Jayne Stinson, Inquiry Chair (FIVEaa 11.37-11.41)
HOST: Matthew Pantelis: Jayne Stinson is the Member for Badcoe.
Jayne Stinson: Goodmorning Matthew. I’m the Chair of the inquiry. I established this inquiry earlier in the year and it’s now underway. It was great to hear from Sian and also her interstate colleague Nicole this morning from the RACGP and we also heard from the Rural Doctors today.
In past weeks we’ve heard from the AMA as well, and in the future we’ll be hearing from the Pharmacy Guild and the Pharmaceutical Society.
Really importantly we’ll be hearing from patients which is the whole reason why I put forward this inquiry.
I, myself, am a sufferer of regular UTIs and patients have been raising with me that this is a model that works well in Queensland and was something they wanted South Australia to investigate. It can be, and it is, a very painful, excruciating in fact condition when you get it and we don’t women suffering any longer than is absolutely necessary.
Looking at this model that Queensland have had in operation for some time now is what we’re doing and as Sian said we’re hearing from a range of different people about the issues that are involved with that and ultimately we’ll be making a recommendation to the Government about how to proceed.
HOST: Regarding a doctor might pick up on something else that a pharmacy through, maybe the fact they’re busy, maybe the fact they assume … I don’t know … never dispensed a drug in my life … but clearly a doctor is skilled to pick up on a range of different things that a pharmacist just may not.
What we’re looking at is the Queensland model, so I’ll run you through what happens there. A patient who suspects they may have a UTI (and certainly when I’ve got one I know I’ve got it!) will go into a pharmacy and say ‘I’d like to speak with the pharmacist. I suspect I may have a UTI’ and then the pharmacist will essentially interview or have a consultation with that patient in a private area, a private area is mandated, and they’ll ask them a series of questions.
What they’re looking for is red flags … are you pregnant or might you be pregnant? have you had bleeding? There are other indications that might indicate that either this is more serious than a UTI or is a particularly bad UTI or just isn’t likely to be a UTI at all. They go through a checklist or protocol and if they find it is most likely that this is a UTI then the pharmacist is empowered to prescribe.
Importantly, what happens is if they’ve got any concerns or doubts or think this might not be a UTI is they send them to a doctor and give them some very firm advice about the need to go and see a GP because we only want medication going to those who most likely have a UTI.
HOST: When do you report? Over the coming months we’ll be hearing more evidence from a range of different players, it’s safe to say that doctors and pharmacists while they work together on lots of things are not of one mind on this so it’s the committee’s job to pick through that evidence and see what’s best for patients rather than one profession over another and we’re probably doing that for the next few months.
We’re also actually going up to Queensland to have a look at how the program is working up there, what sort of record management they do, how do they interact with patients, how do we improve it in South Australia if we were to adopt it, how to make it a better system. Obviously we’ve got an eye on the New South Wales trial as well.
All other state are now looking into this in one form or another so we’re paying close attention to what’s happening elsewhere and what’s going to be in the best interests of patients, particularly women aged 18 to 65 here in South Australia.
HOST: Thanks for all your work Jayne.
Caller Matthew (FIVEaa 11.41-11.42) HOST: A couple of pharmacists have called in. Matthew …
CALLER MATTHEW: Great to hear from Jayne, she’s very clearly articulated some of the reasons why pharmacies are the perfect setting to be able to deliver this care in the best interests of the patient. What Jayne said around having the best interest of the patient at heart is core to what pharmacy does day in, day out. The private setting is happening in all pharmacies across Australia on a number of different levels, vaccinations, all these things are happening in private settings. I can assure you in practice we are doing these things in the interests of the patient in a very private setting.
Caller Morag (FIVEaa 11.42-11.44)
HOST: Morag, also a pharmacist…
CALLER MORAG: I think that Matthew has articulated that well and Jayne about the private settings that we do have in pharmacy. My concern is that when I’m asked for UTI treatment I have to refer the patient to a doctor and the concern of myself and the patient is the length of time that it’s going to take to actually see a doctor who’s going to treat them thoroughly. We see people resorting to these dial-a-script services and I do have concerns about the level of care that the patient receives when they’re just calling and asking for a script for a particular item. I’ve seen that recently with people calling to get blood pressure medication and the prescribing doctor’s not actually been able to take the blood pressure and refers them back to the pharmacy to have that taken before the script can be dispensed. And that’s something that I see delaying treatment can be very dangerous.
HOST: Can you say with confidence… you’d be able to pick a UTI? I would be undertaking further training myself. I believe that I can diagnose a simple UTI and I would be referring any unexpected symptoms, any complex or recurring UTIs I would be referring to a doctor. The problem is, people tell you it’s two weeks until they can get in and see a doctor. We need this.