Chair, Pharmacy Board of Australia
The Board recently published a position statement on pharmacist prescribing, and I encourage you to read it.
This position statement is the result of extensive work by the Board to examine the issue, including competency mapping and broad stakeholder engagement that saw the Board host a forum and release a discussion paper on pharmacist prescribing.
Through this work, we determined that there are no regulatory barriers for pharmacists to be able to prescribe in two of the models of care within a collaborative healthcare environment, through a structured prescribing arrangement or under supervision (as defined by the Health Professionals Prescribing Pathway).
However, prescribing under these models requires changes in state and territory medicines and poisons legislation to authorise pharmacists to prescribe and these are matters to be determined by those governments. The Board’s view is that autonomous prescribing by pharmacists requires additional regulation via an endorsement for scheduled medicines.
This year was the 10th anniversary of World Pharmacists Day, held on 25 September, and the theme was ‘Safe and effective medicines for all’. On behalf of the Board, I thank all pharmacists for playing their part in ensuring patient safety by reducing errors and contributing to the quality use of medicines. Read the news item.
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Currently in Australia, pharmacists are authorised under state and territory drugs and poisons legislation to supply Schedule 2 and Schedule 3 medicines and can authorise the supply of Schedule 4 medicines without a prescription in limited situations. Pharmacists are also authorised to administer particular vaccines subject to meeting any legislative requirements.
Changes in pharmacy practice in other countries, as well as the interest of the profession, stakeholders and the public in exploring opportunities for innovative and emerging pharmacy practice in the Australian healthcare setting, have generated interest in proposals for pharmacist prescribing.
The outcome of the Board’s work regarding prescribing by pharmacists is published in its position statement on pharmacist prescribing. You can read the position statement and FAQ on the Professional practice issues page.
The Board has approved the Accreditation standards for pharmacy degree (Australia/New Zealand) and intern training programs (Australia) (the revised accreditation standards), developed by the Australian Pharmacy Council (APC).
During 2018-19, the Board provided funding for the review of the current accreditation standards. In line with the requirements set out in the National Law , APC carried out wide-ranging consultation, completed the review in accordance with the AHPRA Procedures for the development of accreditation standards and assessed the standards against the COAG Principles for best practice regulation.
Under the objectives of the National Registration and Accreditation Scheme (the National Scheme), the accreditation standards provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered.
The APC will publish resources on its website to support the transition to the revised accreditation standards.
The Board congratulates the APC on the extensive work done to develop the revised accreditation standards. We have a strong partnership with APC and we look forward to continuing to work together.
The revised accreditation standards are published on the APC website.
Renew your registration by 30 November
Registration renewal for pharmacists with general and non-practising registration is open and we encourage you to renew your registration on time. The quickest and easiest way to renew is online.
Renewal applications received in December will incur a late payment fee in addition to the annual renewal fee. This is outlined in the National Law.
Pharmacists whose application is received on time, or during the following one-month late period, can continue practising while their application is processed.
If you do not apply to renew your registration by 31 December 2019 you will have lapsed registration. You will be removed from the the Register of Pharmacists and will not be able to practise your profession in Australia.
For more information, see:
The Board is sharing this SafeScript information on behalf of the Department of Health and Human Services. This information is specifically relevant to pharmacists practising in Victoria and follows information previously published by the Board in March 2018.
SafeScript, Victoria’s real-time prescription monitoring system, is an important clinical tool that helps pharmacists make safer decisions when dispensing high-risk medicines. SafeScript facilitates the early identification, treatment and support for patients who are developing signs of dependence.
The Department of Health and Human Services has advised it will be mandatory for pharmacists practising in Victoria to check SafeScript before dispensing a monitored medicine from April 2020.
Decisions around dispensing medicines
SafeScript can help you open conversations with patients about safe prescription medicine use. However, it does not supersede your role as a registered pharmacist in deciding whether a prescription medicine should or should not be dispensed to a patient.
Don’t ignore the red, amber and green
The notifications are an important feature of SafeScript. You need to be aware of them and understand that the red, amber and green pop-up notifications prompt you about information in the system that you need to review.
A red notification does not automatically mean you shouldn’t proceed with dispensing. Rather it indicates that some clinical risk has been identified which should be reviewed and managed appropriately.
Remember your regulatory obligations
Good professional practice, as outlined in the Code of conduct for pharmacists, involves ensuring appropriate continuity of care is provided for patients identified as at risk.
