July 2019

Issue 22

• Chair’s message 
• News from the Board
  • Board publishes submissions to pharmacist prescribing discussion paper
  • New accreditation agreement signed: Contemporary framework for public protection 
• Meet the Board
  • Alice Gilbert
• Practice advice 
  • New case studies published
  • Administering vaccinations
  • Continuing professional development – are you on track?
• Regulation at work
  • Latest court and tribunal cases
• National Scheme news
  • Practitioners’ responsibility to support public health programs 
  • Fake practitioners face jail and hefty fines as new regulatory powers come into force
  • Tackling the fear of notifications – one practitioner’s experience
  • New resource focuses on titles in health advertising 
  • AHPRA launches WHO Collaborating Centre for Health Workforce Regulation
• Keep in touch with the Board  

Chair’s message

Brett Simmonds
Chair, Pharmacy Board of Australia

Welcome to our latest newsletter. In this issue we’re letting you know that the submissions to the Board’s pharmacist prescribing discussion paper have now been published. The discussion paper posed a range of questions about the potential role of pharmacists in prescribing and we received submissions from a range of stakeholders.

I encourage you to review the submissions and send us any comments that may further inform the discussion.

On behalf of the Board I want to thank all pharmacists who took part in our meet-and-greet event held in Canberra on Thursday 23 May 2019. More than 70 people attended: students, registered local community and hospital-based pharmacists and pharmacy stakeholders.

The event included a panel discussion on ‘Emerging areas of pharmacy practice’ facilitated by Emeritus Professor Lloyd Sansom. Thank you also to Richard Thorpe, pharmacist, Goodwin Aged Care, Vivian Bevan, Chief Pharmacist, ACT and Emma Ellett, consultant pharmacist, who joined me on the panel.

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News from the Board

Board publishes submissions to pharmacist prescribing discussion paper

We have published submissions to our pharmacist prescribing discussion paper.

The discussion paper, published by the Board in March 2019, posed a range of questions about the potential role for pharmacists in prescribing.

This followed the Pharmacist Prescribing Forum in June 2018, hosted by the Board to help participants consider and discuss the need and opportunities for expanding pharmacist involvement in prescribing.

The discussion paper was intended to help the profession, stakeholders and the public to explore opportunities for pharmacist prescribing, through one or more of the models of non-medical prescribing outlined in the Health Professionals Prescribing Pathway 2013.

We are reviewing the feedback and will publish a report to inform all interested parties about the views expressed in the broad range of submissions. We have not yet set a publication date for the report and we will provide further updates in due course.

The individual submissions are published under Past consultations. We encourage you to review the submissions. You can send any further comments by email to PharmBAfeedback@ahpra.gov.au. 

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New accreditation agreement signed: Contemporary framework for public protection

On 24 June the Board, the Australian Pharmacy Council (APC) and the Australian Health Practitioner Regulation Agency (AHPRA) announced the signing of a new five-year accreditation agreement starting 1 July 2019.

The Board appointed APC as the accreditation body for the pharmacy profession and the new accreditation agreement formalises the arrangement for accreditation services to be delivered. Each year the Board provides funding to APC to perform the accreditation functions outlined in the agreement, including accrediting programs of study against the accreditation standards approved by the Board.

The partnership between the Board and APC enables us to meet the objective of the National Registration and Accreditation Scheme (the National Scheme) − to provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered.

The accreditation agreement, part of the National Scheme, is a contemporary framework designed to address key accreditation issues including:

• cultural safety
• safety and quality
• reducing regulatory burden
• multi-profession collaboration to meet evolving healthcare needs, and
• strengthening accountability and transparency.

We are thankful for the strong partnership we have with the APC and grateful for their determined effort that enabled us to complete this important piece of work. We look forward to working closely together over the five-year term.

Read more in the news item.

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Meet the Board

Alice Gilbert

This month we chat to practitioner member Alice Gilbert about health practitioner regulation and her role on the Pharmacy Board of Australia.

