August 2020

Issue 25 - August 2020


Chair’s message

For many of us, the COVID-19 pandemic has profoundly changed daily life in the space of just a few months.

Pharmacists, like other health practitioners, have been challenged with navigating these changes while continuing to provide safe care to their communities who need their support and expertise more than ever before.

There will possibly be more challenges ahead of us in the weeks to come and I am sure that dedicated pharmacists across Australia and their support staff will prepare to meet those challenges head-on.

On behalf of the Board, I offer a heartfelt thank you to the pharmacists who continue to demonstrate extraordinary leadership during this unprecedented time. Patients and communities around the country are staying safe and healthy because of the work you do; thank you for your significant contribution.

Brett Simmonds
Chair, Pharmacy Board of Australia

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Board news

Supervised practice and examinations for interns

On 30 April 2019, the Board published its decision to modify some of the requirements for general registration during COVID-19. You can read more in the news item.

We also published three new documents to help interns understand the changes:

  • Schedule of oral examinations 2020
  • FAQs for the June 2020 oral examination, and
  • Pharmacy oral examination (practice) candidate guide − COVID-19 addendum.

More information on the changes can be found on the Internships page of the Board’s website.

In response to the pandemic, the Board and Ahpra changed the format of the June oral examination from a face-to-face exam to an online exam delivered through a video conference platform. This ensured that the exam could continue as planned despite the restrictions that were in place and ensured the safety of all participants.

The Board thanks everyone involved in the successful delivery of the exams. This includes the Ahpra Clinical Advisors and Examination Team as well as the dedicated pharmacists who took on the role of examiner. We also thank all the exam candidates for their understanding during this time.

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Review of registration standards and guidelines

Under the National Law1 , the Board must develop registration standards to be approved by Ministerial Council and may also develop and approve codes and guidelines. When the Board develops a registration standard or a code or guideline it must ensure there is wide-ranging consultation about its content.

The Board has committed to review its standards and guidelines at least every five years. This means that we are due to begin reviewing many of our registration standards and guidelines this year.

There are many steps involved in the consultation process which are outlined on the Procedures page of the Ahpra website. The Board plans to start preliminary engagement with targeted stakeholders on its Guidelines on compounding of medicines shortly. When we reach the public consultation phase the consultation will be published on the Board’s website on the Current consultations page and all stakeholders will be notified.

The existing documents will remain in force until the completion and publication of revised registration standards and guidelines.

The Health Practitioner Regulation National Law, as in force in each state and territory.

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Review of confidentiality safeguards for notifiers

Ahpra has welcomed the independent review by the National Health Practitioner Ombudsman and Privacy Commissioner (NHPOPC) of the confidentiality safeguards in place for individuals making notifications about registered health practitioners.

The review was conducted at the request of Ahpra following the conviction of a general practitioner for the attempted murder of a pharmacist who had made a notification about his prescribing practices.

The Board welcomed the National Health Practitioner Ombudsman and Privacy Commissioner Ms Richelle McCausland to a recent Board meeting and we were pleased to see the review report and Ahpra’s response to the recommendations published in June.

You can read more about the review as well as Ahpra’s response to the recommendations from the report in the news item.

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Profile

Meet the Board: Hannah Mann

Hannah MannIn this newsletter we chat to Board member Ms Hannah Mann about her practice as a pharmacist. Hannah is the Board’s practitioner member from Western Australia and is currently serving her first term on the Board.

During the fourth year of her pharmacy degree, Hannah undertook a placement in Broome which unexpectedly put her on a different path to the hospital pharmacy career she thought she would pursue. This path would lead Hannah to work in community pharmacy and Aboriginal health services, providing outreach pharmacist support to remote communities and towns that have no pharmacy.

Hannah has now been a pharmacy owner for 10 years with three very different pharmacies, all in the Kimberley region, and does educational work with pharmacy students and Aboriginal and Torres Strait Islander Health Practitioners. Her role also involves policy and governance work, clinical reviews, patient education, supporting other health professionals in the clinics, and program development.

Working with remote communities is an amazing experience and has taught me so much about healthcare and life. Working in rural Australia connects you to people with incredible stories which change the way you view healthcare and what is important as a health professional.

