Eligible pharmacists in a new NSW prescribing trial will be able to manage chronic conditions, including chronic obstructive pulmonary disease (COPD), in what the pharmacy guild is calling a landmark announcement.
When it will come into effect is yet to be determined.
Last week, The Medical Republic reported the Pharmacy Guild’s NSW branch had urged the state government to allow more than 250 pharmacists completing accredited prescribing training at the University of Newcastle and the University of Technology Sydney to work full scope across 23 common health conditions.
At today’s Pharmacy Connect 2026 conference, NSW premier Chris Minns confirmed that he would be granting this particular wish.
The premier also announced that from 1 January 2027, NSW community pharmacists would also be able to administer all vaccinations under the National Immunisation Program.
However, the NSW government affirmed that regular GP visits remained very important for childhood healthcare, and that children requiring catch-up vaccinations or those with complex medical conditions would not be eligible for pharmacist-led vaccination.
The NSW government said the initiatives would free up GP appointments for patients with more complex health needs and reduce hospital pressures.
AMA NSW President Dr Fred Betros told The Medical Republic he had “grave concerns” about the further fragmentation of care for patients “disconnected from the heart, which is their GP”.
Having trained in both pharmacy and medicine, and worked in community pharmacy, Dr Betros said this dual background gave him insight into what each profession does well.
While he acknowledged pharmacists were adept at managing medications and had many pharmacist colleagues whom he “implicitly trust[ed]”, he told TMR the “crossover of roles” could lead pharmacists to underestimate the seriousness of conditions due to their subtle presentation.
“If you’re not trained in it, you’re going to miss it. We train as doctors for years. We prescribe within a collaborative model under the supervision of senior doctors,” he said.
Ear infections, acute vomiting, high blood pressure and chronic obstructive pulmonary disease were not extensions of dispensing, and could be masking far more serious conditions, he wrote in a statement today.
“A wound that will not heal can be the first sign of diabetes or vascular disease,” the statement read.
“Vomiting is not a diagnosis. It is a symptom, and it sits in front of appendicitis, bowel obstruction, diabetic ketoacidosis, meningitis, ectopic pregnancy and heart attack. An anti-emetic treats none of those.”
This could lead to delays in diagnosis and, in some cases, serious illnesses being misdiagnosed and mistreated. It could also encourage patients to self-treat rather than seek professional medical treatment, Dr Betros told TMR.
AMA NSW supports some expanded scope of practice models, including collaborative models like nursing specialists in psychiatric consultation-liaison and nurse practitioners.
“It’s not about turf protection. This is about what is the best thing for a patient,” he said.
Dr Betros also disagreed with the proposed pharmacists’ vaccination schedule, concerned it would create a further disconnect between patients and their GP.
The AMA NSW president said the main issue was the federal and state governments’ failure to provide tangible increases in primary care resources to deliver gold-standard care.
“All they’re doing is trying to make that same amount of resource stretch further. The more you water it down, the less quality you’re going to get,” he said.
“This is an acknowledgement that they’ve failed the people of NSW, and they’ve failed to provide the quality care that NSW residents deserve.”
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Rural Doctors Association Australia (RDAA) NSW president Dr Rachel Christmas told TMR she accepted pharmacy prescribing for acute, episodic care of uncomplicated UTIs, shingles, or straightforward wound infections, for instance, but was concerned about pharmacists’ management of chronic conditions.
“Very rarely do chronic conditions exist in isolation. Patients may not understand their own complexities either,” she said.
Dr Christmas also questioned whether a pharmacist working two to three days a week in a small country town, for instance, would be able to complete accredited training in the near future to prescribe and administer vaccinations.
Rural and remote communities are also disproportionately affected by higher rates of disability and disease burden, and face up to 2.5 times more avoidable deaths than major city residents, according to a 2025 National Rural Health Alliance snapshot report.
She also challenged the government to redirect funds to better support general practices and nurse immunisers in providing preventive healthcare.
The government’s claim of easing pressure on GPs was “a very lazy statement” and “a simplistic way of improving access”, Dr Christmas told TMR.
“General practice does everything. Because if someone comes in to see me with a relatively simple problem, that provides an opportunity to discuss those other things: health promotion, vaccinations, screening tests, family history.
“A straightforward consultation actually provides opportunity to enhance the care that we provide,” the RDAA NSW president said.
RACGP president Dr Michael Wright expressed concern that policy was being implemented faster than the evidence supporting it, pointing to the recent Grattan and Sax Institute reports.
“We need to make sure that any such policy is evidence-based and not lobbyist-led,” he told TMR.
“Investing in general practice is the best investment in the health system. It’s going to be much cheaper, safer and more effective than investing in policies that fragment the system and which we don’t have the evidence of being either safe or necessary,” he said.
The announcement builds on existing initiatives that have seen more than 2000 women receive resupplies of oral contraception since the program’s June rollout, and approximately 40,000 patients access treatment for uncomplicated UTIs, a NSW government statement said.
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