Accreditation standards for pharmacist prescribing

06 Oct 2022

The Pharmacy Board of Australia (the Board) has announced its decision to develop accreditation standards for pharmacist prescribing education programs that would qualify and equip pharmacists to prescribe autonomously in accordance with any emerging authorisations set out in state and territory medicines and poisons legislation.¹

Stakeholders including pharmacists and governments have been exploring different models of pharmacist prescribing over the past several years and the accreditation standards will facilitate these discussions in the public interest.

The Board has asked the Australian Pharmacy Council (APC), the accreditation authority for the pharmacy profession, to develop the accreditation standards. The development will include wide-ranging consultation with stakeholders including the public, pharmacists, governments and other health professions. The project will be funded by the Board and the APC will follow the same procedures²  as when developing the accreditation standards for undergraduate pharmacy education programs for general registration that are approved by the Board.

The goal of this project is to assure high standards for pharmacist prescribing courses by developing:

a. accreditation standards for education programs on autonomous prescribing by pharmacists

b. a performance outcomes framework for graduates of pharmacist prescribing programs, and

c. an evidence guide to support education providers to develop evidence of compliance with the accreditation standards.

The development of pharmacist prescribing accreditation standards will be informed by the NPS Prescribing Competencies Framework, which describes prescribing expectations for all prescribers in all health professions.

The Board’s 2019 pharmacist prescribing position statement

Under the National Law,³ the Board must ensure that only pharmacists who are suitably trained and qualified to practise are registered.

The decision to develop accreditation standards for pharmacist prescribing programs follows and complements the Board’s prior extensive work that explored the capacity for competent and safe prescribing by pharmacists.

The 2019 position statement outlined the following three models of non-medical prescribing as defined by the Health Professionals Prescribing Pathway 2013 (HPPP):

• prescribing via a structured prescribing arrangement (sometimes described as prescribing according to a protocol)
• prescribing under supervision (within a documented collaborative arrangement for example, between a pharmacist and the patient’s GP), and
• autonomous prescribing.

In its 2019 position statement, the Board stated:

Under the National Law, the Board has no regulatory barriers in place for pharmacists to prescribe via a structured prescribing arrangement or under supervision within a collaborative healthcare environment. However, prescribing under these models requires changes in state and territory medicines and poisons legislation to authorise pharmacists to prescribe and these are matters to be determined by state and territory governments.

The Board’s view is that autonomous prescribing by pharmacists requires additional regulation via an endorsement for scheduled medicines. This would require the Board to make an application to the Ministerial Council for approval of endorsement for scheduled medicines under section 14 of the National Law and to develop a registration standard for endorsement of registration. An application could only occur after completion of preparatory work to develop a case proposing the need for an endorsement as outlined in the Ahpra Guide.⁴ The Board is not making an application for approval of endorsement for scheduled medicines at this time.

Currently, pharmacists are authorised to prescribe some medicines via a structured prescribing arrangement in all states and territories, for example, specific vaccines which are Schedule 4 medicines and to prescribe Schedule 2 and Schedule 3 medicines. At this stage, the Board is not developing an application for approval by Ministerial Council for approval of endorsement for scheduled medicines for pharmacists to prescribe a wider range of medicines autonomously. If an application is progressed by the Board in the future and approved by Ministerial Council, it would be subject to development of accreditation standards for pharmacist prescribing education programs. Accreditation standards would be included with an application.

Emerging practice and potential changes to pharmacists’ scope of practice

If state and territory governments determine that pharmacists can make an important and safe contribution to the delivery of healthcare to the public by prescribing a wider range of medicines autonomously and if pharmacists are authorised to do so, accreditation standards for pharmacist prescribing education programs would be an important resource to ensure that pharmacists complete an accredited and approved education program and are competent to prescribe.

The Board has decided to develop accreditation standards now, for completion by December 2023, so that they can inform future development of models of autonomous prescribing by pharmacists and the education programs that pharmacists would need to complete. If autonomous prescribing models and corresponding education programs emerge before the Board publishes the proposed accreditation standards, the standards, once published, could be used to review any existing pharmacist prescribing education programs.

The Board welcomes contributions to the development of accreditation standards for pharmacist prescribing programs and encourages stakeholders to become involved in the conversations.

The Board will continue to monitor developments in proposals for pharmacist prescribing and will continue to provide advice in the public interest. This engagement will also inform the Board’s work with the APC.

Further information

The Board’s website includes further information on:

• its pharmacist prescribing position statement, as well as FAQs and other work related to pharmacist prescribing, which can be found on the Professional practice issues page
• the role of the Board, other pharmacy regulators and stakeholders, and
• resources supporting professional practice.

¹Granting legal authorisation to pharmacists in Australia to prescribe medicines requires independent decisions by state and territory governments to change their legislation and are not decisions made by the Board.

²The Ahpra and National Board ‘Procedures for the development of accreditation standards’.

³The Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

⁴Ahpra Guide for National Boards developing submissions under the AHMAC Guidance for National Boards: Applications to the Ministerial Council for approval of endorsements in relation to scheduled medicines under section 14 of the National Law.