Experts answer your top practice questions

Each week, pharmacists across the country ring PSA’s Pharmacist to Pharmacist advice line looking for guidance on everything from practice-related queries to ethical dilemmas. In this series, Australian Pharmacist speaks to the experts to answer some of the most frequently asked questions.

This month Amanda Fairjones MPS, PSA Professional Support Advisor, and Peter Guthrey MPS, Senior Pharmacist – Strategic Policy, answer your questions about the end of digital image prescriptions, administering Novavax as a booster, supervising rapid antigen tests and more.

Q: What are the transition arrangements for digital image prescriptions?

The PBS Special Arrangement for digital image prescribing, which enables pharmacies to supply and claim prescriptions directly from faxed/emailed/SMS images from a prescriber, ended on 31 March 2022 (except within hospitals). 

The following transition arrangements apply:

• Prescribers who send faxed/emailed prescriptions written after 31 March 2022 must also immediately send the paper copy of the prescription directly to the pharmacy. 
• Prescriptions written on or prior to 31 March 2022 can continue to be supplied under the digital image prescribing initiative until they expire. This includes repeats that have been kept at the original supplying pharmacy.
• Hospital pharmacies can supply digital image prescriptions for hospital patients’ PBS prescriptions until 31 March 2023. 

Pharmacists should be aware:

• In NSW, temporary measures will allow supply of non-PBS medicines under this measure until 30 September 2022, without hard copy prescriptions being sent to the pharmacy.
• Victorian regulations do not recognise faxed prescriptions as a legal order.
• Queensland regulations for telephone/fax orders have changed since digital image prescribing was temporarily enabled. Pharmacists should be aware of shorter periods prescribers have to send original prescriptions to the pharmacy (7 days for Prescription Only Medicines, 5 pm next business day for Controlled Drugs).

The PSA COVID-19 microsite has state-by-state descriptions of requirements for telephone/fax orders. 

Q: Can I administer Novavax as a booster dose?

Yes, but its use would be rare. In accordance with ATAGI advice, Novavax can only be administered as a booster of ‘last resort’.

Immunisers are bound by ATAGI recommendations on the use of a booster dose of Covid-19 vaccine (25 March 2022), which states:

There are limited data on the safety and immunogenicity of Novavax as a booster dose and it is not TGA-registered for this indication. ATAGI advises that Novavax can be used as a booster dose in an individual aged 18 or older if no other COVID-19 vaccine brand is suitable for that individual.

Further information is available at: PSA COVID-19 vaccine information for pharmacists.

ATAGI has stated either mRNA vaccine (Pfizer or Moderna) is preferred for COVID-19 booster doses for people aged 18 years and older.

For individuals aged 16–17 years, only the Pfizer vaccine can be used. The AstraZeneca vaccine is only recommended for individuals with medical contraindications to the Pfizer and/or Moderna vaccines (e.g. anaphylaxis, myocarditis).

Q: Will my PSA indemnity insurance cover pharmacists supervising RATs?

Yes, as PSA considers the supervision of RATs to be within the scope of a pharmacist’s practice, members with PSA Member Insurance are covered for this service.

When practising within their scope, pharmacists must ensure they are educated and competent to perform the professional role and/or service. For the supervision of RATs, it is recommended pharmacists ensure they are appropriately trained, wear appropriate PPE and practise in accordance to recognised standards and guidelines, ensuring clear, written documentation of the service.

Q: I am moving interstate, will my immunisation qualifications be recognised in a different state or territory?

Maybe. This will depend the state or territory to which you are moving to practice. 

Most often, your qualifications will be recognised, but this is not always the case. For instance, if you are moving to Victoria and have completed an immunisation training course other than the Victorian recognised ‘Immuniser program of study’, you will not be authorised to administer vaccinations in Victoria. 

If you will be moving or plan to locum in a different state, we recommend contacting the PSA member Pharmacist to Pharmacist advice line for advice specific to your situation.

Additionally, PSA provides Online Immunisation Refresher Training. This is recommended for pharmacist immunisers moving interstate as the training provides regulatory modules for all jurisdictions, assisting pharmacists to meet state requirements. The training is also recommended for pharmacists who are immunisers and:

• require an annual update on immunisation changes or regulatory updates OR
• need to expand their scope in order to administer additional vaccines that have been added to state jurisdictions since their initial training.

Q: I am interested in becoming a GP practice pharmacist, can you give me further information?

To become a GP pharmacist, the only mandatory criterion for pharmacists is to hold current registration with AHPRA. In addition, PSA recommends the following criteria as ideal characteristics and experience for a pharmacist to enter a general practice setting:

• Minimum 2 years’ experience post-registration 
• Medication Management Review accreditation is desirable but not essential 
• Complete or be enrolled in the PSA GP Pharmacist Foundation Training Program.

The PSA General Practice Pharmacist Foundation Training provides an overview of core knowledge and skills required by pharmacists wishing to work in general practice.  

In general practice, the pharmacist can be involved in quality use of medicines and medication safety activities that support the GP. The pharmacist may undertake a range of activities, including: 

• gathering patient’s medication and medical history information and documenting in preparation for the GP to help inform the development of a GP Management Plan 
• providing training to practice staff on the use of My Health Record in the practice, supporting the practice’s involvement in the Practice Incentives Program
• participating in a Multidisciplinary Case Conference organised by a GP 
• undertaking medication history and review to inform the health assessment that the GP will undertake 
• discussing medication reviews
• delivering patient and staff education
• implementing medication safety activities within the practice 
• responding to medicine information queries.

General Practice Pharmacists’ activities are covered in PSA’s indemnity insurance. 

For further information, please refer to pages 26 and 27 of PSA’s Pharmacists in 2023: roles and remuneration report.

Do you have questions of your own? Contact PSA’s Pharmacist to Pharmacist advice line on 1300 369 772.