November 2013

News and Updates

Issue 3 - November 2013

Chair’s report
REMINDER: 2013 renewal due soon
Graduate applications for registration
National intern training programs
Snapshot of registered workforce
Update on registration standards
Consultations update
Audit update
Practice advice
New publications and resources for health professionals
News from AHPRA and the National Boards
For more information

The Pharmacy Board of Australia

National Board members from left to right: Mr Ian Huett - practitioner member from Tasmania; Mrs Rachel Carr - practitioner member from Western Australia; Ms Bhavini Patel - practitioner member from the Northern Territory; Mr Brett Simmonds - practitioner member from Queensland; Mr Stephen Marty - Chair and practitioner member from Victoria; Mr Gerard McInerney - practitioner member from New South Wales; Mr Trevor Draysey - practitioner member from South Australia; Dr Rodney Wellard - community member from Victoria; Ms Karen O’Keefe - community member from South Australia; Mr John Finlay - community member from Western Australia; Dr Katherine Sloper - community member from Queensland;Mr William Kelly - practitioner member from the Australian Capital Territory

Chair’s report

This year has been very busy for members of the Pharmacy Board, with each of its four standing committees dealing with a considerable workload.

Recommendations from a number of reviews undertaken by the Board have been implemented during the past 12 months. These recommendations, together with AHPRA reviews and systems changes, have resulted in improvements to enable timely responses to matters.

The Board also engaged external consultants to conduct a performance review of the Board, which has proven very useful and has enabled the Board to review its strategic, business and work plans, and set priorities for the year ahead.

The Board committee chairs have enthusiastically and professionally pursued their responsibilities, leading the various committees through a heavy workload throughout the year. Committee members have again made valuable contributions to ensure that all matters that have come before them have been undertaken in a timely manner or, where delay has occurred, that appropriate action has resulted in improvement. Board members have never lost sight of their primary role of protecting the public.

The Board has engaged with the profession about guidelines for compounding, advanced practice, possible vaccination by pharmacists and registration standards, and has appreciated the participation and contribution from stakeholders.

I sincerely thank all Board members for their diligence, enthusiasm and participation in the Board’s work. I acknowledge the contributions and support from the AHPRA executive team and the support staff in the national and jurisdictional offices. In particular I thank Mr Joe Brizzi, the Board’s Executive Officer, Ms Michelle Pirpinias, the Board’s Senior Policy Officer and Ms Casey Ip, the Board’s Support Officer for their highly professional, dedicated service and contributions on behalf of the Board.

Annual report 2012/13 released

The 2012/13 annual report of AHPRA and the National Boards was recently released. The Pharmacy Board’s report details statistical information including that:

27,339 pharmacists were registered at the end of June 2013, an increase of 5.4 per cent since national registration data was first published in June 2011
429 notifications (concerns/complaints) were received about pharmacists and of these, 246 were lodged outside of NSW which has a co-regulatory system¹
396 notifications were closed by the end of June 2013, including 227 managed outside of NSW
of the 227 cases closed under the National Scheme, the Pharmacy Board of Australia determined:
- to take no further action or that the case was to be retained and managed by the health complaints entity in the relevant state or territory or be referred to another body in 130 cases
- to suspend one pharmacist’s registration
- to accept the surrender of registration from two pharmacists
- that a caution should be issued in 77 cases
- that five pharmacists be reprimanded
- to impose conditions on the registration of nine pharmacists, and
- to accept an undertaking from three pharmacists.

Stephen Marty

Chair, Pharmacy Board of Australia

¹Complaints in NSW are managed by the Health Care Complaints Commission (HCCC).

REMINDER: 2013 renewal due soon

Pharmacists’ registration is due for renewal by 30 November 2013. We urge you to provide up-to-date email contact details to AHPRA so you don’t miss the reminders to renew. To update your contact details, go to the AHPRA website.

If you do not want to renew your registration you can simply ignore the reminders from AHPRA or go online to ‘opt out’ of renewing. Using the ‘opt out’ service puts a stop to renewal reminders.

Renew online, on time

Make sure you renew your registration on time. The quickest and easiest way to do this is online (90 per cent of pharmacists used this secure service last year).

Renewal applications received by AHPRA after 30 November will incur an additional late fee. See fees for the cost of annual renewal, including the late payment fee.

If you haven't renewed by one month after 30 November 2013, your registration will lapse. This means you must apply again for registration and will not be able to practise until your registration application has been finalised.

Further information

The following pages on the Pharmacy Board website contain useful information for pharmacists:

You must ensure you understand the declarations you are required to make about meeting the Board’s registration standards as information to support your declarations may be sought.