Refusing to dispense medications to patients who have been taking high-risk medicines over a long period of time, without any consideration for their ongoing care plan, may be endanger patient safety. For the patient, there are implications to discontinuing some medicines too quickly. For example, sudden withdrawal of benzodiazepines may result in rebound insomnia or anxiety or, at worst, seizures.
Not registered yet? You need to register to use SafeScript, which you can do online in 10 minutes. Over 15,000 health practitioners, including 67 per cent of Victorian pharmacists, are already registered. Join them to start using SafeScript to improve patient care.
There are many benefits for patients when you use SafeScript. However, there are also benefits for you.
Did you know you can earn CPD credit by completing the SafeScript training? Available online, this training covers planning for consultations, alternative management options and having challenging conversations.
Make sure you visit the Victorian Department of Health and Human Services’ SafeScript page, where you can find:
You can also access advice over the phone from leading addiction medicine specialists through the Drug and Alcohol Clinical Advisory Service (DACAS) (1800 812 804).
The Board has released its quarterly registration data online: read the latest report and other statistics. The data profiles Australia’s pharmacy workforce, including information on types of registration held, principal place of practice, registrant age and gender.
At 30 September 2019, there were 32,035 registered pharmacists in total, classified by registration type:
The Board publishes case studies to help pharmacists understand and meet their professional and legal obligations. New case studies published this month include:
It was alleged that a pharmacist made false and misleading declarations about meeting the Board’s recency of practice requirements on their renewal of registration applications lodged annually over the previous three years. You can read more on the Board’s case study page.
Owing to a dispensing error resulting in incorrect labelling of a dose administration aid (DAA), it was alleged that adequate procedures may not be in place at the pharmacy to manage public risk and a notification was raised in relation to the proprietors of the pharmacy. You can read more on the Board’s case study page.
Recently, jurisdictional regulatory authorities for pharmacy premises have noted a range of issues relating to compounding. This includes complex compounding, which requires or involves specific competencies, equipment, processes and/or facilities to manage the higher risks associated with preparing and dispensing these medicines.
The Board’s Guidelines on compounding of medicines provide guidance to pharmacists to ensure product quality, safety and efficacy. The guidelines are not the sole or primary source of information on compounding and make reference to other sources of information such as the Australian Pharmaceutical Formulary and Handbook.
The guidelines state that they must be read in conjunction with relevant state, territory and Commonwealth legislation, a range of other publications including codes and guidelines published by pharmacy premises regulatory authorities, and professional practice standards.
If you provide complex compounding services, you must ensure that you are competent to do so by:
The Pharmacy Council of New South Wales has recently published compounding resources to support pharmacists in understanding their professional obligations.
In 2018, the Board conducted a national survey giving interns and preceptors the chance to give feedback on their own experiences, so we can continue to improve the supervised practice process for future interns and preceptors. You can read more in the news item.
The role of the preceptor is a vital part of the intern’s development. We thank all pharmacists who take on the important role of a preceptor and contribute to the development of future pharmacists.
Are you thinking about being a preceptor to an intern pharmacist? Here we chat to two preceptors, Diana Sandulache, hospital pharmacist and Marc Segler, community pharmacist, about the importance of the intern year and the role of the preceptor.
Diana Sandulache, hospital pharmacist
Diana has been preparing for the role of a preceptor since her first days as an intern at the Royal Melbourne Hospital in 2012. Working with countless pharmacists who have acted as mentors and preceptors and reflecting on the support and mentorship she received from her own preceptor has taught Diana a lot about the role as well as helping to identify things she might do differently.
The Board’s Intern pharmacist and preceptor guide outlines how the preceptor assumes the role of teacher during the practical training period, and that the preceptor should provide positive and developmental feedback during the learning process.
‘Previously, we thought that just by being an experienced clinician, that made you a good teacher and mentor. However, we have learnt that this is not the case and we should all be developing our teaching and feedback skills’, Diana said. She continually improves her skills by identifying her own strengths and limitations, conducting tutorials and practice exams and doing formal training.
In Diana’s opinion, the most important skill is engagement with the intern. ‘You have to be invested in their development and genuinely care about their progress throughout the year. This goes hand in hand with being empathetic and able to listen to comments on non-academic issues. We need to remember what it was like for us during that time and things that may not seem important now were a big deal back then!’
For pharmacists considering taking on the role of a preceptor, Diana has the following advice: ‘Seek some formal training on feedback and teaching, such as Teaching on the Run. I also recommend approaching a more experienced preceptor to go to for advice when there is a curly situation – I still ask for help from my network across the country! And finally, always take it back to first principles. We are there to help the interns progress through their year and become qualified pharmacists. Giving constructive feedback to your intern may be uncomfortable in the short-term but it will help them immensely in the long term.’