Hannah’s experience in rural and remote healthcare and her work in policy and governance in the Kimberley region sparked her interest in health practitioner regulation. Hannah feels that her work in Aboriginal health continues to highlight the importance of supporting culturally safe pharmacy practice.

Culturally safe practice is not an optional extra – it’s something we all as pharmacists need to be working on.

The COVID-19 pandemic, as for many pharmacists, had a big impact on Hannah’s practice. Remote trips were placed on hold, so rapid medication mobilisation to remote areas was required. Patients in remote communities were in isolation, people were in communities or towns in which they did not usually live due to border closures, and some patients wanted to head out bush to avoid any risk of becoming infected with the virus.

As managing health services and patients’ medicines remotely is central to Hannah’s work, the infrastructure and logistics were already in place to act immediately to support the clinics and patients to ensure medicines were accessible when they were needed. The community pharmacies (like many) had to make changes − working in split shifts, extending opening hours, delivering medicines to homes and hotels, seeing people in the carpark and doing more phone consults.

I am very proud of how well the Kimberley has worked as a team across all aspects of health to manage what could have been a terrible situation, given we had positive cases in small remote towns. COVID-19 has also highlighted the need to address housing and access to affordable food in remote communities. 

If you would like to hear more about Hannah’s experience working in rural and remote areas, tune into Ahpra’s podcast A glimpse of healthcare in our rural and remote communities, part of its Taking care series. Read more about the podcast on the Ahpra website.

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Registration

Pandemic response sub-register

On 6 April 2020 the short-term pandemic response sub-register established by Ahpra and National Boards came into effect. The aim of the sub-register is to help with fast-tracking the return to the workforce of experienced and qualified health practitioners. Over 40,000 doctors, nurses, midwives and pharmacists were added in the first phase and an additional 5,000 diagnostic radiographers, physiotherapists and psychologists in the second phase later that month.

The sub-register operates on an opt-out basis with eligible practitioners added to the pandemic sub-register automatically. There is no obligation for anyone added to the sub-register to practise or remain on it. They can opt out at any time for any reason. Only those who are properly qualified, competent and suitable should be on the register.

As of 23 July 2020, there are 1,952 pharmacists on the pandemic response sub-register.

Pharmacists who choose to stay on the pandemic sub-register and go back to work, must comply with the Board’s Code of conduct, professional indemnity insurance requirements and work within their scope of practice. After 12 months, they will be removed from the sub-register. If they would like to continue practising after that time, they will need to apply for registration through the standard process.

More information, including FAQs for practitioners and employers, is available on the Ahpra website:

Latest workforce data released

Registration data for the period 1 January 2020 to 31 March 2020 is now available. It shows that at this date, there were 32,777 registered pharmacists in Australia. Of these, 29,620 had general registration, 1,865 had provisional registration and 1,274 had non-practising registration.

For more data, including registrant numbers by age, gender and principal place of practice, visit our Statistics page.

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Practice advice

New case study published

The Board publishes case studies to help pharmacists understand and meet their professional and legal obligations. A new case study was published this month:

Brand substitution

It was alleged that the practitioner dispensed a different brand of warfarin to the patient than what they were currently taking. You can read more on the Board’s case study page.

Telehealth services

The Board’s expectation is that telehealth should only be used if it is safe and clinically appropriate for the service being provided. You must adhere to the same principles you apply when providing services during a face-to-face consultation.

Telehealth guidance has been developed outlining Ahpra and the National Boards’ expectations of how registered health practitioners will use telehealth in the context of the COVID-19 pandemic.

You should also check with your professional indemnity insurance (PII) provider to ensure your PII arrangements cover you for telehealth.

Additional resources

Member organisations such as Member organisations such as the Pharmaceutical Society of Australia (PSA), the Society of Hospital Pharmacists of Australia (SHPA) and the Pharmacy Guild of Australia (PGA) have published resources for pharmacists in relation to COVID-19 telehealth arrangements.

The Australian Government Department of Health (the Department) has partnered with PSA in developing resources for pharmacists conducting medication reviews via telehealth. There are also resources for patients receiving these services. These tools can be accessed on the PSA website.

