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Patient health put at risk by expanded prescribing rights

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The health of patients will be put at risk unless the nation’s Health Ministers reverse a controversial decision to allow optometrists, nurse practitioners, midwives and other non-medical health professionals to prescribe drugs, the AMA has warned.

 The Standing Council on Health, which comprises the Federal, State and Territory Health Ministers, has approved changes allowing non-medical health professionals to prescribe medications without supervision from a medical practitioner.

The meeting on 8 November approved the Health Professionals Prescribing Pathway developed by Health Workforce Australia, which sets out the steps required for a health professional to be authorised to prescribe drugs within their scope of practice.

The Pathway was developed on the assumption that doctor shortages in some areas were making it difficult for patients to get the medication they needed, and that this problem was likely to worsen as the population ages.

But AMA President Dr Steve Hambleton said approving the Pathway was a dangerous decision that could lead to fragmented care and potentially put patients at risk.

“In the interests of patient safety, the AMA is strongly opposed to autonomous prescribing by non-medical health professionals,” Dr Hambleton said.

He said the AMA had argued “long and hard” against the idea throughout the year-long consultation process undertaken by Health Workforce Australia (HWA) because of the likelihood that it would compromise health care.

An advisory group of health professionals formed to advise the HWA on the addressing barriers to care included some who backed the autonomous model, by the AMA’s representative on the group, Dr John Gullota, steadfastly opposed the idea.

“HWA should not have put the autonomous prescribing model to the Health Ministers as an option,” Dr Hambleton said. “It was very poor advice. Autonomous prescribing encourages fragmented health care and poses greater risks to patient safety.”

He said the AMA supported prescribing by non-medical health professionals, but only when it was carried out within strict collaborative care arrangements in partnership with doctors.

Dr Hambleton said most prescribing by non-medical health professionals occurred in public hospitals, where strict protocols were in place.

He said the prescribing competency framework developed by the National Prescribing Service last year should be upheld.

“This framework sets high standards for prescribing that are currently only met by medical practitioners.”

State and Territory legislation permits certain non-medical health professionals to prescribe a defined range of medications, but unless this authority is also recognised by the Pharmaceutical Benefits Advisory Committee they are not able to prescribe medicines through the Pharmaceutical Benefits Scheme.

Adrian Rollins