquine where prescribing is restricted to certain medical specialists.

 

PSA will continue to work closely with the Department of Health and Wellbeing to support pharmacists during the COVID-19 pandemic. Resources can be found through the PSA COVID-19 web page: http://www-dev/coronavirus/

 

PSA contact: Helen Stone PSA SA/NT State and Territory Manager 0418 846 426

 

Dowload media release

Australians to access medicines without a prescription during COVID-19

31 March 2020

 

All Australians will be able to access their essential medicines continued by a pharmacist at PBS prices if their prescription has run out under continued dispensing arrangements announced by the Federal Government today.

 

Pharmaceutical Society of Australia National President Associate Professor Chris Freeman welcomed the announcement made by the government which will see continued dispensing arrangements extended until at least the end of June and the implementation of medicine substitution when medicines are out of stock following consultation with states and territories.

 

“This will enable Australians to continue access their vital medicines as a “one-off” in an emergency if they cannot get a prescription during the COVID-19 pandemic,” he said.

 

“Subject to professional guidelines and state and territory regulation, the initiative allows for a standard pack size of most ongoing prescription medicines to be provided, usually equivalent to one month’s supply.

 

PSA has been working with the Federal Government to ensure the emergency measure is extended during the current COVID-19 pandemic.

 

Medicines supplied under this arrangement are available at regular PBS prices – standard co-payments being $6.60 for concession card holders, and up to a maximum of $41 for general patients.

 

A/Prof Freeman congratulated the coordination of states and territories and the Commonwealth on working to enact the regulatory changes required in relation to both PBS funding and legality of supply and noted that it is understood that all states and territories if not already aligned intend to have aligning legislation.

 

“While this announcement is welcomed by PSA, we will continue to call for permanent emergency supply provisions of this nature.

 

“Whether it be a bushfire, pandemic or any other emergency, Australians need to be confident they can access medicines in an emergency from the time they strike.

 

“We will continue to work with the Federal Government, in collaboration with its state and territory counterparts, after this crisis subsides to permanently incorporate effective and nationally consistent emergency supply provisions.”

 

“As front line health professionals, pharmacists continue to play a vital role during the current COVID-19 pandemic and it is important they receive all the tools necessary to ensure they can deliver services in a timely manner that meets the health care needs of their patients and the community.”

 

The Federal Government also announced it will be implementing changes to allow community pharmacists to substitute dose strengths or forms of medicines without prior approval from the prescribing doctor, if a medicine is unavailable at the time of dispensing.

 

“PSA strongly supports this announcement having worked in partnership with the Department of Health and the Pharmacy Guild of Australia for this much needed change.
“We will continue to work with the Government on the implantation of this common sense initiative.”

 

Media contact: 0487 922 176

 

Download media release

Emergency supply of medications in Tasmania

31 March 2020

 

Tasmanians will now be allowed the supply of certain medicines by a pharmacist without a prescription following an announcement by the Tasmanian Health Minister, Sarah Courtney today.

 

The move has been welcomed by the Pharmaceutical Society of Australia Tasmanian President, Dr Ella Van Tienen and The Pharmacy Guild of Australia Tasmanian President, John Dowling that will ensure Tasmanians continue to receive the medical care they need.

 

These changes will help Tasmanians with ongoing medical needs, who may not have access to their valid prescription or are unable to see their usual doctor due to movement restrictions.

 

To qualify for emergency supply patients must previously have been prescribed the medicine and the pharmacist must be satisfied it is urgently needed.

 

“The changes announced today bring Tasmania into line with other jurisdictions that have made similar changes in response to COVID-19, and the recent bushfires, it’s a sensible approach which will reassure patients that they will be able to access medicines, further, the emergency supply will be covered under the PBS, meaning patients won’t pay more than the normal co-payments” said Mr Dowling.

 

“Patients running short of prescription medications will now be able to obtain additional supply under special arrangements, this change allows pharmacists to dispense prescription medications, subject to meeting certain conditions, the changes are in effect immediately until 30 June 2020,” said Dr Van Tienen.

 

The medicine must have been previously prescribed and be for the continuation of current essential treatment where it is impractical to obtain a prescription. In light of the developing COVID-19 pandemic, this change will enable pharmacists to best service their patients.

 

“Our patients are looking to us to provide them with medicines, on-going care, critical information and support,” said Mr Dowling.

 

We also welcomed the announcement that the Federal Government is implementing changes recommended by the both organisations to allow community pharmacists to substitute dose strengths or forms of medicines without prior approval from the prescribing doctor, if a medicine is unavailable at the time of dispensing. These changes will allow patients to receive their medicines from their pharmacist immediately.

 

PSA and the PGA will continue to work closely with the Department of Health to support pharmacists and the Tasmanian community during the COVID-19 pandemic.

 

Resources can be found through the PSA COVID-19 web page: http://www-dev/coronavirus/ or the Pharmacy Guild of Australia COVID-19 webpage: https://www.guild.org.au/resources/business-operations/COVID-19-Information

 

PSA contact: Paquita Sutherland, PSA TAS State Manager 0408 308 339

PGA contact: John Dowling, PGA Branch President 0408 131 094

 

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