The Department has also prepared a checklist on its website to help you comply with your privacy obligations when providing telehealth services.

Make sure to check your state and territory health department website for any additional information or resources as well.

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Electronic prescriptions

Changes have been made to Commonwealth legislation to recognise an electronic prescription as a legal form to allow medicine supply. This provides prescribers and patients with an alternative to paper prescriptions.

Since early May 2020 electronic prescriptions have started to be used in ‘communities of interest’ (COIs). COIs have been established as test sites to ensure that electronic prescriptions can be successfully implemented across Australia. There are two models for electronic prescribing, Token and Active Script List. Currently only the Token Model is being tested by the COIs but the Active Script List Model is expected to be included in testing from August 2020.

We encourage all pharmacists to keep up to date with developments in electronic prescribing so that you are ready for your patients who may request electronic prescriptions. There are several resources available from member organisations as well as from the Australian Digital Health Agency that outline the two models and how to prepare your pharmacy for electronic prescriptions.

The Board welcomed Mr Paul Naismith to its June 2020 meeting to give a presentation on electronic prescriptions. His briefing ensured that all community and practitioner members of the Board are aware of developments in electronic prescribing and the potential impacts on pharmacists and patients. The Board will continue to keep abreast of developments and during the upcoming schedule of review of our published guidelines for pharmacists, we will assess the need for any changes to reflect these developments.

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Prescription opioids – new resources

In order to minimise the harms caused by opioid prescription medicines, the Australian Government, through the Therapeutic Goods Administration (TGA) within the Department of Health, is implementing several regulatory changes. To support this initiative, the Pharmaceutical Society of Australia (PSA) in collaboration with stakeholders, has developed a new cautionary advisory label (CAL) warning of the risk of opioid overdose and dependence.

The opioid CAL along with an Opioid medicines patient information handout will be published in the Australian pharmaceutical formulary and handbook (APF).

The TGA Prescription opioids web page has further information on the regulatory changes as well as resources and information for consumers, patients, carers and healthcare professionals.

We encourage you to use the opioid CAL and Opioid medicines patient information handout during practice when appropriate. These may be useful as counselling aids when supplying opioid medicines to patients and carers. Pharmacy practice standards advise that written information such as CALs should be provided to reinforce verbal counselling. The Board’s Guidelines for dispensing of medicines also advise that routine use of ancillary labels in the APF is recommended, taking into consideration the individual patient circumstances.

In practice, you should routinely apply relevant practice standards, associated guidelines and guidance published by the Board. The Board’s guidelines advise that when considering notifications (complaints) against pharmacists, the Board will give consideration to whether a breach of its guidelines has taken place and that it will also have regard to the legislation and practice standards and guidelines relevant to pharmacy practice.

Pharmacy practice standards and guidelines can be accessed on the Pharmaceutical Society of Australia and the Society of Hospital Pharmacists of Australia websites.

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National Scheme news

Podcasts on the pandemic and beyond

Ahpra has released many podcasts on areas of interest to all health professionals in the Taking care podcast series. The topics covered in the podcasts include pandemic and non-pandemic-related issues. 

In a recent episode on Health practitioner wellbeing in the pandemic era and beyond, psychiatrist Dr Kym Jenkins, clinical psychologist Margie Stuchbery and Dr Jane Munro, a rheumatologist, share personal and professional insights on practitioner wellbeing. They discuss practical and evidence-based strategies to safeguard and support practitioners and teams through the COVID-19 pandemic and beyond.

Ahpra releases a new episode every fortnight, discussing current topics and the latest issues affecting safe healthcare in Australia. Podcasts include:

  • How is COVID-19 changing the experience of healthcare from both sides of the bed?
  • Let's meet the decision-makers
  • A glimpse of healthcare in our rural and remote communities
  • Balancing purpose and progress in regulation: Professor Kieran Walshe
  • Professor Valerie Braithwaite on the importance of trust
  • Health practitioner wellbeing in the pandemic era and beyond
  • Telehealth in the pandemic era
  • Introducing the COVID-19 pandemic sub-register
  • Dr Gerald Hickson on patient safety and high-risk practitioners
  • Eliminating racism from the health system is a team effort
  • A new look at mandatory notifications
  • Ahpra’s role in the health system
  • A view of mental health from both sides
  • The practitioner experience of a notification
  • Safe, competent and ethical health practitioners
  • Vexatious notifications.

