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Health Minister Greg Hunt considering ‘supervised prescribing’ by pharmacists

Health Minister Greg Hunt is considering “supervised prescribing” by pharmacists to ease pressure on the health system and free up GP appointments, after receiving the green light from the regulator.

Mr Hunt told The Sydney Morning Herald and The Age he had directed the Chief Medical Officer, Brendan Murphy, to examine the proposal, a move which comes as the powerful Pharmacy Guild continues to push for unsupervised prescribing of common medications like the contraceptive pill and travel vaccinations.

The Pharmacy Board, which regulates the profession to protect public safety, said in a position paper released this week that pharmacists are adequately trained to prescribe under supervision, with “any gaps in competencies” able to be addressed through continuing education.

Pharmaceutical Society of Australia president Chris Freeman welcomed the position paper, saying “collaborative prescribing” – where pharmacists worked closely with GPs and other doctors – could boost Australians’ access to healthcare, while also improving patient safety.

The Australian Medical Association opposes the guild’s push for independent pharmacist prescribing because it says patients would be at risk, but it supports doctor-supervised prescribing by pharmacists on the condition that doctors are in charge.

Chris Moy, an Adelaide GP who is chair of the association’s ethics committee, said if something went wrong “the doctor will be the one kicking the can”.

The AMA wants the ban on doctors owning pharmacies to be lifted so pharmacists can be embedded within GP clinics.

Dr Moy said pharmacists already worked closely with doctors – including prescribing under their supervision – in settings like palliative care and specialist clinics within hospitals, saying a similar model could work in GP practices.

Associate Professor Freeman said the continued dispensing initiative, which allows pharmacists to prescribe statins and oral contraceptives through the PBS to patients in “exceptional circumstances” where they are unable to get to the GP but have “an immediate need” for the medication, should be expanded to include other drugs.

This would address “a significant proportion of the administrative burden that community pharmacists see day-to-day, with patients running out of their medicines,” he said.

Pharmacy Guild president George Tambassis said if pharmacist prescribing was to achieve its aim of improving access to medicines, “then it has to be autonomous”, meaning pharmacists did not need supervision by doctors.

He said independent pharmacist prescribing would benefit patients who needed to get a new script for their medication after hours and on weekends “when access to other healthcare professionals is limited or non-existent”.

Royal Australian College of General Practitioners president Harry Nespolon rejected the push for pharmacist prescribing – whether supervised or independent – calling it “a solution looking for a problem”.

He said the rules should instead be changed so that patients could pick up double the amount of pills at a time for commonly-prescribed medicines, under the two-month prescribing plan that was scrapped from the federal budget earlier this year after lobbying by the Pharmacy Guild.

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