July 2021

Issue 29 - July 2021


Chair’s message

This month, we have two main stories I’d like to highlight.

The Board and the Australian Pharmacy Council (APC) are developing new intern assessment tools and a trial of the proposed tools is scheduled to begin this August. See the story below for details.

Ahpra and the National Boards recently published a joint statement: No place for sexism, sexual harassment or violence in healthcare. We encourage you and your staff to speak up about disrespectful behaviour and unprofessional conduct. Read more below.

In other news, we have been continuing to engage with stakeholders about the risk of errors involving methotrexate. Please ensure your own processes, and those of the pharmacy where you are practising, support you to carry out your professional responsibilities in the safest way possible.

I'd also like to welcome Dr Janet Preuss to the Board. Dr Preuss has been appointed by Health Ministers as an acting community member. The communiqué announcing National Board appointments is published on the Ahpra website.

Brett Simmonds

Chair, Pharmacy Board of Australia

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Board news

No place for sexism, sexual harassment or gendered violence in healthcare

There is no place for sexism, sexual harassment or gendered violence in healthcare. Ahpra and National Boards want to remind registered health practitioners of their professional obligations and encourage speaking up about disrespectful behaviour and unprofessional conduct in healthcare.

The Australian Health Practitioner Regulation Agency (Ahpra) and the National Boards have published a joint statement, No place for sexism, sexual harassment or violence in healthcare.

Our expectations of practitioner conduct and respectful, professional behaviour, including maintaining appropriate professional boundaries, are set out in the Board’s Code of conduct.

Practitioners must always treat patients, consumers, students, employees and colleagues with respect. They must always communicate professionally and respectfully with and about others, including when using social media. Respect is a cornerstone of good, professional practice and it is fundamental to the Australian community’s trust in registered health practitioners.

There is no place for sexism, sexual harassment or gendered violence in healthcare. Ahpra and National Boards explicitly condemn this behaviour by registered health practitioners.

Ahpra and the National Boards encourage all registered practitioners to speak up if they witness or experience disrespectful behaviour or unprofessional conduct. Together, we can all help build and maintain a culture of respect in healthcare that facilitates better patient outcomes and contributes to safer care.

Read our joint statement for more information about where and how to raise concerns about disrespectful behaviour and unprofessional conduct in healthcare. Concerns about a registered health practitioner’s unprofessional conduct, including sexual harassment, should be reported to Ahpra. For more information, visit the Ahpra website.

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Structured tools for assessing interns

In collaboration with the Australian Pharmacy Council (APC) we have been developing structured tools for assessing interns. This work follows finalisation of the Intern Year Assessment Blueprint which is now mapped to the new pharmacy student and intern Performance Outcomes Framework.

During the internship year, supervising pharmacists and preceptors are expected to assess and provide feedback on the knowledge, skills, and performance of the intern so that experiences can be built upon, and difficulties identified and remediated.

The Board’s survey, The intern training experience from perspective of the intern and preceptor – a large scale study, found that the majority of pharmacists and interns agreed that the internship period gave them the necessary skills and knowledge to practise independently as a pharmacist.

Preceptors were most concerned about workload and support.

Key concerns raised by interns included:

  • preceptor teaching skill and ability to provide feedback
  • preceptor time spent with interns, and
  • preceptor rapport, interest, and enthusiasm for teaching. 

Improving the internship experience by providing more structured assessment tools will ensure that interns are achieving the performance outcomes necessary for general registration. These structured assessment tools aim to:

  • support intern learning and reflective practice
  • help preceptors provide better feedback to interns, and
  • improve interaction and time spent between preceptors and interns to support intern learning.

Supervision of an intern already requires a significant amount of work, and the introduction of new assessment tools may increase the time commitment for both preceptors and interns. We realise that many preceptors will be quite familiar and comfortable with the use of the proposed types of assessment tools, while others will have minimal experience with them. With your help, we aim to make the tools easy to use and applicable across a range of internship sites.

APC sought feedback through consultative workshops and an open consultation between May and July 2021. A trial of the proposed tools is scheduled to begin in August this year.

For more information about this project and the proposed intern assessment tools, please write to APC at projects@pharmacycouncil.org.au.

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Registration

Pandemic response sub-register extended for 12 months

The pandemic response sub-register will remain open for another 12 months. The Australian Government asked for the extension to support the national COVID-19 vaccination effort.

Pharmacists (as well as medical practitioners, nurses, midwives and Aboriginal and Torres Strait Islander Health Practitioners) who are already on the sub-register will remain on it until 5 April 2022. Their registration will be limited to helping with the COVID-19 vaccination rollout.

If you are on the sub-register, you don’t have to do anything to stay on it and no fees apply. You are not obliged to practise and can opt out or remain on the sub-register. If you remain on the sub-register, you might be contacted by health department representatives to see if you wish to support the vaccination rollout.

You can opt out for any reason and do not need to say why.

The sub-register was established in April 2020 as a temporary measure in response to COVID-19.