Download and listen to the latest Ahpra Taking care podcast episode today. You can also listen and subscribe on SpotifyApple Podcasts and by searching ‘Taking care’ in your podcast player.

If you have questions or feedback about the podcast, email communications@ahpra.gov.au.

Taking care podcast image July 2020

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No place for racism in healthcare

In April, the Australian Indigenous Doctors’ Association (AIDA) issued a media release detailing instances of medical practitioners denying Aboriginal and Torres Strait Islander people access to culturally safe healthcare. They were seeking testing for COVID-19. These cases in rural New South Wales and Western Australia involved refusal of care on the grounds of patient identity and racist stereotypes of Aboriginal and Torres Strait Islanders not practising self-hygiene.

Racism from registered healthcare professionals will not be tolerated, particularly given the vulnerability of Australia’s Aboriginal and Torres Strait Islander Peoples to the virus. They continue to experience prejudice and bias when seeking necessary healthcare. Discrimination in healthcare contributes to health inequity.

We encourage Aboriginal and Torres Strait Islander people who have experienced culturally unsafe incidents of care or refusal of care by a registered health practitioner to submit a notification or complaint to Ahpra.

In February 2020, the National Scheme’s Aboriginal and Torres Strait Islander health and cultural safety strategy 2020-2025 was released,  proving our commitment to achieving patient safety for Aboriginal and Torres Strait Islander Peoples as the norm and the inextricably linked elements of clinical and cultural safety. The strategy strives to achieve the national priority of a health system free of racism.

We remind all registered health practitioners that they are required to comply with their profession’s Code of conduct, which condemns discrimination and racism in health practice.

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False and misleading advertising on COVID-19

Ahpra and National Boards recognise the vital role of registered health practitioners in treating and containing the COVID-19 emergency. We know you are working hard to keep people safe in a demanding and fast-changing environment.

A consequence of the current situation is greater public awareness of individual health and wellbeing, leading to many questions about treating and containing the disease. Members of the public are likely to seek reassurance and answers about COVID-19 from their trusted health professional. While most health practitioners are responding professionally to the COVID-19 emergency and focusing on providing safe care, we are seeing some examples of false and misleading advertising about COVID-19.

It is vital that health practitioners only provide information about COVID-19 that is scientifically accurate and from authoritative sources, such as a state, territory or Commonwealth health department or the World Health Organization (WHO). According to these sources, there is currently no cure or evidence-based treatment or therapy which prevents infection by COVID-19 and work is underway on a vaccine.

Other than sharing health information from authoritative sources, you should not make advertising claims about preventing or protecting people from contracting COVID-19 or accelerating recovery from COVID-19. To do so involves risk to public safety and may be unlawful advertising. For example, we are seeing some advertising claims that spinal adjustment/manipulation, acupuncture and some products confer or boost immunity or enhance recovery from COVID-19 when there is no acceptable evidence to support this.

We will consider action against anyone found to be making false or misleading claims about COVID-19 in advertising. For a registered health practitioner, breaching advertising obligations is also a professional conduct matter which may result in disciplinary action, especially where advertising is clearly false, misleading or exploitative. There are also significant penalties for false and misleading advertising claims about therapeutic products under the Therapeutic Goods Act 1989.

For more information, see Ahpra’s Advertising resources web page.


Keep in touch with the Board

  • Visit the Pharmacy Board website for the mandatory registration standards, codes, guidelines and FAQs. Visiting the website regularly is the best way to stay in touch with news and updates from the Board.
  • Lodge an online enquiry form.
  • For registration enquiries, call 1300 419 495 (from within Australia) or +61 3 9275 9009 (for overseas callers).
  • To update your contact details for important registration renewal emails and other Board updates, go to the Ahpra website: Update contact details.
  • Address mail correspondence to: Brett Simmonds, Chair, Pharmacy Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

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Page reviewed 3/08/2020