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Prescribing and dispensing using the PBS Hospital Medication Chart

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 Duty Pharmaceutical Officer at the Pharmaceutical Regulatory Unit, NSW Ministry of Health by telephone on (02) 9391 9944 or email MOH-Pharmaceuticalservices@health.nsw.gov.au.

Medication handling in NSW public health facilities

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:

  • the provision of emergency supplies of morphine to NSW Ambulance paramedics (section 4.4.3)
  • the provision of tenecteplase to NSW Ambulance paramedics under the Pre Hospital Thrombolysis Program (section 5.13.2).

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.

Special licence for supply of medications

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 Director of Pharmacy of a public hospital or
  • the Director of Nursing at a public hospital without a Pharmacy Service.

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.

Public hospital pharmacist supply of medications to community patients

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:

  1. On the digital image of a prescription, sent in a secure email or by facsimile, from an authorised practitioner (such as a medical practitioner or nurse practitioner) to the hospital pharmacy. 
  2. For Schedule 8 medications, as if a patient in special hotel accommodation is an inpatient at a public hospital. The hospital prescriber may continue to prescribe the Schedule 8 medication without a NSW Health Authority in accord with the NSW Health Authority held by a community prescriber.

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.

Image-based prescribing in public health organisations

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:

  1. Prescriber issues a regular prescription, including a handwritten signature
  2. Prescriber prepares an image of the prescription (photo or scan) and sends it directly to the public health organisation pharmacy by fax or email
  3. Pharmacist dispenses the prescription and arranges supply to the patient
  4. Prescriber keeps the signed prescription either in hard copy form or as a reproducible digital image for two years.
  5. Pharmacist keeps any repeats and all prescriptions for two years.

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. 

Frequently asked questions

How does a prescriber make an image-based prescription?
The medical or nurse practitioner can issue a prescription as normal, including signing the prescription by hand. Once the prescription is complete, the prescriber takes an image (photo or scan) and sends it to the public health facility pharmacy via fax or email. The prescriber must keep the signed prescription either in hard copy form or as a reproducible digital image for two years.

The patient has a photo of their prescription. Can a pharmacist dispense it?

No. Image-based prescriptions are only valid when sent directly to the pharmacy by the prescriber using email or fax.

What does a pharmacist do if the medicine requested on an image of a prescription is not in stock?

If a pharmacist cannot dispense a medicine on an image-based prescription, they should inform the prescriber so that the prescriber can make other arrangements. A pharmacist cannot forward an image-based prescription to another pharmacist for dispensing.

Current as at: Friday 31 March 2023
Contact page owner: Pharmaceutical Services