Important COVID-19 actions for pharmacists
20 March 2020
The last seven days have been some of the most extraordinary and stressful days most pharmacists will have experienced in their career. The progression of COVID-19 public health measures have been met with fear, anxiety and panic from consumers who have rushed to supermarkets and community pharmacies in an attempt to secure large quantities of medicines and other household goods.
The burden on pharmacists has been extreme with the profession responding to never-before-seen volumes of prescription and non-prescription requests in community pharmacy. Pharmacists in all practice settings have had their daily role upended by this public health emergency.
In extraordinary times, pharmacists step up and do extraordinary things. I am so immensely proud of the way in which pharmacists are responding to support Australians. Health Minister the Hon. Greg Hunt has echoed these sentiments in an open letter to pharmacists where he recognises and thanks the dedication and service of pharmacists to the Australian community under extreme pressure.
In this email, I want to address the issues our members have told us are the most significant challenges they are currently working with, and how we are working to help address these problems:
Demand for medicines
Demand for medicines has increased considerably in response to the COVID-19 pandemic which has the potential for numerous product lines to be out of stock and some pharmacists are being pressured and abused to provide unsafe quantities of medicine.
It is important you are familiar with these limits:
- pharmacists are required to limit dispensing of certain prescription products to one month supply at the prescribed dose, and sales of certain over-the-counter medicines to a maximum of one unit per purchase
- pharmacists are strongly encouraged to limit dispensing and sales of all other medicines to one months’ supply or one unit
- pharmacists are required to place paracetamol paediatric formulations behind the counter to assist in allocating supply equitably
- Supply of salbutamol inhalers are also subject to additional restrictions, assessment and recording requirements.
PSA stands united with the Pharmacy Guild of Australia and the Department of Health on these measures. The Federal Government has now backed all pharmacies to limit dispensing of medicines to one month supply. This gives pharmacists the Government’s backing to say NO to patients who are pressuring them to dispense more than a month’s supply.
To help you explain these changes to patients PSA has produced a poster you can use in your pharmacy or for social media.
Abuse of pharmacists and staff
Pharmacists are reporting significant mental strain from dramatically increased workload volumes, abuse and frustration from patients and disruption to people’s personal lives.
Reach out to your support networks. The Pharmacist Support Service is available to you on 1300 244 910 if you need support.
Continued Dispensing and Therapeutic Substitution
In anticipation of general practice workforce challenges and possible medicines shortages we continue to advocate for the following:
- Permanent extension of emergency PBS Continued Dispensing initiative to allow for a single supply of a PBS medicine when patients are unable to obtain a prescription for essential medicine. This was successfully introduced for a limited time period during the summer bushfire crisis
- Implementation of therapeutic substitution program to enable pharmacists to provide alternative dose forms, strengths and medicines within the same therapeutic class in a shortage.
PSA has been working with the Guild in progressing this proposal with the TGA’s medicine shortages working group for some months. These measures are vital are essential to ensuring continuity of medicine supply during the COVID-19 pandemic.
Home Medicine Service
The Department of Health released Program Rules for the Home Medicines Service announced by the Health Minister Greg Hunt on Wednesday 11 March. This service was announced by Minister Hunt last week as part of the Federal Government’s $2.4 billion COVID-19 health package.
PSA welcomed the announcement of the Home Medicine Service, noting it will be essential for Australians to limit COVID-19 exposure and ensure people can continue to take their essential medicines during the COVID-19 pandemic. However, we recognise the payments and program rules allocated to this service are insufficient to cover the costs of providing the service. We are concerned the $5.00 fee will result in uptake of the service being low, and therefore not achieve its crucial objective of supporting the health needs of people who are confined to their homes.
PSA is urgently liaising with the Department of Health to seek adjustments to the program rules to ensure the program is viable and protects the health of Australians during the COVID-19 pandemic over coming months.
Medicine management reviews: are telehealth consultations on the way?
PSA has provided a submission to the Department of Health to enable delivery of Medschecks, Diabetes Medschecks, Home Medicine Reviews and Residential Medication Management Reviews via telehealth during the COVID-19 pandemic. For the same reasons telehealth consultations have been temporarily extended to general practice, the same modifications need to be made for medicine review services.
We remain significantly concerned if there is a reduction in the delivery of these services there will be an increase in admissions to hospitals as a result of medicine related problems, placing strain on an already stretched health system.
Social distancing and hand washing is effective, and should be used throughout the community. This includes in health environments such as pharmacies. Pharmacists need to maintain strong hand hygiene and quickly implement measures to keep a distance of 1.5 metres between pharmacists, support staff and patients where possible.
I encourage pharmacists to think actively on adapting their work environment to protect themselves, their colleagues and their patients through measures such as:
- Talking to consumers from the other side of a counter or desk where possible. Do not ‘lean in’ to conversations.
- Encourage consumers queuing to give each other adequate space. Signage, floor markings and verbal instructions are important in helping achieve this
- Increasing the distance between chairs for patients waiting for prescriptions.
- Asking colleagues and consumers to stand further away in discussion and work areas
I encourage you to undertake the infection control training for health professionals which the federal government has made available.
Distribution of Personal Protective Equipment (PPE) Tranche 2
Yesterday the Australian Government has released new information on obtaining surgical masks and P2/N95 respirators for community pharmacy. This second tranche of PPE release provides for small quantities of masks to be provided for use by an unwell patient or staff protection.
We encourage all pharmacists to contact their PHN to secure PPE which is available. Find out more on how to secure PPE for you and your staff here.
Stay up to date
I encourage you register for a webinar next Wednesday night at 7.30pm AEDST where I will be co-presenting with Robert Booey, Head Clinical Research NCIRS will present on COVID-19, including discussion of infection control measures, medicine delivery services and immunising during COVID-19.
PSA’s dedicated COVID-19 website is rapidly updated, often multiple times daily, with the latest information pharmacists need to be across to support the community during the COVID-19 crisis. Significant updates are amplified via our social media channels.
PSA supporting you and the profession
PSA’s teams across the country are working hard to ensure you are supported during the COVID crisis. This includes our network of officers around the country engaging with health departments, political leaders and health stakeholders to respond to member concerns and keep you informed.
From next week, I will be writing to you each Tuesday’s with key information regarding what pharmacists need to be across in supporting Australia’s COVID-19 response.
Please contact our team if there is any way in which PSA can help you in these unprecedented time.
Associate Professor Chris Freeman
Pharmaceutical Society of Australia