Graduate applications for registration

AHPRA is calling for online applications from students who are in their final year of an approved program of study. Pharmacy graduates are eligible to apply for provisional registration to undertake a Board-approved period of supervised practice.

Pharmacy students who will be completing studies at the end of 2013 are urged to apply for registration four to six weeks before completing their course. An email to individuals on the Student Register urging them to apply early and online will be sent by AHPRA on behalf of the National Board.

Applications can also be made by completing a paper application form. All applications, online or in hard copy, require students to post some supporting documents to AHPRA. An application for approval of supervised practice must also be sent to AHPRA before supervised practice may be commenced. Pharmacy students are encouraged to read the information on AHPRA’s website.

Graduates must meet the Board’s registration standards and hold provisional registration before they start practising. New graduates are registered and eligible to start working as soon as their name is published on the national register of practitioners.

National intern training programs

Again, it has come to the Board’s attention that some accredited providers of the pharmacy intern training program may have attempted to influence interns in their decision of which training program to undertake. The Board advises that interns should be free to choose the training program of their choice, and should not be inappropriately influenced by their employer or the intern training program provider.

Snapshot of registered workforce

In 2012, the Pharmacy Board of Australia began publishing quarterly data profiling Australia’s pharmacy workforce, including a number of statistical breakdowns about registrants.

The Board’s September data update shows there are 27,339 registered pharmacists in Australia, an increase of 905 practitioners. Of these, 24,571 have general registration and 1,809 have provisional registration.

A total of 942 pharmacists are non-practising and 17 have some form of limited registration.

The largest number of pharmacists is in NSW: 8,460 (30.94%); followed by Victoria with 6,315 (24.93%) and Queensland with 5,361 (19.61%). For further details, see the table below.

Pharmacists: state and territory by registration type

Pharmacists: Registration Type by State
State	General	Limited			Non-practising	Provisional	Total	% By State
		Postgraduate training or supervised research	Teaching or research
ACT	405				12	30	447	1.64%
NSW	7,636	4		1	259	560	8,460	30.94%
NT	166				5	23	194	0.71%
QLD	4,826		1		92	442	5,361	19.61%
SA	1,811	4			49	123	1,987	7.27%
TAS	604			1	5	46	656	2.4%
VIC	6,113	3		1	324	374	6,815	24.93%
WA	2,708	2			63	211	2,984	10.91%
Not Stated	302				133		435	1.59%
Total	24,571	13	1	3	942	1,809	27,339

For more information, visit the Board’s website.

Update on registration standards

The National Law² requires practitioners to meet registration standards set by their National Board, and to declare their compliance with these standards when they renew their registration each year.

Two standards to which the Board would like to draw your attention are those on supervised practice and recency of practice.

Supervised practice

The Supervised practice arrangements registration standard outlines a number of requirements including:

an individual must be registered by the Board to undertake the period of supervised practice required for initial general registration
each period of supervised practice is undertaken under the direction and/or supervision of a Board-approved preceptor for a minimum period of 152 hours, and
(for interns) supervised practice hours may be undertaken from the date that supervised practice begins or from the date of publication of final results of an approved pharmacy program, whichever is later.

Supervised practice is accepted by the Board if an application (using the form available on the Board’s website) has been submitted and approved before the supervised practice begins.

Recency of practice

Pharmacists are required to maintain experience in their scope of practice as part of their competence to practise and provide services to the public. The Board’s Recency of practice registration standard outlines the requirements to be met by applicants to be eligible for general registration and renewal of general registration

Pharmacists who have not practised pharmacy for more than 450 hours within the previous three years must provide evidence to satisfy the Board of their current competence to practise. To meet the minimum practice requirements specified in the standard, the applicant’s practice must have occurred in Australia and/or New Zealand, given the mutual recognition arrangements in place.

In cases where an applicant has not met the standard, the Board (or its delegate) will decide whether to impose conditions on general registration.

Conditions are removed by the Board once evidence is provided to AHPRA that the requirements specified in the conditions have been satisfactorily met.

Continuing professional development (CPD)

The current CPD period for pharmacists began on 1 October 2013. Between 1 October 2013 and 30 September 2014, pharmacists are required to achieve at least 40 CPD credits in accordance with the current Continuing professional development registration standard and Guidelines on continuing professional development.

These registration standard and guidelines are part of the current review of registration standards, codes and guidelines (see the consultations update in this newsletter). The Board advised in its August 2013 communiqué that it is reviewing these documents and as part of the public consultation process, the draft revised documents will be published on the Board’s website later in 2013. While consultation takes place, there is no change to the current requirement for pharmacists to achieve 40 CPD credits annually.

