Pharmacy Council News October 2023 

Council Message

Welcome to the October 2023 edition of the Pharmacy Council of NSW newsletter.

In this edition, we provide an update on Schedule 8 medicine destruction in community pharmacies. Also included is a link to communications from the Ministry of Health which includes information about improving SafeScript NSW data, an update on Covid-19 and influenza transmission, ATAGI recommendations for vaccination, listeria risk and an important message on summer preparedness.

The CPD year for 2023 has now come to an end and we remind all pharmacists of the importance of CPD in maintaining and improving your current levels of competency and familiarity with all aspects of your scope of practice. It is prudent to try to include some face-to-face education in your CPD plan for 2024 as this gives you the opportunity to network with other members of the profession.

As you may have seen, 25 September was World Pharmacists’ Day. In celebration of this, I’d like to thank you for continuing to have a positive impact and influence on the health outcomes of your communities.

Finally, a reminder that annual registrations are now open. When completing your renewal, please ensure that Ahpra has your correct email address as this will ensure you receive relevant notifications from Ahpra, the Pharmacy Board of Australia and the Pharmacy Council of NSW.

Veronica Murdoch
President, Pharmacy Council of NSW

Updated guidelines: Destruction of Schedule 8 medicines by community pharmacists

As of 29 September 2023, the Poisons and Therapeutic Goods Regulation 2008 will allow a pharmacist who practises at a community pharmacy to destroy a drug of addiction (Schedule 8 medicine) at the pharmacy in the presence of an *independent witness.

A pharmacist who destroys a Schedule 8 medicine must record the following in the drug register kept at the pharmacy:

(a)the date of destruction
(b) the name and quantity of the medicine destroyed
(c) the pharmacist’s name, registration number and signature
(d) the independent witness’s name, registration number and signature.

* independent witness means a medical practitioner, nurse practitioner or pharmacist who:

(a) is not employed or otherwise engaged to provide professional services at the pharmacy, and
(b) is not a family member# of the pharmacist, and
(c) if the independent witness is a pharmacist—does not have a financial interest, within the meaning of the Health Practitioner Regulation National Law (NSW), Schedule 5F, in the pharmacy.

#family member means the person’s:

(a)  spouse or de facto partner
(b)  parent or step parent, or a sibling of the person’s parent or step parent
(c)  grandparent or step grandparent
(d)  sibling or step sibling, or a child of the person’s sibling or step sibling
(e)  child or step child
(f)  grandchild or step grandchild.

How to destroy Schedule 8 medicines

Things to remember:

• Any identified Schedule 8 medicine returned by a patient must be entered into the drug register immediately on receipt listing the patient’s name, address, medicine and quantity.
• Any expired Schedule 8 medicine from pharmacy stock must be quarantined from usable stock and transferred to separate page of the register labelled for Schedule 8 medicines for destruction.
• No medicines should be discarded down the sink or into the toilet.
• Schedule 8 medicines from a private health facility or residential care facility need to be destroyed on those premises (and not returned to the pharmacy).

Methods for destroying Schedule 8 medicines

Things to have on hand:

• absorbent material such as clay kitty litter or paper towels
• liquid soap detergent and/or other detergents to render medicines “unusable”
• sharps bin and/or RUM bin
• mortar and pestle.

All Schedule 8 medicines for destruction should be removed from packaging (except ampoules) and rendered unusable.

Ampoules:  Wrap cardboard box containing the ampoules in paper towel to absorb the liquid, stomp on the box to crush the ampoules, place in a sharps container.

Liquids:  Pour into absorbent material such as kitty litter, add detergent.

Tablets/Capsules/Films/Lozenges:  Place in a heat resistant container such as a mortar and add boiling water and detergent, allow to dissolve over time, crush any remaining solids using the pestle, pour into absorbent material such as kitty litter (start with extended-release products as they take longer to dissolve).

Transdermal patches:  Remove the patch from packaging, cut patch with scissors in small pieces, add to kitty litter with detergent.

Cannabis plant material: Grind using a mortar and pestle, add detergent, pour into absorbent material such as kitty litter.

Place all destroyed materials other than sharps into a RUM bin and seal closed.

Support improving SafeScript NSW data quality

SafeScript NSW is part of NSW Health’s commitment to reduce harm from monitored medicines and help save lives. The prescribing and dispensing information in SafeScript NSW helps prescribers and pharmacists make safer clinical decisions about a patient’s care.

Pharmacists have a role in providing accurate data in our clinical systems to create a single patient record with a reliable overview of the prescribers, pharmacists and medicines used.

When dispensing Schedule 8 medicines, NSW Health asks that you:

• Ensure that you record the patient’s date of birth in your dispensing software: Please ensure that the patient’s date of birth is entered into the dispensing system. Recording the date of birth when dispensing Schedule 4 and Schedule 8 medicines is a legal requirement and helps to ensure accurate information is stored in SafeScript NSW and avoids duplication of patient records
• Ensure dispensing pharmacist details are up to date in the system: Having this information allows for the pharmacist to be contacted if needed.
• Ensure prescriber information is accurately entered when dispensing, and that the right pharmacist name is used: When dispensing, ensure that the prescriber information is correct. Check also that the pharmacist’s name is the dispensing pharmacist, not the technician or pharmacy assistant. This ensures that patient records are correctly matched, providing a more accurate patient history and reducing duplicate records in the system.
• Ensure medicine information is entered correctly: When dispensing, avoid the free text entries where possible and record dosage and quantity information accurately. The SafeScript NSW alerts and notifications rely on this information being correct for it to accurately alert/notify prescribers and dispensers about any at-risk patients.

We appreciate your support with improving data quality. If you have any questions or would like to learn more, please email MOH-PharmaceuticalServices@health.nsw.gov.au or for more information about SafeScript NSW, please email SafeScript@health.nsw.gov.au.

