AMA NSW and the RACGP say the move is ‘politically driven’, a 'conflict of interest’, and ‘reckless’.
At last week’s Pharmacy Guild conference, NSW health minister Ryan Park announced plans were already underway to expand pharmacists’ scope to include the treatment of several acute conditions – with no mention of a preceding pilot.
According to Pharmacy Daily, and unbeknownst to AMA NSW and the RACGP, the government will also launch a pilot in regional NSW to allow pharmacists to treat chronic conditions like asthma and chronic obstructive pulmonary disease.
This will go ahead within 12 months.
Minister Park’s office did not reply to Rheumatology Republic’s requests for confirmation of the regional pilot prior to the publication deadline.
Speaking to RR, RACGP NSW & ACT chair Dr Rebekah Hoffman said expanding pharmacy scope to include chronic diseases was a “terrible idea” for many reasons.
Complex, chronic disorders could not be managed with “five-minute medicine” and the move would fragment care, she said.
AMA NSW Councillor and Western Sydney GP Dr Ken McCroary told RR that, increasingly, the AMA and the RACGP were consulted by the government for appearance’s sake.
“It’s all smoke and mirrors,” he said.
“If [the government] are saying they’re thinking about a trial going ahead, then you can guarantee it’s going ahead regardless of feedback from any medical organisation or any concern for patient safety, ongoing fragmentation of care, deteriorating antibiotic stewardship, the development of multi-resistant microbials, the poor outcomes, increased burden on the health system … if the minister wants to do it because it might be convenient, it will happen.”
Dr McCroary said the announcement was “short-sighted”, “narrow-minded” and “wrong”.
Separating prescribing and dispensing, which has long been the “bedrock” of the Australian healthcare system, is on its way out, he said.
Dr Hoffman said she was hopeful there would be an opportunity to work with NSW Health to design a pilot and called on the government to evaluate previous community pharmacy trials before spending money on further expansion.
The acute conditions expansion will enable pharmacists who have completed a year-long training course to treat acute nausea, ear infections, minor wounds, reflux, acne and musculoskeletal pain.
A far cry from the 10-plus years it takes to become a specialist GP, said Dr Hoffman.
NSW health is currently working with universities to develop the training.
Dr Hoffman labelled the policy “politically driven” and said it disregarded patient safety.
“The NSW Government is kidding itself if it thinks this move will do anything to reduce pressure on the state’s overflowing hospitals. If anything, it will have the opposite effect,” she said.
“We know from the UK that letting non-medically trained health professionals do the work of GPs results in much higher rates of incorrect treatment, delayed diagnosis and serious illnesses being missed.”
Dr Hoffman said prescriptions protected health, which is why the TGA mandated them.
“State governments like NSW are incredibly reckless in bypassing our national regulations for the safe use of medicines, without even piloting it to see the impact on patients’ health outcomes,” she said.
“NSW is on a trajectory towards a two-tier healthcare system in which those who can afford GP care can see it, while everyone else will have to settle for ‘cheaper’ services at a retail pharmacy.”
The changes mirror a pilot being undertaken in Queensland. Any pharmacists who have completed the Queensland pilot training will be able to deliver some of these services in NSW from January 2025.
Beyond that, the roll out could commence as early as 2026.
Pharmacy Guild of Australia NSW branch president David Heffernan said that vaccine provision during covid and the UTI trials showed pharmacists “are able to offer more of the everyday healthcare patients need”.
The NSW community pharmacy trial began with phase one, involving treatment of UTIs, which was completed in May this year.
Despite a lack of evaluation of the trial, the government transitioned UTI treatment into usual pharmacy care from June this year.
The final stage, involving the treatment of minor skin conditions is set to run until early 2025, with an evaluation of all three stages due in 2025.
Pharmaceutical Society of Australia (PSA) NSW President Luke Kelly touted the “success” of the NSW pharmacy trial, despite the lack of evaluation.
The NSW government reiterated that the moves were part of an effort to “alleviate pressure on GPs”, despite pharmacy scope expansion continuing to attract ire from the profession and other medical bodies.
