National President’s Message: COVID-19 Update
14 April 2020
I know that Easter for many of you was spent on the frontline, working to address this COVID-19 crisis that is enveloping us. I know that for many of us, COVID-19 is consuming not only our personal lives but our work lives.
There has been some good news in the last few days with some promising developments. Physical distancing, testing and quarantine measures are consolidating the flattening of the curve, with a rise in cases of about 2 per cent overall cases. This is a call for real hope and real aspiration.
PSA has been working over Easter to address the issues affecting you, and the policy and regulatory changes that have been made by State or Territory and Commonwealth Governments continues to change the health landscape which we work in.
Digital Image Prescriptions
I am getting an enormous amount of feedback, concern and frustration from you all on the issue of digital image prescriptions and the increasing confusion, workload and stress that this measure is causing.
Many of you from all around Australia are being left in a quandary and are stuck in the middle between the federal legislative instrument and the state and territory regulations. This is causing profession-wide confusion, greater workload and more administration at an already frantically busy time.
There is particular confusion given the Australian Government factsheets did not effectively communicate that state and territory regulatory changes were required prior to supplying of medicines under this arrangement become lawful.
Victoria and WA are currently the only jurisdictions where supply under this PBS special arrangement can be lawfully made at present. NSW has announced digital image prescription arrangements which will commence this Friday (17 April). These states have shown terrific leadership in this case and all other states and territories should follow suit with a matter of urgency.
I have made representations about this issue with both the Department of Health and Minister of Health’s office. I have made it clear that it is unacceptable that pharmacists are expected to break the law to provide patients with their medicines. GPs are heeding Commonwealth advice that they can send prescriptions electronically without forwarding a hard copy with the legislation in the states playing catching up.
PSA is working with the state and territory governments to accelerate this as quickly as possible in a way to minimise the additional burden this has caused you all. We understand what the Government is attempting to do in keeping the community safe – but this has to be done in a way that does not expose pharmacists to professional risks from being forced to break the law.
Personal Protective Equipment (PPE)
I was pleased to see the Australian Government announce last week that it will distribute 500,000 masks to pharmacy workers.
This is a good start as there has been significant and increasing demand for face masks and personal protective equipment for pharmacists working on the frontline face-to-face with patients. But we must ensure that pharmacists, like other frontline health workers, receive the adequate protection they need to care for their patients.
While the advice from Government regarding PPE has not changed, I will continue to work with the Government on your behalf to ensure there is adequate supply of personal protective equipment when it is needed for you all throughout this pandemic.
I understand some of you are having difficulties sourcing the PPE through your PHNs. If you are please let me know and we will follow up with the PHNs for you.
I am frustrated to report that work on the therapeutic substitution arrangements recently forshadowed by the Health Minister are not progressing well.
The Australian Government’s current proposed model involves a protocol being issued by the TGA to instruct pharmacists on how they should respond to every shortage.
This is not workable and is unacceptable to us. Being able to substitute strength and dose is well within a pharmacists’ skills and knowledge. In fact, it treats pharmacists with contempt at the time when we are providing vital healthcare to our communities. We will be providing you, our members with information later this week, and we may urge you to contact your local members to discuss this issue with them.
In a profession where we are accountable for making complex medicine safety decisions, it is inconceivable that the Government would see the need to advise pharmacists that 2 X 20 mg tablet equals one 40mg tablet.
We have long called for a Chief Pharmacist to be located within the Commonwealth Department of Health. A pharmacist, like the Chief Medical Officer and Chief Nurse who would be there fighting for the role of pharmacists in this pandemic. We will again make this call, so we know that pharmacists will have a voice, and that medicines policy advice comes from medicines experts – pharmacists.
I have heard of pharmacies being forced to close due to isolation requirements for staff in NSW and West Australia. Pharmacists, who come into contact with a member of the public who is COVID-19 positive, are unlikely to be considered close contacts and therefore not likely to need to self-isolate for 14 days.
However, should a staff member become COVID-19 positive it is highly likely that anyone who has worked with them would be considered close contact during the period of working together and would need to self-isolate. In some small pharmacies this could mean your entire workforce would need to isolate.
If pharmacies are forced to close, particularly in a rural or remote area, there are serious implications for medicine supply, particularly if other staff are unavailable.
It is therefore essential that you either separate your workforce of if that is not possible, introduce additional measures to protect your team including additional restrictions on the number of patients in your pharmacy.
I have had a number of pharmacy interns contact me in regards to concerns about completing their required hours should they have to go into quarantine or self-isolation, and I know this is currently the case for a small number of interns across the country. While the Pharmacy Board’s response to this issue indicates that they may consider options for supervision, I am recommending that they do more to assist interns affected by COVID-19.
Simply put, there must be a relaxation of the supervised hours requirements for pharmacy interns and representatives of the PSA will meet with the Pharmacy Board this week and we will strenuously put the case for relaxation of the supervised hours requirements. Until this is dealt with and dealt with quickly, I am concerned that this will put undue stress on our pharmacy interns and exacerbate anxiety and stress at this time.
I will also stress that the Pharmacy Board should make representation to the Commonwealth as their agents for public safety to waive the fees of all pharmacists for re-registration in 2020.
Webinar COVID-19: Pharmacy layout and protection
Last Wednesday, I was joined by Associate Professor Alistair Reid, who as well as being Australia’s only rheumatologist and infectious disease physician, delivered valuable insights on treating COVID-19 in immunocompromised patients, medicines supply issues and herd immunity. His comments were supremely practical and, if you missed it, I encourage you to watch the recording here.
This week’s webinar to be held tomorrow night from 7.30pm-8.30pm will focus on the best way to set up your pharmacy or pharmacy practice to accommodate the changes and new ways of working to protect you, your staff and your patients during COVID-19. I will be joined by Queensland Branch President Chris Campbell to answer your questions on these topics. You can register for the webinar here.
Volunteer your expertise
I know that significant expertise lies in our membership and a large number of you work in a variety of practice settings. I would like to encourage you to offer your expertise to your fellow pharmacists by joining our COVID-19 pharmacy register where you can lead and be involved in creating resources and tools for your fellow pharmacists in tackling the COVID-19 pandemic. We will be establishing the sign-up to this register in the coming week, so stay tuned, if you can’t wait, feel free to email me or the membership team with your area of interest.
I am pleased to tell you that visits to our dedicated COVID-19 website have more than doubled over the past month. The site is continually updated with the latest information that you need to be supported while you care for the community during the COVID-19 crisis. There are series of FAQs on the website and can be found here.
Please contact our team or myself for support, feedback or any inquiries you may have at firstname.lastname@example.org.
As we move into a more stable period of our pandemic response, I am confident that the profession will continue to serve the community with compassion, care and professionalism that has been evident from the moment that the pandemic started.
Associate Professor Chris Freeman
Pharmaceutical Society of Australia