Two states go big on pharmacy prescribing

NSW pharmacists will have the permanent power to supply the pill, while SA plans to substantially expand pharmacist prescribing from 2026.

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South Australia is following in the footsteps of New South Wales by promising a substantial expansion of pharmacist prescribing, to the continued dismay of the RACGP and the AMA. 

Meanwhile, NSW has made its trial to allow over-the-counter access to the contraceptive pill permanent. 

The shift will see all certified pharmacists able to restock the contraceptive pill for women with a two-year history of taking the medication, from Saturday. 

Taking a leaf out of NSW’s book, SA’s new program will allow pharmacists to prescribe treatments for some skin conditions – including shingles, psoriasis, dermatitis and acne, ear infections, wound management, nausea, reflux, rhinitis and musculoskeletal pain, after additional postgraduate training. 

The program may be rolled out as soon as 2026, subject to completion of training. 

According to AMA SA president and GP Dr John Williams, expanding pharmacists’ prescribing powers threatens patient safety and distracts from more pressing issues. 

“Let’s not take shortcuts with patients’ care,” he said. 

“The stakes are too high, and the consequences are too serious. 

“This conversation distracts from the main point which is that we need an urgent overhaul of Medicare to increase support for general practice.” 

The program expands on the rollout of the treatment of UTIs and resupply of oral contraceptive pill by pharmacists already underway in SA. 

Dr Williams said increasing pharmacist prescribing power posed “serious health implications” for patients, particularly in relations to UTI medication. 

“For instance, pharmacists aren’t required to test patients’ urine, which from a GP perspective is a worrying oversight,” he said. 

“This can lead to situations where patients are prescribed antibiotics whether they need them or not.  

“Often, they need further treatment because of complications or misdiagnoses.  

“GPs are highly skilled and equipped to diagnose the difference between a UTI and other serious and potentially deadly health conditions.  

“Convenience should never outrank quality GP care.” 

The RACGP also chastised the SA government over the “risky move”, which it said was “driven by political lobbying and the state’s stretched health system rather than patient needs”. 

RACGP SA chair Dr Siân Goodson labelled the move “reckless” and said it could lead to delayed medical treatment. 

“There’s a reason why doctors diagnose patients before we treat them,” she said. 

“Eczema, meningitis, and shingles look similar to an untrained eye.  

“What looks like an ‘uncomplicated’ ear infection could lead to a hearing loss or could even be cancer.  

“You need someone who’s trained in differential diagnosis to know if the right step is antibiotics, or an entirely different approach.” 

Dr Goodson hit back at what the SA government labelled “postgraduate education” for pharmacists. 

“Even someone who has finished medical school, but not trained as a GP or other specialist doctor, does not claim to be ready to make such big calls without supervision, yet the SA Government wants pharmacists to make these kinds of decisions off the back of a short online course,” she said. 

“Calling that postgraduate training is stretching the definition as far as it can go.” 

The Office of the Chief Pharmacist is currently working with education services to develop post-graduate courses for prescribing and clinical assessment.