Alice’s interest in health practitioner regulation was born from a belief that it is an important approach to ensuring the best possible health outcomes for the community.

‘I have been lucky enough to have had a number of mentors who have previously served on the Pharmacy Board, both at state level before the implementation of the National Scheme and on the National Board,’ she said.

‘My mentors helped me understand the role of the Board and expressed what a professionally rewarding experience it had been. I enjoy thinking strategically and recognise the impact that policy decisions can have not just on professionals and the profession, but most importantly, on consumers.’

Alice believes that the regulatory challenges the Board is going to face in the future will be determined by the direction, focus and interests of the pharmacy profession.

‘The Board must be proactive in understanding healthcare trends and innovations, such as shared electronic health records, but the regulatory challenges will be determined by the interaction and involvement pharmacists choose to have with these emerging areas of practice,’ she said.

Alice grew up in South Australia and completed her internship at the Royal Adelaide Hospital. After a short stint at the Royal Melbourne Hospital, Alice accepted a six-month position at the Royal Darwin Hospital to escape the cold. The rest, as they say, is history. Alice fell in love with the Northern Territory and is yet to leave after 12 years.

Alice has had an extensive career in research and clinical pharmacy. Her primary interests are in mental health, translational research, improving the continuum of care, Aboriginal and Torres Strait Islander health and quality use of medicines.

Currently, Alice is the Policy Maker and Strategist for the Medicines Management Unit for the Northern Territory Department of Health. She feels that her background in hospital pharmacy, research and policy has helped to prepare her for a role as a Board member. Her career path to date has given her a sound understanding of drivers of change, such as political and organisational factors, and helped her develop the skills to effectively engage with key stakeholders.

Alice is a practising senior clinical pharmacist with expertise in mental health and is the current chair of the Society of Hospital Pharmacists of Australia Mental Health Specialty Practice Stream.

With a solid background in offering and organising continuing professional development (CPD), Alice is a mentor to many hospital pharmacists across Australia and is involved in supporting them to develop their own CPD plans.

‘I was recently selected as part of AHPRA’s random audit of practitioners to ensure my compliance with mandatory registration standards. As a result, I have a clear understanding of the audit process from a professional and personal level,’ Alice said.

‘My work as a clinician-researcher has also helped me develop a sound understanding of critical thinking, which I apply to my daily practice. I understand the importance of not accepting things at face value and the need to investigate and probe beneath the surface.’

Alice was appointed to the Board in 2018 for her first term of three years. Appointments are made by the Minister for Health in each jurisdiction under the Health Practitioner Regulation National Law, as in force in each state and territory.

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Practice advice

New case studies published

The Board publishes case studies to help practitioners understand and meet their professional and legal obligations as a registered pharmacist. New case studies published this month include:

Inappropriate use of social media

A notifier alleged that inappropriate comments published on a pharmacist’s personal Facebook page concerned the practitioner’s personal views on abortion. Although the Facebook page was a closed group, pharmacy patients were members of the group. The practitioner’s Facebook page included photos of the practitioner at work as a pharmacist. You can read more on the Board’s case study page.

Privacy and dispensing procedures

A notifier alleged that a pharmacist failed to ensure patient privacy by affixing the pharmacy dispensing label to the primary container over the top of another label showing another patient’s details. You can read more on the Board’s case study page.

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Administering vaccinations

We remind pharmacists that any person administering vaccinations must be an authorised immuniser according to the requirements set out by the health department in each jurisdiction. You cannot provide immunisation services unless all legislative requirements are met.

An authorised immuniser may be either a medical practitioner or an appropriately qualified and competent registered pharmacist or registered nurse. An appropriately qualified and competent registered pharmacist:

• has completed an approved course of study and maintained recency of practice to immunise
• holds a current statement of proficiency in cardiopulmonary resuscitation (CPR) and first aid
• is permitted under state or territory legislation to administer vaccines, and
• is authorised by the state or territory Department of Health.

