Council News December 2022

Council Message

Welcome to the final edition of the Pharmacy Council of NSW newsletter for 2022.

Webinar

Recently, 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.

Challenges for community pharmacy

In this newsletter we include an article on the challenges that community pharmacy faces during the holiday season and the importance of extra vigilance during this busy time.

Updates – Covid-19 and expansion of pharmacist vaccination program

We also include the following messages from the NSW Ministry of Health:

An update on Covid-19, vaccinations and antivirals
Information about the expansion of the NSW pharmacist vaccination program

Development of pharmacist resources

The Council continues to interact with stakeholders with the most recent Pharmacy Stakeholder Forum held on 4 November. Stakeholders identified a need for the development of resources to assist pharmacists in their clinical practice. In response, a Forum working party was established and has developed a number of resources, with more currently under development. Click here to access the Supporting resources for managing S8, S4B & S4D medicines in NSW and here for the Monitored Medicines Dispensing Flow Chart Protocol.

The next forum will be hosted by the PSA in March 2023.

Podcasts

If you have not yet listened to our first two podcasts, we encourage you to do so now. Please access the podcasts via our useful links section below.

Office closure

We advise that the HPCA office will be closed from Monday 26 December 2022 to Friday 6 January 2023. HPCA will continue to process urgent complaints during this period. Ownership applications and less urgent complaint matters will be dealt with after the office reopens on Monday 9 January 2023. If you have any queries, please contact the Council secretariat prior to the office closure on 1300 197 177. Ownership queries may be sent via our new application email address: hpca-cms-pharmacy-applications@health.nsw.gov.au

We would like to take this opportunity to wish all pharmacists and their families and loved ones a safe and happy festive season.

Veronica Murdoch
President, Pharmacy Council of NSW

Challenges during the holiday season

As the year nears its end, it is even more important for practitioners to be aware of additional time constraints and challenges faced in community pharmacy practice during the holiday season.

When the volume of work increases so, too, does the risk of error. It is critical that practitioners are vigilant and adhere to best practice dispensing guidelines.

Regular communication is a critical component of the relationship between practitioners and their non-professional staff. It is prudent to conduct staff meetings to review Standard Operating Procedures, ensure staff are aware of all policies and procedures, and confirm that there is agreement by staff on workplace policies.

Often, there is pressure during this time from patients to supply medication as an ‘emergency supply’. Please ensure you are aware of the policies and protocols to which all staff must adhere and ensure practitioners and staff abide by all legislative requirements.

During the holiday period, many patients are likely to seek early dispensing because of their travel arrangements. It is critical to abide by the legislation and guidelines applicable to dispensing prescriptions earlier than normal.

As a refresher in relation to an ‘Emergency supply’, please review this link to the relevant clauses, reproduced below, in the Poisons and Therapeutic Goods Regulation 2008:

45 Emergency supply by pharmacists otherwise than on direction of health practitioner

(1) A pharmacist may supply a person with a restricted substance (other than a prescribed restricted substance) if the pharmacist is satisfied—
(a)  that the person is undergoing treatment essential to the person’s well-being, and
(b)  that the substance has previously been prescribed for the treatment, and
(c)  that the person is in immediate need of the substance for continuation of the treatment, and
(d)  that, in the circumstances, it is not practicable for the person to obtain a prescription for the substance from an authorised practitioner.

(2) A restricted substance may not be supplied to any person under this clause unless—
(a) the quantity supplied is no more than that required for 7 days’ treatment, or
(b) in the case of a liquid, aerosol, cream, ointment or anovulant tablet that is contained in a standard pack, the standard pack is the smallest standard pack in which that kind of liquid, aerosol, cream, ointment or anovulant tablet is generally available.

45A Supply by pharmacists in accordance with determination under National Health Act 1953 of the Commonwealth

(1) A pharmacist may supply a person with a restricted substance that is covered by the Continued Dispensing Determination under this clause if—
(a)  the supply is made in accordance with conditions that are specified in that determination, and
(b)  the supply is made in accordance with the document entitled Guidelines for the Continued Dispensing of eligible prescribed medicines by pharmacists, published by the Pharmaceutical Society of Australia in 2018 and as in force from time to time, and
(c)  the pharmacist is an approved pharmacist within the meaning of the National Health Act 1953 of the Commonwealth, and
(d)  the person is in immediate need of the substance for continuation of treatment.

