RACGP Raises Safety Concerns Over Expanded Pharmacist Prescribing
11 Aug 2026
The concerns were outlined in the college’s submission to the Pharmacy Board of Australia on its proposed approach to pharmacist prescribing.
The RACGP said there is not enough evidence to show that diagnostic risks can be safely identified and managed under the proposed framework.
The college also questioned how regulators would identify problems early and respond to delayed diagnoses if prescribing authority were expanded at the registration level.
It said effective safeguards would need to include systems for tracking patient outcomes, sharing relevant health information, identifying warning signs and taking action when concerns arise.
The RACGP supports models where pharmacists and other healthcare professionals work together within clearly defined services. It said these arrangements should include shared responsibility, clinical review, escalation processes, ongoing oversight, audits and feedback.
RACGP President Dr Michael Wright said improving access to healthcare is important, but it must be balanced with patient safety and continuity of care.
He said prescribing decisions should be connected to a patient's medical history and followed by appropriate review when needed.
The college also argued that prescribing should be viewed as part of a wider diagnostic process rather than simply the supply of a medicine.
According to the RACGP, clinicians need to be able to recognise when symptoms may point to a more serious condition, reassess patients as their condition changes and respond when the initial diagnosis is uncertain.
The submission asks the Pharmacy Board to explain how delayed or missed diagnoses would be identified and managed if its proposed registration-level prescribing model proceeds.
The RACGP included nine case studies to demonstrate the potential risks it believes could arise without stronger safeguards.
The examples included a patient experiencing domestic and sexual violence whose circumstances could remain unidentified when receiving treatment from different pharmacies without a physical assessment.
Other examples involved medication easing reflux symptoms while an underlying oesophageal cancer remained undiagnosed, and a kidney cancer diagnosis being delayed because symptoms appeared similar to a straightforward urinary tract infection.
Another case involved a patient being advised by a pharmacist but not receiving urgent escalation. A later medical assessment identified pancreatitis that required hospital treatment.
The RACGP's submission follows recent reports from the Grattan Institute and Sax Institute, which also identified limited evidence supporting pharmacist-led prescribing models.
Medical indemnity insurer Avant raised similar concerns in June, warning that proposed changes could increase the risk of patient harm linked to incorrect diagnoses or inappropriate prescribing.
The RACGP said patient safety should remain the central consideration as regulators assess any changes to pharmacist prescribing.
RACGP Raises Safety Concerns Over Expanded Pharmacist Prescribing
Source: RACGP / newsGP