The options put forward by the Pharmacy Board in its discussion paper on pharmacist prescribing have been closely examined by the Pharmacy Guild.
Aspects that have been examined include what would work best in community pharmacy, and what would produce the best health outcomes for patients.
The Guild is clear that allowing pharmacists to work to their full scope of practice is fundamental to improving health outcomes. It believes the Pharmacy Board’s paper is a very positive step in this direction.
The Board offered three options for discussion: autonomous prescribing, prescribing under a structured prescribing arrangement, and prescribing under supervision.
In their response to the Board’s paper, the Guild restricted its comments to autonomous prescribing, believing it to be the only feasible option for improving medicines access and management.
“Autonomous prescribing would see pharmacists prescribe within their scope of practice without the supervision or approval of another health professional,” the Guild said. “They also would have undertaken education and be authorised to autonomously prescribe in their specific area of clinical practice.”
The following is from the Guild’s media release on the subject, published on May 1.
“Our response points out pharmacists are as trusted as general practitioners by the Australian public and this trust needs to be leveraged so pharmacists can administer basic healthcare services to drive down costs to patients and the health budget, reduce waiting times and increase accessibility.
“Quite clearly, autonomous pharmacist prescribing would improve access to treatment options for conditions that can be managed by a pharmacist, including after hours and weekends when access to other healthcare professionals is limited or non-existent.
“And if pharmacist prescribing is to contribute to the delivery of sustainable, responsive and affordable access to medicines then it has to be autonomous. The other models put forward are dependent on another prescriber and would therefore be less effective.
“Prescribing under a structured prescribing arrangement or under supervision relies on another healthcare professional and would not be flexible enough to meet the needs of all Australians who, for example, may live in a rural or remote area where there is no or very limited access to a medical doctor or nurse practitioner. Other examples include after hours, palliative care, aged care or addiction medicine where an autonomous pharmacist prescriber will be able to provide the necessary care.
“The autonomous pharmacist prescriber will be no different to a nurse practitioner where the pharmacist will provide the necessary care within their individual scope of practice and work collaboratively will other members of the healthcare team, with the primary purpose being to best meet the health needs of the consumer.
“Not surprisingly, the issue has seen a heated response from doctors’ groups.
“The RACGP insultingly claimed pharmacists ‘do not have the healthcare training required to safely deliver healthcare services’, a statement that ignores the training, skills and knowledge that community pharmacists use every day when helping patients.
“The AMA said it was ‘very concerning that the discussion paper suggests that this type of prescribing is already within pharmacists’ scope of practice and very little additional training would be required’.
“Both responses from the doctors’ groups ignore the years of training undertaken by pharmacists – and indeed doctors – before they can practise. Rather they concentrate predictably on negativity which does them no credit and could ultimately serve to limit patient access to the best possible healthcare.”