More information about the sub-register is available on the Ahpra website.

Latest workforce data released

The Board’s registration data report for 1 January to 31 March 2021 is now available. As of this date, there were 35,182 registered pharmacists in Australia. Of these:

  • 32,312 had general registration
  • 1,790 had provisional registration
  • 1,070 had non-practising registration, and
  • there were 10 pharmacists with limited registration.

A total of 1,933 pharmacists who are part of the short-term pandemic response sub-register are included in the number of pharmacists holding general 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

Resources to support dispensing of opioid medicines

During 2020, several regulatory changes were implemented by the Australian Government to minimise harm caused by opioid medicines. We would like to remind pharmacists of some of the resources available to help you support your patients to use opioid medicines safely.

The Pharmaceutical Society of Australia (PSA) released a new Cautionary Advisory Label (CAL) for pharmacists to use when dispensing opioid medicines. The CAL states, ‘Use of this medicine has the risks of overdose and dependence’ and was released in July 2020 to address the risk of harm from opioids. To coincide with the release of this CAL, PSA also developed an Opioid medicines patient information sheet that can be used as supporting information for the CAL.

The Therapeutic Goods Administration has an Opioid resources webpage which provides tools and resources for health professionals and patients on pain management services.

We encourage you to use the available resources, including 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.

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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.

Disrespectful communication

It was alleged that a pharmacist acted in a rude and aggressive manner towards the notifier and a family member who was considered an at-risk patient. Read more on the Board’s Case studies page.

Pharmacist-administered vaccinations

There are differences in the pharmacist-administered vaccination programs across the states and territories. All pharmacists who are authorised to administer vaccines must be familiar with the pharmacist-administered vaccination program in the state or territory where they practice.

Pharmacists are authorised to administer vaccines in a state or territory if they have met the requirements set out by the local health department, including training requirements. Pharmacists practising in different states and territories (for example locum pharmacists) will need to ensure they are aware of any differences in the requirements and the local pharmacist-administered vaccination programs. This includes differences in the types of vaccines and the minimum age of patients who can be vaccinated.

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Alerts

Information for practitioners on voluntary assisted dying law in Western Australia

The Voluntary Assisted Dying Act 2019 (WA) (the Act) came into full effect on 1 July 2021. Registered health practitioners need to be aware of the Act and its requirements. There are some provisions that are relevant to all registered health practitioners (and healthcare workers) and some provisions that are more specifically relevant to medical practitioners, nurse practitioners, pharmacists and paramedics.

Resources have been developed by the WA Department of Health and the Voluntary Assisted Dying Implementation Leadership Team in collaboration with stakeholders. These are available at: https://ww2.health.wa.gov.au/voluntaryassisteddying and include the WA Voluntary assisted dying guidelines.

The following resources provide a starting point for health practitioners in understanding their obligations, responsibilities and protections under the Act:

For further information, visit the website.

Information for practitioners on changes to Queensland Criminal Code: Child Sexual Offences

As of 5 July 2021, Queensland’s Criminal Code Act 1899 is amended under the Criminal Code (Child Sexual Offences Reform) and Other Legislation Amendment Act 2020 to include two new offences (Criminal Code, Chapter 22 – Offences against morality):

  • ss. 229BB – Failure to protect a child from a sexual offence: will make it an offence to fail to protect a child from a sexual offence in an institutional setting. The offence will be punishable by up to five years’ imprisonment for an ‘accountable person’ who fails to protect a child from a sexual offence.
  • ss. 229BC – Failure to report sexual offending against a child to police: will make it an offence for any adult not to report sexual offending against a child by another adult to police. This obligation extends outside of the workplace to our responsibility as members of the Queensland community to protect children. The offence will be punishable by up to three years’ imprisonment for any adult who fails to report child sexual abuse to police.

The offences recognise the difficulties victims have in disclosing or reporting abuse, the vulnerability of children, and the risk that perpetrators of child sexual abuse may have multiple victims and may continue to reoffend against particular victims over lengthy periods of time.

The Criminal Code amendment does not replace the mandatory reporting obligations of doctors and registered nurses under the Child Protection Act 1999 (Qld) (the CP Act).

This advice applies to all registered health practitioners; for further information please visit: www.qld.gov.au/law/crime-and-police/types-of-crime/sexual-offences-against-children.

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Regulation at work

Latest court and tribunal cases

We regularly publish court and tribunal summaries for their educational value for the profession. Links to past and recent tribunal cases can be found on the Board’s Pharmacy regulation at work: tribunal decisions page. Here are the recent tribunal cases.

Pharmacist fined $38,000 for practising while suspended

A New South Wales pharmacist who continued to practise after his registration was suspended has been convicted and fined a total of $38,000 following charges filed by Ahpra. Read more in the news item.

Pharmacist reprimanded for having personal relationships with two patients

A tribunal has reprimanded and imposed conditions on a pharmacist’s registration for professional misconduct by having personal and sexual relations with two patients. Read more in the news item.

