Prescribing a better future
Last year, UK physiotherapists gained the right to prescribe medications to patients. There have been several projects in developing this over many years in the UK, but this decision was considered a milestone. While this certainly doesn’t mean that all physiotherapists are trained to prescribe, there is now an agreed process by which physiotherapists can do further credentialing to get prescribing rights.
In 2013 in Australia, the Standing Council on Health (which consists of the health ministers from all of the states and territories and the commonwealth) endorsed the Health Practitioners Prescribing Pathway. This work was the result of a program led by Health Workforce Australia, which sought to define a consistent policy framework around how future prescribing by non-medical professionals would be developed.
There are obviously significant issues that need to be grappled with in order for physiotherapists to become prescribers. Physiotherapy education will need to incorporate different elements in order for graduates to be 'prescribing ready'. There are regulatory issues to be resolved with the Physiotherapy Board of Australia. The poisons legislation varies from state to state, so while we now have a national framework, the pathway to prescribing will be different in each jurisdiction.
Perhaps more importantly, we will need to support appropriate pilots of physiotherapists prescribing to demonstrate safety and efficacy. We are unlikely to be able to do this in isolation. We will need to have advocates in our patients, workplaces and with our medical colleagues in order to achieve this type of change.
We will need to have discussions about funding, in particular support for funding of medications under the Pharmaceutical Benefits Scheme (PBS). It would be frustrating to go through a process of achieving system change to allow physiotherapists to legally prescribe, but not have patients able to access medications at a comparable rate to if they were prescribed by an alternate practitioner. This situation currently exists in regard to some radiology procedures, and is quite challenging for providers.
There will need to be discussions about our existing physiotherapy workforce, and what training should be available to current physiotherapists who wish to become prescribers. An element of this discussion is also relevant to ongoing professional education of prescribers, once they are able to prescribe.
It is fair to say that in conversations with many people about this topic over the last few years, not every physiotherapist believes that this is an important issue. Some are of the view that our current scope of practice enables us to provide excellent care to many Australians. This is true. It does. But in the future, what other opportunities are there likely to be for physiotherapists to assist our medical colleagues and others in the health system to meet the future health needs of Australians?
Earlier this year, the APA Board of Directors agreed to pursue prescribing rights for physiotherapists as a high priority advocacy issue. In order to progress this, there will be a range of activities undertaken through 2014 and beyond. These will include work from the National Advisory Council and the advocacy team in getting some good exemplars of where physiotherapist’s prescribing would be safe, improve the patient experience and improve the efficiency of the Australian health system. I strongly encourage you to consider this issue, and provide input through the many available channels.
It is my hope that over the next few years in Australia, physiotherapists will be able to prescribe.
MARCUS DRIPPS, APAM
APA National President
If you wish to get in touch with the APA National President please click here.