Three big healthcare wins were announced by NSW Premier Dominic Perrottet earlier this week, designed to improve patient access to medicines and vaccines by expanding pharmacists’ scope of practice.

The first big change is expanded formulary of vaccines, with National Immunisation Program (NIP) stock available for eligible people for the first time from community pharmacies. From 14 November, NSW pharmacists can administer hepatitis A, hepatitis B, Japanese Encephalitis Virus (JEV), poliomyelitis, typhoid, and zoster vaccines to patients.

Two pharmacist prescribing trials were also announced, with NSW Health committing to a 12-month pilot allowing pharmacists to prescribe medicine for urinary tract infections (UTIs), similar to the successful Urinary Tract Infection Pharmacy Pilot – Queensland (UTIPP-Q).  Other state-wide trials include pharmacist prescribing for oral contraceptives, and medicines for ear infections and minor skin ailments.

The aim of the reforms is to alleviate pressure on an overstretched healthcare system by widening community access to primary care services, the Premier said.

‘By giving the community greater access to medications and vaccines through their local pharmacist, we are taking pressure off our hardworking GPs by giving them more time for patients with other medical issues,’ he said.

Acknowledging pharmacists’ hard work and support for the community throughout the COVID-19 pandemic and the recent spate of natural disasters, Chief Health Officer Dr Kerry Chant told a packed NSW Health webinar on Monday this week that pharmacists can administer the additional range of vaccines, ‘provided the relevant training and standards have been met’.

‘In relation to a UTI pilot … we have issued an [expression of interest] for an academic partner in the university sector,’ she said. ‘We will then be working very much with partners in the pharmacy sector.’

Improving access to medicines and vaccination

Welcoming the move, PSA NSW President Chelsea Felkai said the initiatives would improve access to medicines and vaccination for residents across the state in the midst of the GP shortage crisis.

‘Trained Queensland pharmacists have been successfully prescribing for uncomplicated UTIs since 2020, giving patients timely access to medicines in an environment where it could otherwise take up to 6 weeks to get a GP appointment,’ she said.

‘Allowing pharmacists to renew prescriptions for oral contraceptives is the first step in giving patients greater access to medicines for stable but chronic conditions that have already been diagnosed.’

With pharmacists now delivering a significant number of vaccines every day, Ms Felkai said they are primed to protect the community against potential JEV outbreaks in regional NSW this summer. 

The JEV vaccine is now recommended for patients aged 2 months and over who live or routinely work in 41 at-risk Local Government Areas. This includes those who:

• spend 4 hours or more per day outdoors for work, recreation or education, or other essential activities
• live in temporary or flood-damaged accommodation such as camps or tents with increased exposure to mosquitoes
• are engaged in the recovery efforts of stagnant waters following floods.

Meanwhile, with the world now reopened for travel and the festive season fast approaching, Australians are also more likely to be exposed to vaccine-preventable communicable diseases.

‘Providing patients with more options to access travel vaccinations just makes sense,’ Ms Felkai added.

PSA commends NSW, calls on others to follow suit

While PSA National President Dr Fei Sim commended the NSW government on the announcement, she said it’s ‘time for other jurisdictions to follow NSW’s lead’.

‘The PSA has been calling on governments around Australia to allow pharmacists to play a greater role in community health,’ she said. ‘It’s great to see NSW leading the way in improving patient access to medicines.’

The PSA ACT President Olivia Collenette, agreed, saying Canberrans deserve the same access to basic healthcare as residents across the border.

‘In the ACT we have patients waiting up to 3 weeks for an appointment with a GP, leaving significant gaps in care,’ she said.

‘Forcing a patient who has been on oral contraception for years, for example, to wait for a GP appointment to get their script renewed significantly limits the accessibility of contraception and basic healthcare.’

Ms Collenette added that allowing pharmacists to treat minor ailments would bridge the access gap caused by GP shortages.

‘When a patient has a painful infection and can’t see their GP, they’re going to go to the emergency department (ED) to seek treatment,’ she said. ‘This is only putting more pressure on our already stretched hospitals.’

Hazzard’s message to prescribers: ‘relax’

UTIPP-Q, which has since been continued indefinitely, allowed thousands of women in Queensland to receive timely and successful treatment for uncomplicated UTIs, with 87% reporting a resolution of symptoms following treatment prescribed by a pharmacist.

Almost 1,000 ED presentations were also prevented, with many UTIPP-Q participants indicating they would have sought hospital care had the service not been available.

Echoing this finding, NSW Health Minister Brad Hazzard told ABC News Breakfast this week that pharmacist prescribing for conditions such as UTIs is necessary, because, ‘If patients can’t get in to see their GP, they will end up in ED’.

While acknowledging the expertise of doctors, he said it’s essential they ‘look beyond their immediate borders’.

‘We’re absolutely convinced this pilot is going to be successful. The GPs need to settle down, relax, and let the pilot take place,’ he said.

‘No one’s suggesting for even a second that patients shouldn’t go and see their GPs regularly. But if you need to get antibiotics for a UTI, you should be able to do it … quickly and not wait for a GP for possibly 6 weeks.’

Mr Hazzard pointed to overseas models of care that allow pharmacist prescribing, emphasising that patients should be prioritised.

‘We need to look after patients and you should be part of that equation, not blocking it,’ he said.

Click here to access a recording of the NSW Health Webinar: Update on pharmacy vaccination.