New state-led changes could further fragment care.
AMA Queensland has hit back at proposed changes to immunisation regulations, which it says have the potential to fragment care.
Changes to the Medicines and Poisons (Medicines) Regulation 2021 would allow immunisation administration without a prescription from a range of non-GP practitioners.
“The latest example [of fragmentation] is a plan to enable administration of all S4 immunisations without a prescription by a range of health practitioners, including pharmacists, registered nurses and midwives, outside of a multidisciplinary team setting,” AMA Queensland president Dr Nick Yim told The Medical Republic.
“Immunisation appointments are an invaluable opportunity for doctors to comprehensively screen patients and prevent or detect and treat issues early before they progress.
“Many non-medical practitioners are not trained to screen for or treat these issues and often do not work in settings where that would be appropriate.
“The proposal does not contain adequate record keeping requirements which have been poorly implemented under similar scope expansions, including the Queensland Government community pharmacy prescribing program.”
The AMAQ also expressed concerns over the potential removal of age restrictions for pharmacy immunisations.
“It requires knowledge of surface anatomy and communication and examination skills which pharmacists are not trained in,” the AMAQ submission reads.
“New parents respond poorly to any hesitation or lack of confidence in handling of the infant, set up, and reassurance and education at time of vaccination.
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“Incorrect immunisation of infants or a suboptimal experience at time of immunisation greatly affects parent trust and buy-in with the National Immunisation Program, and this would detract from the intent behind these regulations in addressing immunisation decline in QLD.”
The AMAQ also argued that children’s immunisation should come as part of GP child health checks that would align with developmental milestones and opportunities for intervention when it comes to post-natal depression and anxiety.
However, the removal of barriers for the administration of adrenaline for anaphylaxis was welcomed.
“Benefits far outweigh risks for removing as many barriers as feasible for the prompt administration of adrenaline,” the submission said.
“The link between immunisation and child health checks will be lost and this can only lead to missed opportunities to pick up issues with the child or the parent.
“This model is a far cry from the one where immunisations and health checks were done at the local community maternal and child clinics by trained nurses.”