Health authorities in the relevant state or territory may have different legislative requirements and a pharmacist must meet these requirements before administering a vaccine. Pharmacists practising in different states and territories (for example a locum pharmacist) will need to familiarise themselves with the differences in the requirements to be able to administer a vaccine as well as the differences in the types of vaccines that can be administered.

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Continuing professional development – are you on track?

The current CPD recording period for pharmacists ends on 30 September 2019. Between 1 October 2018 and 30 September 2019, pharmacists (except those holding non-practising registration) are required to have achieved at least 40 CPD credits in accordance with the Board’s Registration standard: Continuing professional development (CPD registration standard) and Guidelines on continuing professional development (CPD guidelines).

The CPD registration standard also requires that all pharmacists develop an annual CPD plan, which helps identify areas in need of further development. Periodic review and amendment (if required) of your CPD plan will help you to reflect on whether the activities you completed enabled you to achieve these goals. This may lead you to target additional CPD activities to address your professional development needs.

On its website, the Board has published frequently asked questions (FAQ) about the annual CPD requirements and a blank template CPD plan/record to help you develop and maintain your own CPD plan and record your activities.

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Regulation at work

Latest court and tribunal cases

We regularly publish court and tribunal summaries for their educational value for the profession. Links to past and recent court and tribunal cases can be found on the new Pharmacy regulation at work: tribunal decisions page on the Board’s website. Here are some recent cases.

Tribunal cancels pharmacist’s registration after her conviction for drug theft

A pharmacist convicted of drug theft was reprimanded and had her provisional registration cancelled by a tribunal for professional misconduct. Read more in the news item.

Pharmacist reprimanded after importing ice-pipes

A tribunal found a Western Australian pharmacist’s behaviour constituted professional misconduct and reprimanded him after he was convicted of unlawfully importing over 2,000 ice-pipes. Read more in the news item.

Unregistered man convicted of holding out as a pharmacist

A New South Wales court has convicted and fined a man for holding himself out as a registered pharmacist following charges laid by AHPRA. Read more in the news item.

Suspended NSW pharmacist investigated by AHPRA, convicted and fined $24,500

A New South Wales court has convicted a suspended pharmacist, Mr David Le, of holding out as a registered pharmacist and fined him $24,500. Read more in the news item.

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National Scheme news

Practitioners’ responsibility to support public health programs

Australia’s health regulators have reminded health practitioners about their responsibility to support public health programs, including vaccination.

Regulators have spoken out to support public safety, given mounting concerns about a five-year high in measles cases and an early spike in flu cases this year.

AHPRA and the National Boards for 16 professions have urged more than 740,000 registered health practitioners to take seriously their responsibilities for public health, including by helping patients to be protected from preventable illnesses.

AHPRA CEO Martin Fletcher reminded practitioners that supporting public health programs, including vaccination and immunisation, and not promoting anti-vaccination views were regulatory responsibilities.

‘Registered health practitioners have a regulatory responsibility to support patients to understand the evidence-based information available,’ Mr Fletcher said.

National Boards set codes, standards and guidelines, including about protecting and promoting the health of individuals and the community, which they expect registered health practitioners to meet.

‘Practitioners are of course entitled to hold personal beliefs, but they must ensure that they do not contradict or counter public health campaigns, including about the efficacy or safety of public health initiatives,’ he said.

If practitioners do not comply and meet the professional standards set by their National Board, regulators can and do take action.

National Boards and AHPRA have acted to manage risk to the public, in response to a number of concerns raised about practitioners (including medical practitioners, nurses and chiropractors) who have advocated against evidence-based vaccination programs. This has included restricting practitioners’ practice pending further investigation, when there was a serious risk to the public.

Read the media release on the AHPRA website.

