Pharmacy Guild's 'misconceived' take on ambulance ramping

Despite the AMA expressing concern about serious risks to patient safety posed allowing pharmacists to prescribe Schedule 4 and 8 medications, the Guild has used the AMA’s commentary on ambulance ramping to back up its own call to expand pharmacy led care.

A press release distributed by the Guild quoted AMA National President Dr Danielle McMullen who described ambulance ramping as a "whole-of-system problem".

Guild President Professor Trent Twomey said it reinforced the need to make better use of Australia's highly skilled health workforce and that community pharmacists were well placed to be part of the solution.

"Expanding access to pharmacy-led care will help patients receive the right care, at the right time, in the right place — improving access, strengthening primary care and supporting better health outcomes for Australians,” Professor Twomey said.

AMA (WA) President Dr Kyle Hoath described the suggestion as “misconceived”.

“The AMA (WA) supports better access to timely care, but access must be safe, clinically appropriate and properly governed,” he said.

“Pharmacists are highly skilled in medication management and play an important role in dispensing medicines, advising patients and supporting the broader healthcare team.

“However, the diagnosis and management of medical conditions should be left to doctors who have extensive medical training, clinical assessment, continuity of care and accountability.”

Dr Hoath said successive national governments had failed to address the underlying issue of specialist general practitioner access around the country.

“The notion of pharmacy-led prescribing as a potential solution to ambulance ramping is misconceived,” he said.

“The Federal AMA’s Ambulance Ramping Report Card identified a whole-of-system problem driven by record ambulance demand, public hospital access block, workforce shortages, insufficient hospital capacity, and gaps in general practice, aged care, prevention and early intervention — not a problem that can be solved by substituting specialist GP-led care with autonomous pharmacy prescribing.”

Dr Hoath said the solution was greater investment in general practice, early intervention, aged care, hospital capacity and the health workforce.

“Shortcut models that fragment care or shift clinical risk onto patients and pharmacists do not address the underlying causes of ambulance ramping.”

In a submission to the Pharmacy Board of Australia's (PBA) consultation on expanding pharmacists prescribing the AMA warned of patient safety concerns. The PBA has proposed a national endorsement to underpin autonomous pharmacist prescribing.

The proposal would see endorsed pharmacists become qualified to autonomously prescribe Schedule 4 and Schedule 8 medicines, where authorised by state and territory legislation. The AMA has consistently pushed back on the proposal.

“State/territory health ministers have embarked on an experiment with pharmacist prescribing, which contrasts with the collaborative models that are dominant in other countries, and the PBA looks to be facilitating this approach,” the AMA's submission reads.

“The AMA remains deeply concerned with the expansion of prescribing being handled on a profession-by-profession basis. We understand Ahpra is working to determine a framework for the expansion of scope of practice and suggest the PBA’s proposal should be delayed until that process is complete and/or consider undertaking an independent assessment for the proposed changes."