If any change to the annual CPD requirement for pharmacists is supported by feedback to the Board’s consultation, details will be published in the revised registration standard approved by Ministerial Council and guidelines approved by the Board.

The Board has published answers to frequently asked questions and other information on these requirements. You can find these documents under Codes and guidelines on the Board’s website.

²The Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).

Consultations update

The Board is reviewing its registration standards, code of conduct and guidelines for pharmacists in preparation for consultation. Stakeholders and the public will be given an opportunity to provide feedback on any proposed changes.

The Board, together with other National Boards, is consulting on the following two registration standards common to all National Boards:

English language skills registration standard (largely common), and
Criminal history registration standard (common).

You can access the consultation papers under Current consultations on the Board’s website.
Other registration standards and guidelines, including:

Recency of practice registration standard
Continuing professional development registration standard and guidelines, and
Professional indemnity insurance arrangements registration standard

will be progressively published for consultation on the Board’s website later in the year.

Audit update

AHPRA and the National Boards are developing a nationally consistent approach to auditing health practitioners’ compliance with mandatory registration standards. Pilot audits have been conducted which were designed to determine the frequency, size and type of audits required and establish our audit methodology. Pharmacists should note that auditing may occur at any time, not just as part of the renewal process, and ensure records of activities which meet the requirements of the standard are retained for three years.

Each time a practitioner applies to renew their registration they must make a declaration that they have met the registration standards for their profession. Practitioner audits are an important part of the way that National Boards and AHPRA can better protect the public by regularly checking these declarations made by a random sample of practitioners. Audits help to make sure that practitioners are meeting the standards they are required to meet and provide important assurance to the community and the National Boards.

Auditing of all professions has begun. If you are selected for audit you will be notified in writing and requested to provide evidence that you meet the requirements of the standard.

Further information will available shortly on the Pharmacy Board of Australia website.

Practice advice

Paracetamol packs and promotion

The Therapeutic Goods Administration (TGA) has advised on its website that the maximum paracetamol pack size to be sold by Australian retailers (other than in pharmacies) has changed from 25 to 20. From 1 September 2013, this change is being fully implemented.

Smaller packs of paracetamol in pharmacies may contain 20 tablets instead of 24 tablets.

The TGA advised: ‘Paracetamol can cause serious liver damage if taken in high doses. The decision to decrease the pack size was made after considering the risks of different pack sizes in Australia. It is expected that this decision will result in fewer people requiring medical intervention following a paracetamol overdose.’

The evidence considered and the reasons for the scheduling change are outlined in the Poisons Standard (SUSMP) and on the TGA website.

Given the risk associated with high doses of paracetamol, the Board has serious concerns about the decision of some pharmacists to make paracetamol available for purchase in ‘dump bins’, noting the larger pack sizes are typically made available in this way and are as freely available as non-medicinal items.

Pharmacists have a professional obligation to ensure that the sale of Schedule 2 poisons (Pharmacy Medicines) and Schedule 3 poisons (Pharmacist Only Medicines) to members of the public includes the provision of appropriate advice. The Board therefore believes that it is inappropriate to promote the sale of scheduled medicines by ‘dump-binning’, particularly when there is a well-known record of presentations to hospital accident and emergency departments following misuse of paracetamol.

Supply of Schedule 3 poisons (pharmacist-only medicines)

Guideline 4 of the Board’s Guidelines on practice-specific issues, published on its website, highlights to pharmacists their obligation to observe their statutory responsibilities regarding the supply of pharmacist- only medicines. Additionally, Guideline 4 includes guidance on the supply of appropriate quantities of these medicines.

Pharmacists must be satisfied that there is a therapeutic need for a pharmacist-only medicine. As outlined in Guideline 4, this means more than agreeing to supply the medicine on request, or merely asking patients if they have used the medicine previously and know how to use it.

You may receive requests from consumers for specific pharmacist-only medicines by brand name as a result of advertising of these medicines. This does not abrogate your statutory obligation to establish a therapeutic need and to determine whether supply should occur.

Advertising of delisted products

Pharmacists are reminded that the advertising of delisted products may amount to an offence under the Therapeutic Goods Act 1989 and/or result in prosecution by AHPRA under Part 7 and/or an investigation under Part 8 of the National Law.

The Board has received reports that despite announcements by the TGA of the cancellation from the Australian Register of Therapeutic Goods (ARTG) of products such as Sensaslim Solution and Reducta Fatblaster Tablets, some pharmacists have continued to advertise these products. We would like to remind you of your obligation to comply with your responsibilities under all legislation regarding advertising of regulated health products and services.