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Fake practitioners face jail and hefty fines as new regulatory powers come into force

From 1 July, the law is getting tougher on people who pretend to be a registered health practitioner.

The penalties for anyone prosecuted by AHPRA under the National Law for these offences now include bigger fines and the prospect of prison time.

AHPRA CEO Martin Fletcher said the strengthened sanctions better protect the public. ‘All health ministers recognise that penalties need to be tougher for serious cases. When someone pretends to be a registered health practitioner, they pose a significant risk to the public.

‘We don’t hesitate to act when someone is pretending to be a registered practitioner. If you claim to be registered when you’re not, you will face serious consequences when you are caught,’ said Mr Fletcher.

Since 2014, AHPRA has successfully prosecuted more than 50 cases where people were falsely claiming to be registered practitioners. For example:

• Mr Raffaele Di Paolo was successfully prosecuted in two state courts (Victoria and Queensland) for offences under the National Law, including holding himself out as a medical practitioner and specialist health practitioner, when he was in fact a homeopath. He was fined more than $28,000 in Queensland and in Victoria he was sentenced to nine years and six months in jail.
• Another high-profile case involved the successful 2017 prosecution of Mr Shyam Acharya, who claimed to be UK-based doctor Dr Sarang Chitale. Mr Acharya was convicted in a New South Wales Local Court and fined $30,000 and was ordered to pay AHPRA’s legal costs of $22,000.
• A New South Wales court convicted and fined Mr Michael Simon for holding himself out as a registered pharmacist at a family-owned pharmacy in Randwick and dispensing scheduled medications on numerous occasions. He was fined $10,000 and ordered to pay AHPRA’s legal costs of $4,000. Mr Simon has never held registration under the National Law and is not eligible to be registered as a pharmacist.

Other prosecutions have included people pretending to be nurses, physiotherapists, psychologists and dentists.

Fake practitioners betray the trust that patients place in them. The amendments mean that offenders will face the possibility of a maximum term of three years’ imprisonment per offence. They also face an increase in the maximum fines from $30,000 to $60,000 per offence for an individual and from $60,000 to $120,000 per offence for a corporate entity.

Members of the public can check the online register of practitioners to make sure they are seeing a registered practitioner. The register assures patients that the practitioner is qualified and must meet national standards.

Summary of the new laws

• The amendments were passed in February 2019 by the Queensland Parliament under the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2019 (Qld) (the Act).
• The new offence provisions will apply in all states and territories, except Western Australia. The amendments to offence provisions do not apply to advertising offences under the National Law.
• Under the National Law, anyone who calls themselves any of the ‘protected titles’, such as ‘chiropractor’, ‘medical practitioner’ or ‘psychologist’, must be registered with the corresponding National Board.
• It is an offence to use one of the protected titles, and it is also an offence to knowingly or recklessly claim to be a registered practitioner when you’re not or use symbols or language that may lead a reasonable person to believe that an individual is a registered health practitioner or is qualified to practise in a health profession. These offences are known as ‘holding out’.

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Tackling the fear of notifications – one practitioner’s experience

Earlier this year, AHPRA launched a series of videos to support the public and registered health practitioners as they go through the notification process.

The video series, called ‘Let’s talk about it’, explains what happens when concerns are raised with the regulator, gives easy-to-follow information about the notifications process and addresses common questions, so consumers and health practitioners know what to expect when they interact with AHPRA and National Boards.

A new video has just been added to the series, to help tackle the fear of notifications: A notification was made about me: A practitioner’s experience.

This unscripted video is an honest, first-hand account of a health practitioner’s experience of what it is like to be the subject of a notification to AHPRA. The medical practitioner featured agreed to participate to share her experience and reflections with other practitioners in her situation. In particular, she reflects that she wishes she had reached out for help sooner.

Getting support early is important for any practitioner going through the notifications process, as many practitioners tell us that the notification process is very stressful. A good support network is essential.

