PSR weighs into NQ pharmacy trial

The Professional Services Review (PSR) has raised concerns about the North Queensland pharmacy prescribing trial, warning that it is inconsistent with Commonwealth law.

The proposed trial sits firmly within PSR’s focus to protect patients from the risks associated with inappropriate practice and prevent the Commonwealth from having to meet resulting medical and health service costs.

AMA President Dr Omar Khorshid wrote to PSR Director Professor Julie Quinlivan in early February expressing concerns about the lack of regulatory oversight of the proposed pilot, which would allow pharmacists to diagnose, treat and prescribe for 23 serious conditions without any medical guidance or oversight.

The PSR’s latest quarterly report says Prof Quinlivan conveyed concerns over compliance and regulation with the Commonwealth Department of Health at a meeting on 10 February.

“The Director raised concerns that the proposed pathway for pharmacy prescribing appears to have no external independent regulatory or compliance oversight that allows external evaluation of inappropriate practice in relation to prescribing,” the PSR said.

“The trial is also inconsistent with Commonwealth legislation that identifies the clinicians that may prescribe medications, and this does not include pharmacists. These are two significant concerns.

“There are clear regulatory and compliance pathways to review the activity of clinicians who currently prescribe under the PBS.”

Prof Quinlivan told newsGP that there is no legislative basis to provide external regulatory oversight for pharmacists prescribing PBS medications, meaning there is no pathway to review inappropriate prescribing that causes patient harm.

“[The pilot] does not include a requirement that pharmacists implement a recognised system of medical record keeping so that consultation records are able to be retained for statutory periods and able to be independently reviewed by an external regulator to ensure that prescribing was appropriate,” she said.

“All other professions have a requirement that patient records must be kept that enable another practitioner to read the records and safely provide ongoing patient care.”

The pilot would allow pharmacists to prescribe a number of Schedule 4 (S4) medicines that can currently only be prescribed under the guidance of a doctor, including the oral contraceptive pill.

The Therapeutic Goods Administration (TGA) recently reviewed applications to downschedule the contraceptive pill and decided that it should remain a prescription medication for patient safety reasons.

However, the NQ trial would allow pharmacists to sell the contraceptive pill over the counter.