No more prescriptions?

A review of PBS arrangements suggests scrapping prescriptions in nursing homes along with the introduction of increased prescribing rights for pharmacists and nurse practitioners.

Prescription-free nursing homes are at the top of a list of controversial suggestions outlined in a recent review of medication supply arrangements in aged care facilities.

Prepared on behalf of the Commonwealth Government and the Pharmacy Guild of Australia, the discussion paper looks at ways to improve efficiencies in the delivery of medications to residents under the Pharmaceutical Benefits Scheme (PBS).

Under the proposal for prescription-less nursing homes, residents’ medication charts would be used to make orders to pharmacies as well as to record the delivery and administration of medications.

“The medication chart could form one central document which meets the needs of the resident, medical practitioner, pharmacist, nurse, RACF and MA,” the discussion paper said.

The document included measures to increase the prescribing rights of pharmacists and nurse practitioners, under a process described as “collaborative prescribing”.

It suggested that pharmacists be allowed to authorise repeat prescriptions from Medicare and to arrange for the continuation of prescriptions when residents are admitted to private hospitals.

The paper outlined a scenario in which nurse practitioners could make prescriptions under the PBS as part of a care plan prepared by GPs.

A final option suggested in the discussion paper is that facilities enter into contract arrangements with local GP practices.

Under this model, participating GPs would be paid a retainer to perform an agreed number of medication reviews within the facility in a given period.

“This option could work on a similar basis to the way in which RACFs currently engage with community pharmacy,” the paper said.

The government and the guild are calling for feedback on the proposal until  21 January.

Click here to see the full discussion paper, which includes instructions on how to make submissions.

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