(2) In this clause, Continued Dispensing Determination means the National Health (Continued Dispensing) Determination 2022 of the Commonwealth, as in force from time to time.

Message from NSW Ministry of Health

COVID-19 Update

The current COVID-19 wave is expected to decrease as we enter the holiday period. There is uncertainty about the rate of case decline and the projections beyond this wave due to the diverse mix of variants circulating in the community. In addition, population mobility and social behaviour over the holiday period may contribute to transmission and influence case rates.

COVID-19 Vaccination

Continued support and promotion of COVID-19 vaccine boosters, particularly for those at high risk of severe disease, is strongly encouraged.

We ask you consider ways to encourage those who are eligible to have their COVID-19 booster vaccination and your ability to provide vaccination to priority populations. In particular consider:

discussing vaccination with people who may be at high risk of severe disease from COVID-19
discussing vaccination with Aboriginal people
working with local residential care facilities to offer booster visits

COVID-19 Antivirals

Facilitating the timely administration of antiviral medications to those eligible is vital to support the community. Pharmacists should expect increase demand for COVID-19 antivirals in coming weeks as the wave of cases peak.

NSW Health recommends people at high risk of severe disease to see their doctor to develop a plan if they get sick, including having a pre-assessment for anti-viral medications.

COVID-19 antiviral eligibility criteria was updated on November 1 to include:

Everyone aged over 70
People aged 50 years and older with TWO or more risk factors for severe disease
Aboriginal or Torres Strait Islander people aged 30 years and older at least ONE risk factor for severe illness
People aged 18 years and older with moderate to severe immunocompromised

Further expansion of current AV eligibility is likely following the recommendations made by the Pharmaceutical Benefit Scheme Committee in November. Please remain up to date with AV eligibility here.

Please encourage the community to visit their GP to discuss risk of severe illness from COVID-19 and make a plan, including vaccination and antiviral pre-assessment.

Thank you for your ongoing work to keep the NSW community safe.

Expansion of NSW pharmacist vaccination program – from the NSW Ministry of Health

The NSW pharmacist vaccination program has been expanded to include an additional six vaccines:

Hepatitis A
Hepatitis B
Japanese encephalitis
Poliomyelitis
Typhoid (IMI formulation)
Zoster (Shingrix only)

This is in addition to the vaccines that you are already able to offer:

Flu
Measles, mumps and rubella
Diphtheria, tetanus and pertussis
Human papillomavirus (HPV)
Meningococcal ACWY
COVID-19

Some of these vaccines are available from the state or National Immunisation Program depending on patient eligibility. They are also available from the private market (excluding COVID-19 vaccines).

You can order these vaccines for use in your pharmacy if you have trained and accredited pharmacist immunisers and meet any required criteria.

Additional training may be required for pharmacist immunisers to administer certain vaccines. Check the training requirements in the NSW Pharmacist Vaccination Standards.

Learn more about ordering vaccines for your pharmacy here.

Guidance to help you provide vaccinations and general travel advice has been developed and is available here.

Support materials have also been developed to promote vaccinations in your pharmacy. Print and digital resources are available here.

Recent Tribunal decisions

Health Care Complaints Commission v Hany Samir Youssef Ibrahim

The Tribunal found complaints of unsatisfactory professional conduct and professional misconduct proven. Mr Ibrahim’s registration was cancelled. He may not apply for a review of the cancellation order for 2 years.

Health Care Complaints Commission v Shilo Wannell

The Tribunal found complaints of unsatisfactory professional conduct and professional misconduct proven. The Tribunal imposed conditions on the practitioner’s registration and ordered that she be referred to the Pharmacy Council’s Health Program.

Useful links

Pharmacy Council podcasts:

Episode 1: Keeping the public safe - What pharmacists need to know

Episode 2: The dangers of high-risk medications

Forged scripts: Did you know that NSW Health publishes a table with details of ‘prescribers’ appearing on prescriptions reported to be lost, stolen or forged? If you are inquiring into the validity of a script and whether it may be forged, click here.