New publications and resources for health professionals

Panel and tribunal hearing decisions published

In the interests of accountability and transparency in the National Scheme, AHPRA has published a list of panel hearings conducted since July 2010. Summaries have been provided where there is educational and clinical value. These summaries are accessible from hyperlinks within the table. Practitioners' names are not published, consistent with the requirements of the National Law.

Published hearing decisions from adjudication bodies (other than panels) relating to complaints and notifications made about health practitioners or students are available on the Austlii website.

Some summaries of tribunal decisions are also provided, to help share information and guide practitioners.

AHPRA has also published a series of legal practice notes to support the consistent understanding and application of the National Law by National Boards and AHPRA staff, and these are available on the AHPRA website for their wider value.

Online searchable course database - an Australian first

A comprehensive, easily searchable national database of approved programs of study is now accessible through the AHPRA website.

For the first time, potential students, practitioners, the public and education providers can conduct an easy online search to identify approved programs of study. This allows potential students to check courses to ensure that they will lead to registration with one of the National Boards.

Detailed information about individual programs of study, such as course length, approval dates and any conditions, is published in one place. It also means that education providers can check, in real time, any changes or updates to the approved programs of study that they are required to report on for student registration.

The online service provides a single point of entry to important information that was previously scattered between states and territories. It is possible through the National Scheme because education programs for all professions are accredited nationally and AHPRA is able to gather national data about accredited courses.

Pharmacy programs among the searchable lists

The searchable database replaces previously published static lists for each profession and makes it easier and quicker to find important information about approved programs of study for the following professions: chiropractic, dental, medical, nursing and midwifery, optometry, osteopathy, pharmacy, physiotherapy and podiatry. Searchable lists for the other professions in the National Scheme will follow.

Access the database on the AHPRA website.

Guides on notifications (complaints)

AHPRA has published new guides for health practitioners and the community about how notifications (complaints) are managed in the National Registration and Accreditation Scheme (the National Scheme).

The Guide for practitioners and a series of fact sheets explain to practitioners what happens when AHPRA receives a notification on behalf of a National Board. The information complements the direct correspondence that individuals receive if a notification is made about them.

AHPRA has also developed a guide for the community about making a complaint (or notification) about a health practitioner. This guide for notifiers: Do you have a concern about a health practitioner? A guide for people raising a concern will be a focus of review by the newly established Community Reference Group for AHPRA and the National Boards.

Both guides are published online on the AHPRA website in a wholly revised section on complaints and notifications.

News from AHPRA and the National Boards

Community Reference Group established

A Community Reference Group has been established to work with AHPRA and the National Boards as part of the National Registration and Accreditation Scheme (National Scheme). The group will advise AHPRA and the National Boards on engaging with communities.

The group has a number of roles, including providing feedback, information and advice on strategies for building better knowledge in the community about health practitioner regulation, but also advising AHPRA on how to better understand and - most importantly - meet, community needs.

For further details, including the list of members and the group’s communiqués, visit the Community Reference Group members page on the AHPRA website.

Professions Reference Group update

The Professions Reference Group was set up in 2012. It is made up of representatives of the professional associations for the professions included in the National Scheme, including pharmacy, with participation from AHPRA’s CEO and senior staff. Quarterly meetings provide an opportunity for AHPRA to brief the professions about its work and for the professions to ask questions about emerging issues relevant to regulation. The group also provides expert advice to AHPRA in developing a range of information for practitioners, such as the recently published notifications guide and fact sheets.

By working with the group, AHPRA has also been able to establish a practitioner consultative group, made up of individual practitioners nominated by their professional association who are willing to provide feedback on proposals and systems improvements, to inform change and improve services ahead of large-scale implementation.

Regulator logos on practitioner websites

Since implementation of the National Scheme, some practitioners have sought permission to reproduce AHPRA’s logo or their profession’s National Board logo on their business website.

AHPRA and the National Boards have a strict logo use policy and rarely grant permission for their logos to be used by third parties.

The roles of AHPRA and the National Boards in the National Scheme make it inappropriate for either party to endorse, or be perceived to be endorsing, individuals and organisations; their products or services.

Practitioners who have reproduced the AHPRA or a National Board logo on their business website should remove it and consider publishing a text link to www.ahpra.gov.au, advising that their registration to practise can be confirmed by checking the national register of practitioners.

For more information

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 8708 9001 (for overseas callers).
To update your contact details for important registration renewal emails and other Board updates, go to the AHPRA website.
Address mail correspondence to: Stephen Marty, Chair, Pharmacy Board of Australia, GPO Box 9958, Melbourne, VIC 3001.