Five leading medical organisations have jointly called on the New South Wales Government to pause its planned expansion of pharmacist prescribing into complex conditions, warning the move risks outpacing the evidence and undermining patient safety.
In a joint letter to NSW Premier Chris Minns, the Australian Medical Association (AMA, Australian Salaried Medical Officers Federation, Royal Australian College of GPs, Royal Australasian College of Physicians, and Royal Australasian College of Surgeons have raised concerns about the potential dangers of asking pharmacists to prescribe medication for complex medical conditions, including hypertension and chronic obstructive pulmonary disease (COPD).
The organisations also raised concerns about potential conflicts of interest where prescribing and dispensing are combined. Appropriate safeguards must be in place to ensure prescribing decisions are made in patients’ best interests.
The organisations are calling on the NSW Government to:
- pause further expansion of pharmacist prescribing into chronic and complex conditions until an independent evaluation of the Queensland pilot is completed and publicly released, with any subsequent expansion supported by condition-specific evidence and appropriate safeguards.
- Consult meaningfully with the medical profession and other stakeholders before future scope-of-practice decisions are made
- Meet urgently with Premier Minns to discuss a pathway forward that places patient safety and evidence at the centre of reform.
RACGP NSW & ACT Chair Dr Rebekah Hoffman said continuity of care remained one of the strongest predictors of better health outcomes.
“General practice is built on long-term relationships that allow a patient’s full medical history, medications and changing health circumstances to be understood over time.”
“The evidence is clear that continuity of care improves outcomes and reduces pressure on hospitals. We should be strengthening those relationships, not introducing models that risk fragmenting care.
AMA (NSW) President Dr Fred Betros said the announcement was inconsistent with commitments made by health ministers only days earlier to pursue a nationally consistent approach to prescribing scope of practice.
“The expansion of prescribing into complex chronic conditions should be guided by robust evidence, national consistency and patient safety, not rushed policy decisions.
“Conditions such as hypertension and COPD require accurate diagnosis, ongoing monitoring and continuity of care. These are not one-off presentations that can be safely managed through episodic encounters alone.”
ASMOF NSW – The Doctors Union President Dr Nicholas Spooner said expanding prescribing authority without adequate safeguards risked creating a more fragmented health system.
“Our members work on the frontline of hospitals and see the consequences when care becomes disconnected.
“Patients with chronic and complex illness need coordinated care pathways and clear clinical accountability. Any reform must strengthen those systems, not weaken them.”
RACP NSW & ACT Committee Chair Dr Robert Tait said the evidence base had not kept pace with policy expansion.
“Managing chronic disease safely depends on understanding diagnostic uncertainty, identifying red flags and coordinating care across multiple providers.
“We remain concerned that pharmacist prescribing is being expanded into increasingly complex areas without the level of evidence or evaluation that patients deserve.”
RACS NSW State Committee Chair Dr Danette Wright said major changes to prescribing models required rigorous scrutiny.
“Healthcare reform must be driven by evidence and patient outcomes.
“Before expanding prescribing authority into more complex conditions, governments should ensure there is a clear understanding of the benefits, risks and impacts on the broader health system.”
The organisations said they remained committed to working constructively with the NSW Government on reforms that improve access to care while maintaining the highest standards of patient safety.
“We support multidisciplinary care and the important role pharmacists play in the health system,” the organisations said.
“However, any expansion of prescribing and diagnostic authority must be evidence-based, appropriately governed and designed to support, rather than fragment, continuity of care.”
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