As the Pharmacy Board of Australia considers changes to increase pharmacist autonomy to diagnose illness and prescribe medicines, a cross-sector coalition of leading healthcare organisations has come together with a clear, united position: patient safety must come first.
The Royal Australian College of General Practitioners (RACGP), the Council of Presidents of Medical Colleges (CPMC), the Australian College of Nurse Practitioners (ACNP), the Australian Medical Association, Choice Chemist, Choice Aged Care and the Wellness Partners Foundation have jointly raised concerns about the safety implications of expanding prescribing roles without appropriate safeguards in a joint open letter to Federal and State health ministers and the Pharmacy Board of Australia today.
In the letter to health ministers and regulators and in their individual formal submissions to the Pharmacy Board consultation, the organisations have cautioned that current proposals extend beyond the available evidence base and do not adequately address the complexity of undifferentiated clinical presentations.
"Australians deserve healthcare that is safe, connected and accountable," RACGP President Dr Michael Wright said.
"Safe prescribing requires safe systems, not just the skills or intentions of the practitioner. By allowing prescribing in episodic, isolated settings we risk missing early warning signs for different disease and reduced continuity of care evidence shows leads to worse patient outcomes."
"These risks are particularly serious when problems only become apparent days or weeks after a medicine is prescribed."
"The Australian College of Nurse Practitioners supports reforms that improve access to care, but prescribing must reflect the level of clinical autonomy and advanced diagnostic reasoning required to determine the need for treatment," ACNP President Elise Bryant said.
"The act of prescribing is based on sound evidence of diagnostic need; it does not, in itself, provide the means to establish a diagnosis. Safe care depends on systems that ensure continuity, accountability and patient safety over time."
"Safe and coordinated care doesn't involve a single episode of care; it often entails diagnosis through to treatment and follow-up. Similarly safe prescribing must involve clinical oversight and accountability that helps keep patients safe," CPMC Chair A/Prof Kerin Fielding said.
"We owe it to all Australians to ensure all patients are provided appropriate prescribing safeguards with medical oversight that can monitor their care, to follow up if their condition changes, and take responsibility for their ongoing treatment.
"Our concern is that the proposed model does not provide the level of oversight, continuity and accountability patients deserve. Any expansion of prescribing powers must put patient safety first and ensure there are clear safeguards in place, particularly for higher-risk medicines."
"The AMA is concerned by the scale and pace of the PBA's proposals, and the serious risks they pose to patient safety," AMA President Dr Danielle McMullen said.
"The PBA proposal fails to provide sufficient evidence for the significant changes proposed, and does not provide a cost, risk, and benefit analysis. These are fundamental flaws in a process that could result in seismic changes to the healthcare system in our country, going down the same ill-conceived path as the National Health Service in the United Kingdom that ranks much lower on health care outcomes than Australia according to the internationally respected Commonwealth Fund.
"Pharmacy prescribing can and should be safe. When pharmacists begin prescribing under an endorsed framework, that prescribing should be GP-connected, team-based, and operating within governance structures accountable to the patient and their care system. That is what the endorsement framework needs to deliver, in every setting," Michael Bonner, CEO of Choice Chemist and Choice Aged Care said.
"Wellness Partners Foundation works at the intersection of medicines management and health equity, serving Australians who face the greatest barriers to safe, consistent healthcare. We are calling on the Board to anchor the pharmacist prescribing endorsement framework in connected care systems, strong governance and the priority population settings where it will matter most," Wellness Partners Foundation Executive GM Christine Muller said.
The coalition emphasised that prescribing safely is not just about a single consultation or symptom relief. Most health conditions are not straightforward. Symptoms can be unclear, overlap across conditions, or change over time. In many cases, diagnosis cannot be confirmed in one visit – it develops with time, follow-up and continuity of care.
Across professions, the organisations have come together to develop principles for safe prescribing and diagnostic authority to help guide regulators, policymakers and governments.
The coalition is calling for safe expansion of prescribing and diagnostic authority built on systems that manage uncertainty, ensure continuity of care, and maintain clear accountability over time – not just individual competence. This will protect patients now and into the future.
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