The PBS Hospital Medication Chart published by the Australian Commission on Safety and Quality in Health Care may be used as a form of prescription under exemptions to the Poisons and Therapeutic Goods Regulation 2008.
The PBS Hospital Medication Chart may be used at a private health facility licensed under the Private Health Facilities Act 2007. Prescribing and dispensing of both Pharmaceutical Benefits Scheme (PBS) medications and non-PBS medicines is allowed.
The forms of PBS Hospital Medication Chart eligible for use are available from the Australian Commission on Safety and Quality in Health Care.
Information on the use of the PBS Hospital Medication Chart are available for prescribers and pharmacists.
For further information on the PBS Hospital Medication Chart contact the Pharmaceutical Services Unit, NSW Ministry of Health by email at MOH-Pharmaceuticalservices@health.nsw.gov.au.
The policy PD2022_032 Medication Handling consolidates best practice principles on medication procurement, storage, prescribing, supplying, dispensing and administration at NSW public health facilities with the requirements of the NSW Poisons and Therapeutic Goods Act 1966 and the Poisons and Therapeutic Goods Regulation 2008, NSW Health policies and NSW Health directives relevant to medication handling.
Best practice principles are adopted from recognised standards, such as those published by health practitioner organisations, NSW government departments, the Australian Commission on Safety and Quality in Health Care and the Commonwealth Department of Health.
The policy applies to all public health organisation health facilities including hospitals, institutions, clinical services, outpatient clinics, community health centres, day centres, Hospital in the Home and outreach services within the NSW Health system’s jurisdiction (including where a public health service is contracted to a non-government organisation).
The policy does not apply to medication handling and administration by paramedics and flight nurses employed by NSW Ambulance, except for the following specific services provided by public hospital emergency departments:
Medication handling and administration within NSW Ambulance is mandated in the Medications Management Operating Procedure endorsed by the NSW Ambulance Chief Executive.
The policy does not apply to HealthShare NSW patient transport service, which is mandated in the separate Patient Transport Service Medication Management Policy endorsed by the HealthShare NSW Chief Executive.
All documents endorsed under local governance or department processes may be used to describe facility procedures and do not have to be in the form of a written protocol.
Pre-printed prescription stationery may include the name, address and telephone number of the public health facility and the name and designation of the prescriber.
Where a prescription (other than for a Schedule 8 medication) is issued in duplicate for dispensing at a public hospital pharmacy service, a pre-printed addressograph may be included on both the prescription and prescription duplicate. A prescription for a Schedule 8 medication must not include any other medication, other than two strengths of the same medication, for example, buprenorphine transdermal patch 30 mcg/hour and 5 mcg/hour.
The prescriber at a public health facility must obtain a NSW Health Schedule 8 authority/approval to continue prescribing the Schedule 8 medicine for an inpatient after 14 days in the following circumstances:
a) a drug dependent person, or for
b) dexamfetamine, lisdexamfetamine or methylphenidate*
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.
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.
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.
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.
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.
Special licences have been issued under the Poisons and Therapeutic Goods Regulation 2008 to supply certain medicines by wholesale.
Licence LHD005 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 supplying public health organisation must comply with the conditions of the licence.
Licence COVIDVAX005 allows the supply of COVID-19 vaccines to selected vaccination sites.
Licence NMS0125 allows the supply of medicines from the National Medical Stockpile.
Licence HSD001 allows the supply of certain medicines to certain prescribers.
Licence OTP001 allows specified public health organisations to supply methadone and buprenorphine to a community pharmacy to dispense to patients on the NSW Opioid Treatment Program.
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:
Where there is no NSW Health Authority held by another prescriber, the hospital prescriber may prescribe the medication for 14 days without a NSW Health Authority then must obtain any necessary Authority to continue treatment. See NSW Health Authority requirements.
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:
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.
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.
