Queensland pharmacy pilot left sitting on tarmac

After two years of noise and controversy, the start date for the prescribing trial passed in silence, suggesting it has been delayed.

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The pharmacists are trained, the price schedule is released and the complaints form is live … but there’s still no word on when the long-awaited Queensland pharmacy prescribing pilot will actually begin.  

The Queensland Health webpage only states that the pilot services will be available at participating pharmacies in north Queensland from March 2024, but doesn’t specify the date.  

As of midday on Monday 4 March, neither Queensland Health nor the state Health Minister nor the Pharmacy Guild had released a statement signalling that it had commenced or even giving an indication that it is about to start.  

Queensland Health confirmed with The Medical Republic today that there would be an announcement about the pilot toward the end of the month. They could not confirm its content. 

This all suggests the pilot has been delayed until at least April.  

There’s precedent for the trial having been delayed, too – it was due to commence “any day now” as early as June 2022.  

Queensland Health’s silence has not escaped the notice of AMA Queensland.  

“We are already into March but there has been no official advice to medical associations and no information to share with doctors and the community about what is happening,” branch president Dr Maria Boulton said.  

The Brisbane GP told TMR that she had met with the state’s Chief Health Officer and Queensland Health Director General last week and was told that they intended for the trial to start in the first quarter of this year but were unable to give an exact date.  

“We need to ensure that all the doctors in Queensland – public, private, GPs and non-GP specialists alike – be advised of when the trial starts, what the trial is about, and what the feedback mechanisms are,” she said. 

“Because this is something that wasn’t done with the UTI pilot. As such, feedback was not collected in the way that it should have been collected.”  

Dr Boulton was particularly concerned about the potential for misdiagnosis under the trial and the consequences that may have for patients.  

Asthma is a particularly pertinent example, given that pharmacists will be allowed to refer for spirometry testing, or even conduct it themselves.  

“If a patient goes to a pharmacist, why should they pay to have spirometry done?” Dr Boulton said.  

“They may have had it done already, but the pharmacist won’t know because they won’t have visibility over that patient’s chart.” 

Patients will have to pay completely out of pocket for any pathology ordered as part of the program.   

“Another particular issue we’ve raised is that pharmacists are not trained to interpret investigation results,” she said. 

“Spirometry interpretation is not simple and if you … misdiagnose someone with asthma, for example, that misdiagnosis will follow that patient around when it comes to things like seeking insurance.”  

Limited new information was uploaded to the official Queensland Health site at the tail end of last week.  

This included the long-awaited consult price schedule.  

Patients will be charged $18.85 for consults that last less than 10 minutes, $35.45 for “standard” consults of between 10 and 20 minutes and $68.10 for consults over 20 minutes. 

These roughly correspond to an item 3 level A consult, which has a Medicare rebate of $18.95, an item 23 level B consult, which has a Medicare rebate of $41.40, and an item 36 level C consult, which has a Medicare rebate of $80.10. 

Patients cannot claim a Medicare rebate for pharmacist services.  

They also have to pay full price for any medicines they may be prescribed as part of the consult, because pharmacists cannot write a PBS script.  

The official feedback and clinical incident form is also live now.  

TMR understands that this is the primary way for both patients and doctors to log any issues like misdiagnoses or missed diagnoses that arise as a result of the trial.  

The Pharmacy Guild was contacted for comment but did not respond before deadline.  

It’s also been silent on the outcome of the eighth Community Pharmacy Agreement negotiations, which were meant to have concluded before 1 March.  

As reported in the Australian Journal of Pharmacy, the Guild sent a message to members last Friday indicating that talks were ongoing but that it had not received an “acceptable offer” from the government yet.