Pharmacy support staff
Under direct supervision of a pharmacist, designated Pharmacy support staff (e.g. technician) may be involved in accountable drug management. Processes must be in accordance with local Pharmacy Department procedures for the management and handling of accountable drugs, including dedicated training and competency-based assessment, and processes for pharmacist accountability. A pharmacist must review drug register entries and check all details are correct before signing.
Medication supplies to outpatients and inpatients on discharge
Where clinically indicated, a pharmacist may provide a quantity up to, but no greater than, the quantity prescribed on discharge or for outpatient supply. The supply of discharge medications is limited to a maximum of up to 7 days of treatment under the local protocol other than when approved to meet a specific patient need.
The pharmacist must clearly notate on the prescription the actual quantity dispensed if less than stated on the prescription.
Destruction of expired, unwanted, or unusable Schedule 8 medications
Any technique used to destroy Schedule 8 medication should be in line with facility approved procedures and medication must be made unusable and unrecoverable. Wherever possible destroyed, unrecoverable medication must be disposed of in a pharmaceutical waste bin.
Schedule 8 medication stock transfers
Stock transfers to other public health facilities must be under Director of Pharmacy approved procedures.
Two registered nurses or midwives authorised by the nurse/midwife in charge of the patient care area may transfer Schedule 8 medications within a public health facility.
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Preparation of pharmaceutical and advanced therapeutic products in NSW public health facilities
Preparation of pharmaceutical and advanced therapeutic products in NSW public hospital is governed by the
Policy Directive PD2023_021. For further information see
Preparation of pharmaceutical and advanced therapeutic products in NSW public health facilities.
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Special licence for supply of medications
Special licences have been issued under the Poisons and Therapeutic Goods Regulation 2008 to supply certain medicines by wholesale.
Licence LHD006 allows a public health organisation to supply selected medicines to another public health organisation or to non-government organisations in specified circumstances.
Supply from a public health organisation may be made by:
- the Director of Pharmacy of a public hospital or
- the Director of Nursing at a public hospital without a Pharmacy Service.
The supplying public health organisation must comply with the conditions of the licence.
Licence
COVIDVAX007 allows the supply of COVID-19 vaccines to selected vaccination sites.
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Public hospital pharmacist supply of medications to community patients
The supply of medications to community patients cared for by a Local Health District during the pandemic, by a public hospital pharmacist, has been approved. The approval is an exception to the policy in NSW Health
PD2022_032 Medication Handling (see section 4.4.1 of the Procedures) which normally limits supply to outpatients, inpatients and inpatients on discharge.
The supply by the public hospital pharmacist may be:
- On the digital image of a prescription, sent in a secure email or by facsimile, from an authorised practitioner (such as a medical practitioner or nurse practitioner) to the hospital pharmacy.
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For Schedule 8 medications, as if a patient in special hotel accommodation is an inpatient at a public hospital. The hospital prescriber may continue to prescribe the Schedule 8 medication without a NSW Health approval in accord with the NSW Health approval held by a community prescriber.
Where there is no NSW Health approval held by another prescriber, the hospital prescriber may prescribe the medication for 14 days without a NSW Health approval then must obtain any necessary approval to continue treatment. Refer to
Application forms for approval to prescribe or supply.
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Image-based prescribing in public health organisations
Medical practitioners and nurse practitioners in NSW can issue an image-based prescription for Schedule 4 and Schedule 8 medicines and send it by email or fax to a dispensing pharmacist employed in or engaged by a public health organisation.
Image-based prescriptions do not need to be followed up with a hard copy of the prescription and can be issued with repeats for
Schedule 4 medicines, including those in Appendix D and
Schedule 8 medicines
The steps for image-based prescribing are:
- Prescriber issues a regular prescription, including a handwritten signature
- Prescriber prepares an image of the prescription (photo or scan) and sends it directly to the public health organisation pharmacy by fax or email
- Pharmacist dispenses the prescription and arranges supply to the patient
- Prescriber keeps the signed prescription either in hard copy form or as a reproducible digital image for two years.
- Pharmacist keeps any repeats and all prescriptions for two years.
For a prescription issued with repeats, the pharmacist is to print the repeat authorisation form as normal and attach it to the printed copy of the image-based prescription and store them together at the pharmacy for future dispensing.
Frequently asked questions
How does a prescriber make an image-based prescription?
The medical or nurse practitioner can issue a prescription as normal, including signing the prescription by hand. Once the prescription is complete, the prescriber takes an image (photo or scan) and sends it to the public health facility pharmacy via fax or email. The prescriber must keep the signed prescription either in hard copy form or as a reproducible digital image for two years.
The patient has a photo of their prescription. Can a pharmacist dispense it?
No. Image-based prescriptions are only valid when sent directly to the pharmacy by the prescriber using email or fax.
What does a pharmacist do if the medicine requested on an image of a prescription is not in stock?
If a pharmacist cannot dispense a medicine on an image-based prescription, they should inform the prescriber so that the prescriber can make other arrangements. A pharmacist cannot forward an image-based prescription to another pharmacist for dispensing.
Partnered Pharmacist Medication Charting
The Partnered Pharmacist Medication Charting (PPMC) is a model of care supported by the NSW Ministry of Health that allows credentialled pharmacists to chart medication administration directions as authorised by a medical officer.
The PPMC is to be used in a number of approved public health facilities and is enabled under an
Approval under the Poisons and Therapeutics Goods legislation.
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