COVID-19 and influenza update

COVID-19 continues to circulate in the NSW community but at relatively low levels following an increase over winter. The northern hemisphere is currently seeing an increase in COVID-19 circulation.

Influenza transmission in NSW continues to decline from a peak in July and is now circulating at moderate levels in the community.  Both influenza A and influenza B circulated this winter in NSW, with influenza B predominantly affecting children. 

Listeria risk

There has been a recent rise in the number of people with invasive listeriosis being treated in hospital, as well as a steady increase in notifications, since April 2022.  

When interacting with at-risk people in the community, pharmacists and staff should take the opportunity to counsel those at risk, particularly pregnant women, the elderly and people immunocompromised by certain medications.

Be prepared this summer

Heat

Weather forecasts predict there will be hotter weather this summer. Heatwaves and shorter periods of hot weather can seriously impact people’s health.

NSW Health encourages pharmacists to discuss getting prepared for heat this summer season with people at higher risk of heat-related illness, including prompting relevant actions such as:

• being aware of the dangers of heat exposure
• recognising the signs of heat-related illness
• having a plan in place ahead of summer, such as:
  • knowing contact details for their pharmacist and GP, as well as other people who may be able to assist if in need (e.g., family, friends and neighbours)
  • getting specific advice from their GP/primary care provider on particular medical conditions
  • ensuring adequate stock of medications, food and drinks, to avoid going out in hot weather
     

2023/24 registration fees

The 2023/24 annual registration fees for NSW registered pharmacists have been set by the Pharmacy Board of Australia. The fees are:

• $543 for general registration

• $231 for provisional registration

• $543 for limited registration

• $361 for non-practising registration

The full schedule of fees is available at the Pharmacy Board of Australia website.

The annual registration fee must be paid to Ahpra. It will cover the registration period from 1 December 2023 to 30 November 2024.

The registration fee for all NSW registered health professionals under the national scheme comprises of two components:

• a registration and accreditation component that is independently determined by Ahpra and the relevant National Board
• and a complaints component that is decided by the relevant NSW Council.

The complaints component for NSW health practitioners is subject to approval by the NSW Minister for Health under section 26A of the Health Practitioner Regulation National Law (NSW).

The complaints component is a cost recovery model and is not subsidised by other health professions.

NSW Health Professional Councils and Health Professional Councils Authority joint Aboriginal Cultural Safety Strategy 2023-24

In June 2023, the NSW Health Professional Councils and the Health Professional Councils Authority (HPCA) launched its joint Aboriginal Cultural Safety Strategy.  The joint Strategy aims to improve the experiences of Aboriginal people who interact with the NSW healthcare and regulatory system.

Our Strategy aligns with existing state and national initiatives to improve health outcomes for Aboriginal people.

The Councils, HPCA and regulatory system exist for the benefit and protection of the NSW community and we acknowledge that Aboriginal people have, and continue to suffer, disproportionate levels of disadvantage, including in health outcomes.

Our Strategy aims to strengthen cultural safety within the NSW regulatory system through increased participation of Aboriginal people and collaboration with stakeholders.

Recent NSW Tribunal decisions

Health Care Complaints Commission v Yoseph Akawee

The Tribunal found Mr Akawee guilty of unsatisfactory professional conduct and professional misconduct relating to the dispensing of Schedule 8 drugs. The registration of the pharmacist was cancelled with a non-review period of one year from the date of the orders. He was also ordered to pay the HCCC's costs as agreed or as assessed.

Health Care Complaints Commission v Michael Stanley Lowe

The Tribunal found that the practitioner engaged in unsatisfactory professional conduct by failing to notify the National Board in relation to criminal charges for certain offences. The Tribunal found that Mr Lowe had been convicted of the following offences:

1. Dealing with property suspected to be the proceeds of crime contrary to s193C(1) of the Crimes Act 1900
2. Supply of prohibited drug not less than commercial quantity contrary to s25(2) of the Drug Misuse and Trafficking Act 1985

It cancelled Mr Lowe’s registration with a non-review period of three years from the date of the orders. 

Health Care Complaints Commission v Cheng-Yun (Jason) Mai

The Tribunal found that Mr Mai had been convicted of criminal offences under the Drug Misuse and Trafficking Act 1985 and the Poisons and Therapeutic Goods Act 1966 (NSW) for suppling prohibited drugs and for selling restricted substances. It determined that the practitioner had engaged in unsatisfactory professional conduct for failing to notify the National Board within seven days of being charged with a criminal offence. His registration was cancelled with a non-review period of one year from the date of the orders.

Health Care Complaints Commission v Ms Sabina Kaur Grewal

The Tribunal found that Ms Grewal had failed to notify the National Board within seven days of being charged and failed to disclose her criminal history when lodging an application for renewal of her registration. The pharmacist was also found to have breached conditions on her registration.

The Tribunal cancelled her registration as a pharmacist with a non-review period of three years. The practitioner was further prohibited from providing a health service for a period of three years and ordered to pay the commission's costs.

Useful links

SafeScript NSW is now available to all prescribers and pharmacists in NSW. If you haven’t already registered, you can do it here. 

If you need support to manage patients using monitored medicines, you can call the SafeScript NSW Clinical Advice Line anytime on 1800 434 155 or refer to your local HealthPathways for specific clinical advice for Pharmacists.

Pharmacy Council podcasts: The Council's podcasts are all now conveniently located on a single webpage.

Webinar: Council representatives were pleased to collaborate with the AJP to present a webinar discussing key areas of complaints to NSW regulators and how to avoid the regulatory pitfalls whether you are a pharmacist, proprietor or manager. We encourage you to view the webinar here.