Medical practitioners and nurse practitioners in NSW can issue an image-based prescription for most medicines; sending by email or fax to a pharmacy.
This temporary measure will better support patients, prescribers and pharmacists during the COVID-19 response, and allow better integration of the prescription and supply of medicines with the Commonwealth Government’s COVID-19 response telehealth reforms.
A medical practitioner or nurse practitioner can issue an image-based prescription for emailing or faxing to a pharmacy. Image-based prescriptions do not need to be followed up with a hard copy of the prescription, and can be issued with repeats.
Image-based prescriptions can only be issued and dispensed for Schedule 4 medicines, except those in Appendix D (S4D medicines). S4D medicines and Schedule 8 (S8) medicines are not included in the temporary arrangements due to risks associated with fraudulent prescription and supply.
The steps for image-based prescribing are:
All repeats must be supplied and held in the same pharmacy as the original supply.
There are no changes to issuing and dispensing prescriptions for S4D and S8 medicines. A prescriber may still direct a pharmacist to dispense S8 and S4D medicines by telephone, email or fax, and the paper-based prescription must be sent to the pharmacist within 24 hours.
Image-based prescriptions cannot be used for Schedule 8 medicines and Schedule 4 Appendix D medicines.
On 17 April 2020, additional substances identified as liable to abuse, misuse and trafficking were included in Appendix D as prescribed restricted substances.
The addition of these substances will better align the NSW legislative framework with the National Poisons Standard.
The following medicines are now included in Appendix D as prescribed restricted substances:
As with any Schedule 4 Appendix D medicine, prescriptions for these medicines can only be dispensed for up to six months from the date of issue.
A list of all Schedule 4 Appendix D medicines is available.
No. There is no change to the way you issue a prescription, the instructions required, or any other details required on the prescription. You must sign the prescription by hand (digital signatures are not permitted).
Issue a prescription as normal, including signing the prescription by hand. Once the prescription is complete, the prescriber can fax it to a pharmacist, scan it and email it to a pharmacist, or take a photograph of it and email it to a pharmacist. The prescriber must keep the signed prescription either in hard copy form or as a reproducible digital image for two years.
No, digital signatures are not permitted. The prescription must be printed and signed by hand. An image can then be made.
Yes, image-based prescriptions can include instructions for a repeat supply. To comply with PBS requirements, all repeats must be supplied and held in the same pharmacy as the original supply.
No. The image-based prescription must be sent directly from the prescriber to the pharmacy, either by email or fax.
Use your search engine or tools such as Pharmacy Guild of Australia - Find a pharmacy. It is advisable to confirm details with the pharmacy before sending an email or fax, check if they hold stock of any unusual medicines or medicines known to be in short supply.
A prescriber may record the name of the pharmacist they have sent an image-based prescription to, but this is not required by law.
Image-based prescriptions can be used for Schedule 4 medicines excluding those in Appendix D. Schedule 4 Appendix D medicines and Schedule 8 medicines are not included in the temporary arrangements.
Keep the signed prescription either in hard copy form or as a reproducible digital image at you place of practice for two years from the date of issue.
Image-based prescribing is in place until 30 September 2022. From 1 April 2022 image-based prescriptions are not eligible for a PBS subsidy and should be treated as non-PBS prescriptions in a community pharmacy or as otherwise advised by the Commonwealth.
For more information contact the Duty Pharmaceutical Officer at the NSW Ministry of Health at MOH-PharmaceuticalServices@health.nsw.gov.au.
