2 December 2019

Pharmacist prescribing linked to UK deaths

Drugs Pharmacy Policy

The British pharmacists’ defence union has urged its members to “reflect regularly on their competency”, warning that incidents of unsafe practice have emerged with the rise of independent pharmacist prescribers.

“We have seen a number of serious incidents recently and are currently in the early stages of dealing with cases where patient deaths have been reported,” the Pharmacists’ Defence Association wrote on its website.

“Some of these recent cases are linked in some way to pharmacists prescribing inappropriately or offering poor advice, often underpinned by an assumption of competence which was ill-founded and we cannot impress upon members strongly enough the importance of seriously considering their levels of experience and skill at all times BEFORE making a clinical decision and  issuing a prescription,” the message says.

The warnings will be seen as evidence supporting the stance of leading Australian medical groups’ which are opposed to pharmacist prescribing in this country.

While these UK incidents concern pharmacists working in GP practices, the message is addressed to all UK pharmacists’ association members, “because we are aware that many community and hospital pharmacists are either currently contemplating a move to GP practice-based work or are in the process of attaining their independent prescribing qualification”.

The association provides legal representation to individual pharmacists facing civil claims, prosecution, disciplinary action and employment disputes.

It warns members to use “significant levels of caution” when prescribing a medication for the first time, even when they have routinely supplied it in a community pharmacy setting, since the two settings “should not be conflated, or experience in one assumed to automatically confer expertise in the other”.

“We would urge all members with prescribing responsibilities (wherever they work) to adopt these principles in their daily practice, to regularly reflect on their competency and to contact the PDA should they find themselves expected to adopt practices which they believe are unsafe.”

The UK is regularly cited in arguments by Australian lobby groups in favour of allowing pharmacists to prescribe.

The Pharmacy Guild of Australia, however, has dismissed the UK association’s warning as “an unsurprising cautionary message from a UK pharmacist indemnity organisation, relating primarily to  independent prescribers working in GP practices – a model not being advocated by the Pharmacy Guild of Australia”.

The guild has been strongly pushing a less, not more, conservative model, however, advocating for pharmacists to be able to prescribe autonomously outside of general practice environments. The guild did not respond to further questions.

The Pharmaceutical Society of Australia said it supported all three models put up for discussion earlier this year by the Pharmacy Board of Australia, but that the “structured prescribing arrangement” and “prescribing under supervision” models were its initial priority.

“Medicine safety is everybody’s responsibility including pharmacist prescribers, which is why collaborative prescribing models are important in achieving safe and quality use of medicines,” a society representative said.