Patient safety imperative as pharmacy pilot confirmed

With pharmacists in the process of being trained to treat a range of conditions, some of the fundamentals of the relationship between pharmacists and doctors and patients have changed significantly. 

Under the Enhanced Access Community Pharmacy Pilot (EACPP), after completing their training, pharmacists will be treating Asthma; Smoking cessation; Shingles; Impetigo; Mild psoriasis; Mild to moderate acne; Mild to moderate atopic dermatitis; Mild, acute musculoskeletal pain; Allergic and nonallergic rhinitis; Acute otitis externa; Acute otitis media; Acute nausea and vomiting; Acute minor wound management; Gastro-oesophageal reflux and Gastro-oesophageal reflux disease; Hormonal contraception; Weight loss and management of obesity; and Oral health risk assessment and fluoride application. 

This is in addition to treatment for urinary tract infections, resupply of the oral contraceptive pill, and pharmacist-administered vaccinations.

AMA (WA) President Dr Kyle Hoath made it clear that patient safety is the first priority in assessing this pilot.

“Pharmacists play an important role in dispensing and giving advice on medicines, but they are not trained to diagnose patients,” he said.

“The AMA (WA) has lobbied the Government for adverse outcome monitoring and mandatory pharmacist-GP communication, and will continue to do so. We want to ensure the pilot program is rolled out safely when it is due to begin service delivery by 2027; that it’s for appropriate indications; that we have the right checks and balances; that we have ways of tracking when things go wrong; and that there isn’t further fragmentation from this.”

Dr Hoath said the pilot was fundamentally changing aspects of the relationships that have traditionally bound doctors and pharmacists in relation to their patients.

“The long-held check and balance of separating prescribing from dispensing no longer applies with such changes, and this means the usual oversight about medication reconciliation, where you need another ‘pair of eyes’, has gone,” he said.

Training is starting for the first cohort of pharmacists through accredited Graduate Certificate programs at Western Australian universities. The Government is subsidising training costs for some applicants through a $1.26 million investment in the 2025-26 State Budget. Eligible pharmacists in rural and remote areas will attract a higher subsidy.

Dr Hoath said enabling pharmacists to expand their roles was avoiding the underlying problem: a lack of doctors in the healthcare system. It resembles an admission of defeat on the part of the Government in ensuring Western Australians have access to quality GP care regardless of where they live.

“Rather than concede this perilous state of affairs as the ‘new normal’, the AMA (WA) calls on the State and Federal governments to consolidate their efforts and work together to incentivise and attract GPs to our great State,” he said.

“Western Australians face a unique challenge in accessing GPs, with approximately 15% fewer GPs per person compared to Victoria and NSW. We are playing catch-up on GP numbers.

“To be fair, the number of future GPs training in WA in 2025 has increased by 31%, to 194 – which exceeds the national 19.8% growth in junior doctors training as GPs, bolstered by 67% growth in the number of registrars training as specialist GPs on a rural pathway.”

The AMA (WA) President said cases would inevitably fall through the cracks under the EACPP.

“Doctors spend years of rigorous study and training prior to joining the profession, then many more in the community to understand their patients better, while pharmacists are being invited to a 12-month program,” Dr Hoath said. 

“Patients will front up to GP clinics and EDs for assistance when their initial consultation with a pharmacist is unsatisfactory. Nor do we know how much it will cost the community, given pharmacies will set the prices for such services.”

“A lot of unknowns will become evident as this process unfolds, and the AMA (WA) wants to play a major role in ensuring patients are always our first and last priority.”