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Students and graduates

Professional indemnity insurance: what you need to know

Did you know that once you are a registered pharmacist, including holding provisional registration, you must be covered by your own or third-party professional indemnity insurance (PII) arrangements?

If you are a final year student applying for provisional registration this year, make sure you also take out insurance cover or confirm with your employer that you are covered by their insurance policy. If you are covered by your employer’s PII this will usually only cover you for supervised practice at your employment location.

As stated in the Board’s Registration standard: Professional indemnity insurance arrangements, pharmacists with provisional registration must maintain the appropriate level of individual PII cover while practising. The standard provides further information including the level of cover required and what your PII cover must include.

Learning from errors and incident trends

Reading case studies and tribunal decisions is a great way for pharmacy students to learn about things that can go wrong in practice and how to avoid these happening. We highlight new case studies and court and tribunal cases published on the Board’s Professional practice issues page in each newsletter.

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National Scheme news

Promotion of COVID-19 vaccinations: further information

The Therapeutic Goods Administration (TGA) and Ahpra have released a joint statement about the promotion of COVID-19 vaccinations and responsibilities practitioners and others have under the Health Practitioner Regulation National Law (the National Law) when advertising a regulated health service.

On 7 June 2021, the TGA issued updated guidance about the promotion of approved COVID-19 vaccines to clarify the way health practitioners and others can communicate to the public about COVID-19 vaccines.

This updated guidance gives health practitioners greater flexibility to openly discuss vaccination and allows offers of reward to be made to those fully vaccinated under the Australian Government’s COVID-19 vaccination program.

Here are some key points that the statement helps to clarify:

  • All promotion of COVID-19 vaccines must comply with the TGA’s guidance, including where health practitioners and regulated health service providers offer rewards for COVID-19 vaccination.
  • Where promotion of COVID-19 vaccines involves advertising of regulated health services it must comply with both the TGA’s guidance and advertising requirements of the National Law, as explained in the Guidelines for advertising a regulated health service.
  • The TGA’s guidance and the advertising requirements of the National Law do not apply to information about COVID-19 vaccines provided as part of a consultation or treatment.

When communicating about COVID-19 vaccines, be mindful of your professional obligations under the Board’s Code of conduct. All National Boards have issued a position statement to provide further guidance about how the Boards’ codes of conduct apply to COVID-19 vaccination.

The TGA, Ahpra and the Board support vaccination as a crucial part of the public health response to the COVID-19 pandemic. Many pharmacists have a vital role in COVID-19 vaccination programs and in educating the public about the importance and safety of COVID-19 vaccines.

More information

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Guidance on reflective practice reports

New guidance is now available for practitioners who are subject to education or mentoring conditions as part of their registration.

The new guidance: Information sheet – Reflective reports (Education) and Information sheet – Reflective reports (Mentoring) is published in the Monitoring and compliance section on the Ahpra website.

‘This new guidance will make it easier for practitioners to draft a reflective practice report to the satisfaction of the relevant Board,’ Ahpra’s National Director of Compliance, Jason McHeyzer, said.

The guidance on developing a reflective report is endorsed by the Pharmacy Board.

National Boards have also approved a new form for review of conditions of undertakings (form ARCD-00) which is published on the Registration Common forms page. Ahpra is also developing guidance for practitioners on the information required by National Boards when considering applications to change or remove conditions or undertakings.

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Improvements made to notifier confidentiality safeguards

All improvements recommended in the National Health Practitioner Ombudsman’s (NHPO) Review of confidentiality safeguards for people making notifications about health practitioners have now been implemented or are underway.

The review found that Ahpra’s management of confidential and anonymous notifications offered reasonable safeguards for notifiers and was consistent with the practices of other regulators globally.

The NHPO recommendations to strengthen Ahpra’s policies, guidance, communications and systems to further mitigate risk of harm to notifiers have now been implemented. These include:

  • updating relevant policies to reflect that possible confidentiality safeguards for the notifier will be considered when assessing each new notification
  • publishing an updated privacy policy and collection statement to clarify how personal information will be used and disclosed, and
  • providing new guidance to staff about how to safeguard confidentiality, including in relation to redacting a notifier’s information and sharing a notifier’s information with the relevant practitioner.

As part of this work, we also recognised the importance of procedural fairness for practitioners. Following consultation with professional associations and professional indemnity providers, we have published a new guide for staff to help them manage complaints which may have insufficient detail to allow practitioners to respond meaningfully.

We have also published a vexatious notifications framework and introduced new training for staff in how to identify and manage vexatious complaints.

For more information, read the news item.

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Check out the latest podcasts

Ahpra hosts conversations and interviews with people in our community. We discuss current issues, address myths and common questions, and think about what we can do to best protect the public and support the safe provision of healthcare in Australia.

The Taking care podcast series offers professional and consumer perspectives on current issues and answers some frequently asked questions about public safety in healthcare. Ahpra releases a new Taking care episode fortnightly.

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

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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 9285 3010 (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 26/07/2021