For an intern pharmacist, this is the time to develop the competency required of a pharmacist with general registration. Some interns may struggle to find a good work/life balance in this very busy year. Diana feels that interns need to plan and organise their time to ensure they still have fun.
‘Balance is incredibly important. For many recent graduates, this will be the first time they’d be working full time. On top of this, they need to adjust to a new workplace and prepare for the intern exams. My advice is, make sure you put time aside for yourself as well, don’t expect too much from yourselves and still do relaxing activities with friends and family.’
The intern year is also a time where interns need to think for themselves and embrace the concept of lifelong learning. ‘I sometimes find my interns think that it is best to only discuss the positives about their performance, so they are perceived as more confident. However, I try to explain to them that there is much more power in being able to reflect on and identify your own areas for development, because then you can show how you are working on those. We all have areas we need to work on!’ Diana said.
Marc Segler, community pharmacist
Marc’s extensive experience over the past 37 years as a community pharmacy owner, sessional tutor at the University of Western Australia and Pharmacy Board oral examiner has contributed to his development as a preceptor. Marc’s own preceptors and mentors taught him that his intern year would form the basis of a successful and satisfying career in pharmacy. ‘During my intern year, I learnt that there is an infinite future as a pharmacist for me if only I was prepared to work hard and grasp it,’ Marc said.
The Board’s Intern pharmacist and preceptor guide states it is the preceptor’s responsibility to adapt their teaching style to one most suited to the learning style of the intern. Marc agrees and has refined his teaching skills over his many years as a preceptor. ‘People are diverse in the way they learn, engage and move forward. I quickly learnt that one way does not work for all and that approaching teaching from a number of directions was more likely to result in a better prepared intern than by sticking to the way I had always done it,’ Marc said.
Marc believes that there is no specific set of skills that a preceptor should have. Instead, a successful preceptor should be able to interact, engage and teach a theory-rich but practice-poor new intern how to apply their knowledge in the ever-expanding areas of pharmacy practice. ‘The ability to bring about an outcome is more important in my opinion than a prescribed set of qualifications,’ he said.
‘There is nothing challenging about being a preceptor other than the extra time required to turn an intern into a pharmacist,’ Mark said. ‘We were all interns at one time and our preceptors found the time and energy and patience to turn us into the pharmacists we are and now it is our turn to do the same. The reward far outweighs the effort. I encourage all pharmacists to enhance our profession by giving back and mentoring another young person to enrich our community with their developing skill sets.’
When looking for a site to do an internship, Marc suggests that prospective interns should look for a preceptor who has time to teach and a site where they will have time to learn and consolidate what they have seen and done. This year is likely to be the most important learning year as they transition to their pharmacy career and commitment to lifelong learning.
The supervised practice period is intended to be one of professional and personal maturation, leading to a level of competence that will allow independent professional practice after gaining general registration. Marc ensures that interns learn to think for themselves by not thinking for them and by encouraging them to strive to be the best they can be.
Marc feels that one of the best things about being a preceptor is ‘seeing a young person enter with theoretical knowledge and a willingness to learn, leave as a competent and caring, professional services pharmacist with a variety of skill sets that will enable them to make a difference in whatever they do next.’
In March 2017, the World Health Organization (WHO) launched their third Global Patient Safety Challenge with the theme of medication safety and aims to reduce severe avoidable medication-related harm by 50% globally in the next five years. The Challenge seeks to reduce the frequency and impact of medication errors and reduce patient harm by targeting weaknesses in service delivery and developing more effective healthcare systems. The three key action areas are polypharmacy, high-risk situations and transitions of care.
The Board encourages all pharmacists to do their part in contributing to this important initiative. The WHO website has links to further information including brochures, patient engagement tools and educational materials. You may find the patient engagement tool, 5 Moments for Medication Safety, particularly useful when discussing medications with patients.
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 Pharmacy regulation at work: tribunal decisions page on the Board’s website. Here is a recent tribunal case.
A pharmacist in Western Australia has been reprimanded, had his registration cancelled and has been disqualified from applying for registration for two years for professional misconduct. Read more in the news item.
A public consultation is now open asking for people to have their say on revised guidance to help practitioners and others understand their their obligations when advertising a regulated health service.
Alongside other National Boards and AHPRA, the Board is conducting consultations on revised Guidelines for advertising a regulated health service.
We invite pharmacists and other stakeholders to give feedback to this important public consultation. The deadline is 26 November 2019.
The consultation paper is available on the Current consultations page of the Board’s website. To make it easier to participate, you can use the online survey option to send us your feedback.