There are now four videos:

• A notification has been made about me features five health practitioners who work within the National Scheme and is directed at health practitioners who have had a notification made about them.
• A notification was made about me: A practitioner’s experience is a first-person account from a practitioner who had a notification made about her.
• I have a concern, am I in the right place? is targeted at members of the public who have a concern but aren’t yet sure whether AHPRA is the right place in which to raise it.  
• I have raised a concern with AHPRA provides information for individuals who have just raised a concern with AHPRA.

The videos sit alongside other written resources available on our website, including information about understanding the notifications experience. See: www.ahpra.gov.au/Notifications.

You can view the videos on the AHPRA and National Board websites or from our YouTube and Vimeo channel, and join the conversation by following AHPRA on Facebook, Twitter or LinkedIn, use the hashtag, use the hashtag #letstalkaboutit and tag @AHPRA.

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New resource focuses on titles in health advertising

A new resource to help practitioners understand their legal obligations when using titles in health advertising is now available.

The titles tool was developed to help registered health practitioners understand how titles can be used in advertising. It also outlines some of the common pitfalls that can result in titles being considered misleading under the National Law.

Misuse of a protected title, specialist title or endorsements is an offence under sections 113-119 of the National Law or may constitute behaviour for which health, conduct or performance action may be taken against a registered health practitioner under Part 8 of the National Law.

However, advertisers should also be aware that while use of some titles may not necessarily breach title protections under sections 113-119, they may be considered false, misleading or deceptive under the advertising provisions in the National Law (section 133).

The titles tool addresses the uncertainty practitioners might have around using titles in advertising, and  complements other resources published on the Advertising resources section of AHPRA’s website to help practitioners check and correct their advertising.

The Advertising compliance and enforcement strategy for the National Scheme was launched in April 2017. Under the strategy AHPRA and National Boards have developed several resources to help practitioners and advertisers, including testimonial and self-assessment tools, a summary of advertising obligations, frequently asked questions, tips on words to be wary about, and examples of compliant and non-compliant advertising.

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AHPRA launches WHO Collaborating Centre for Health Workforce Regulation

In April, AHPRA officially launched as a designated World Health Organization (WHO) Collaborating Centre for Health Workforce Regulation in the Western Pacific Region.

 AHPRA, working in partnership with the National Boards, joins a list of over 800 institutions in more than 80 countries supporting WHO programs in areas such as nursing development, communicable diseases, mental health, chronic diseases and health technologies.

Strengthening the regulation of the health workforce is an important part of the WHO’s global strategy to build the human resources needed for access to safe and quality healthcare across the world.

AHPRA and National Boards are excited by the opportunity to share expertise and promote dialogue that collectively improves the standard of regulatory practice within the WHO Western Pacific Region. The global health workforce crosses country borders and is mobile, including in Australia where thousands of overseas-qualified practitioners are registered and take up practice here. It’s important that regulators from different countries work together to set the standards for practitioner education, competence and conduct necessary for the global health workforce to deliver safe and reliable healthcare.

As a WHO collaborating centre, AHPRA will:

• help the WHO in providing technical support to strengthen health workforce regulatory systems in member states
• support the WHO in promoting the adoption of contemporary regulatory approaches to health workforce regulation, and
• strengthen the capacity, skills and knowledge of regulators in member states under the WHO’s guidance. 

Read more about the collaboration on the AHPRA website.

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Keep in touch with the Board

• Visit the Pharmacy Board website for the mandatory registration standards, codes, guidelines and FAQ. Visiting the website regularly is the best way to stay in touch with news and updates from the Board.
• Lodge an online enquiry form.
• For registration enquiries, call 1300 419 495 (from within Australia) or +61 3 9275 9009 (for overseas callers).
• To update your contact details for important registration renewal emails and other Board updates, go to the AHPRA website: Update contact details.
• Address mail correspondence to: Brett Simmonds, Chair, Pharmacy Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

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