Doctors wary of pharmacy move

More pharmacists could end up prescribing medicines under Ministry of Health plans that have the New Zealand Medical Association urging caution.

There are currently only 16 prescribing pharmacists in New Zealand, working within clinical groups and usually in hospital settings.

That could change under the Draft Pharmacy Action Plan 2015-2020 that has been released for feedback by the ministry.

As well as pointing out how the future of pharmacies will look - robots dispensing to free up pharmacists for more patient interaction - it has an action to "explore and develop models for pharmacist prescribing".

How far any new model could go will now be subject to feedback.

"We are not going to have a situation where pharmacists are totally taking over the scope of practice of doctors, because they are not doctors," Health Minister Dr Jonathan Coleman said.

"But it does make sense with pharmacists seeing patients on a regular basis through their pharmacy, looking at the opportunities for them to be much more involved in the long-term care of people, and prescribing is a potential element of that."

There has been a push for more pharmacist prescribing for a number of years, but that has been opposed by some doctors who have concerns including a lack of oversight and expertise.

In 2013, the law was changed to allow suitably trained specialist pharmacists to become prescribers.

The handful of pharmacist prescribers work within larger groups of medical professionals, and do not prescribe independently - for example, one pharmacist prescriber works within a hypertension team, prescribing anti-hypertensives.

Pharmacist prescribers, who require a postgraduate diploma, must ensure a separation of prescribing and dispensing, and must not dispense prescriptions they write.

Dr Kate Baddock, chairwoman of the New Zealand Medical Association general practitioner council, said the association was not averse to the concept of collaborative prescribing.

"We are very keen to look at very much collaborative models, and very much baby steps in the first instance," she said.

"Being aware that we are the ones who have been doing it for a very long period of time and understand the pitfalls and potential harm to public."

Lee Hohaia, chief executive of the Pharmacy Guild, said it supported the clear separation between prescribing and dispensing.

A spokeswoman for the Royal New Zealand College of General Practitioners said it would want to ensure clear communication and collaborative working relationships between GPs and pharmacist prescribers.

Pharmacy prescribers
•Specialist pharmacists who have undertaken postgraduate study can prescribe medicines, working in a wider team of health professionals. They do not usually work in retail pharmacy.

•The Ministry of Health is to "explore and develop models for pharmacist prescribing" - with Health Minister Dr Jonathan Coleman saying it makes sense to look at more pharmacists prescribing.