As pharmacists take on greater responsibilities in primary care, international experience reveals a gap between being authorised to deliver new services and feeling confident enough to implement them in practice.
With further scope of practice changes across Australia in 2027, pharmacists will have more opportunities to assess, treat and manage patients. As we approach the end of the year, it’s a good time to plan how you’ll expand your scope of practice in 2027, including any training you’ll need to get there.
At the International Forum on Primary Health Care in Montreal earlier this year, global pharmacy leaders explored what holds pharmacists back – and shared three ways to build the confidence to take on new responsibilities.
The challenge: ‘I’m allowed to do it, but I’m not comfortable doing it.’
Across many jurisdictions similar to Australia, such as Canada, the United Kingdom, Ireland and the United States, regulatory reform has expanded pharmacists’ responsibilities into new primary care services – for both acute and chronic health conditions.
Prescribing, clinical assessment and chronic disease management are increasingly becoming part of everyday pharmacy practice, yet many pharmacists remain hesitant to step fully into these roles.
While funding and workload play a part, International Pharmaceutical Federation (FIP) Vice President Don Mager suggested this hesitancy also reflects a gap between competence and confidence.
Pharmacy leaders offered three tips to help pharmacists move from ‘allowed’ to ‘comfortable’.
Tip 1: Don’t wait for everything to feel right
Waiting for certainty, or until you feel fully confident, can become a barrier to introducing a new service or skill.
Dr Catherine Duggan, FIP CEO, urged practitioners to become more comfortable and confident in uncertainty.
‘You don’t need to be ready. Just be ready enough,’ she said.
Reflecting on global experience with expanded scope, Dr Duggan encouraged pharmacists to learn through practice rather than wait until every uncertainty is resolved.
Tip 2: Become more comfortable in clinical uncertainty
Professor Lisa Dolovich from the University of Toronto suggested that pharmacy education has traditionally reinforced a preference for certainty and risk avoidance.
‘We train pharmacists for certainty. For eliminating risk,’ she said. ‘However, primary care often requires clinicians to make decisions despite incomplete information.’
Managing uncertainty is not a sign of poor practice, Prof Dolovich argued. Rather, it is a core component of patient care.
Dr Duggan noted that pharmacists are already experts in one area critical to primary care: risk management.
‘As pharmacists, we are risk managers,’ she said.
The goal isn’t to eliminate every risk, but to make safe, informed decisions for patients.
Tip 3: Become more involved in patient follow-up care
Experience from service models shows that confidence and clinical reasoning skills build faster when practitioners are involved in follow-up care, or a cycle of care, rather than one-off encounters.
‘First contact is great. Continuing contact is better,’ Prof Dolovich said.
Confidence develops through sustained patient relationships and repeated clinical interactions, she said.
‘There is a lot to be said for confidence building by having longitudinal care experience, because you’re building on your interaction with care as an individual.’
What’s happening in 2027 and beyond?
If you’re planning your next step, here’s where scope of practice stands across Australia:
- New South Wales: From 2027, pharmacists will be able to administer National Immunisation Program vaccines, including to children under 5. Eligible pharmacists will also be invited to join a trial covering ear infections, wound care and some chronic conditions, such as high blood pressure and COPD. And 250 more pharmacists will be able to treat conditions including reflux, rhinitis, acne and musculoskeletal pain.
- Western Australia: Service delivery under the Enhanced Access Community Pharmacy Pilot is expected to start by 2027, covering conditions such as musculoskeletal pain, nausea and vomiting, and wound care.
- Victoria: The Community Pharmacist Program is still expanding towards 23 conditions and wellbeing services, with more to be rolled out.
- ACT: The government is progressing reforms so trained pharmacists can treat mild, acute conditions, including musculoskeletal pain, reflux, rhinitis, acne, and nausea and vomiting.
Career toolkit
- Training: Ready to expand your scope in 2027? Build your clinical assessment and prescribing skills with PSA’s Graduate Certificate in Pharmacist Prescribing, a nationally recognised qualification.
- Immunisation: Get ready for expanded vaccination services with PSA’s Immunisation Training Program, or keep your skills current with the online refresher course, which is free for members.
- PSA27: Save the date for the PSA National Conference, 5–7 August 2027 at ICC Sydney, to stay up to date on scope of practice and immunisation.
