Pharmacists fresh out of uni will be allowed to prescribe and dispense for 17 conditions, despite holding only provisional registration.
As the first 175 Queensland community pharmacists begin training to diagnose and prescribe without input from a doctor, the Pharmacy Guild has revealed that some of the profession’s newest members will be in on the action.
The North Queensland Community Pharmacy Scope of Practice Pilot will allow specially trained pharmacists to prescribe for a range of conditions including acne, smoking cessation and obesity management.
The training includes 120 hours of “learning in practice”, as well as a clinical education program covering assessment, diagnosis and management of the 17 conditions included in the pilot.
Both a Queensland Health document dated October 2022 and a Queensland Health-issued pre-pilot information sheet state that participating pharmacists have to hold general registration with the pharmacy board with no limitations on their practice.
This would seemingly preclude intern pharmacists, who have graduated from a pharmacy degree but still have to rack up 1575 hours of supervised practice and pass two more exams, from participating given that their registration with AHPRA is still provisional.
The pre-pilot information sheet clarifies that 2023 pharmacy interns can enrol in the second round of education, which commences in August this year, but will not be able to do their learning-in-practice hours and finalise their training until they have general registration.
That makes Pharmacy Guild president Professor Trent Twomey’s comments at last week’s Australian Pharmacy Professional Conference somewhat perplexing.
During his speech at the opening plenary of the annual Gold Coast conference on Thursday 23 March, Professor Twomey talked up the strategic partnership between the guild and the Australasian College of Pharmacy (ACP).
“Also, due to the partnership, interns are now able to study under the North Queensland Scope of Practice Pilot in cohort two,” he said.
“This means by March 2024, interns working in the pilot area will also be able to assist patients with prescribing for everyday health conditions and the chronic disease states covered within the pilot.”
This implies that interns will be able to finalise scope of practice training before receiving general registration.
In the context of the speech, this statement was sandwiched between praise for an announcement that the ACP will provide intern pharmacists enrolled in the guild’s intern training program with complimentary medication use review training and the observation there are currently 550 interns enrolled in the guild training program.
The guild’s program is just one of six accredited programs available for pharmacist interns to choose from.
Given the context of Professor Twomey’s speech, it’s unclear whether only guild-program interns will be able to join the scope of practice pilot or whether it will be open for all.
Queensland Health has already indicated that pharmacists working in guild-member pharmacies may be eligible for an ACP scholarship to complete the prescribing training.
Under the Pharmacy Industry Award, intern pharmacists are paid a minimum $26.12 per hour in the first half of their training and a minimum $27.01 per hour during the second half.
This makes interns a fairly cheap labour source, given the minimum pay for a fully-qualified pharmacist starts at $32.08 an hour.
Experienced pharmacists have a minimum pay of $35.14 per hour, the pharmacist in charge $35.97 and a pharmacist manager $40.08 per hour.
The pilot is operating as a user-pays model and there will be no MBS or PBS involvement, essentially meaning that patients are entirely out of pocket.
The proposed schedule of fees is $20 or $25 for a consult of 15 minutes or less, $30 for an up-to-30-minute consult and $55 for everything above 30 minutes.
It’s not yet clear whether the consult fees will go directly to the pharmacist, like a contracting GP arrangement, or if it will go to the pharmacy itself as part of a salaried arrangement.
