The key question is not whether contraception and UTIs treatment can be provided safely in individual encounters, but whether the broader regulatory, governance and safety framework adequately manages clinical risk and protects patient safety over time.
While this initiative may look good on paper, it lacks sufficient patient safety and continuity of care protocols and distracts from systemic underfunding of primary health in Australia.
The College supports evidence-based access to care. The College is concerned that implementation of the new model of care is premature; it does not currently have a robust evidence base that demonstrates long-term safety, quality and health system benefits.
Independent analyses by the Sax Institute and Grattan Institute have highlighted the limited evidence supporting emerging retail pharmacy prescribing models and the need for rigorous evaluation of patient outcomes. There are also limited safeguards, transparent monitoring or comprehensive assessment about the long-term impacts to patient health. Australia’s largest medical indemnity insurer, Avant, has also called for governments to pause pharmacist prescribing until there is a well-established national safety framework.2
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG; the College) supports pausing implementation and undertaking an independent review of patient outcomes and broader system impacts associated with these new models of care.
Pharmacist prescribing models follows rigid protocols that do not address the nuance or complexity of women’s health needs.
In certain jurisdictions, pharmacists can provide the initial consult for contraception care.3 Contraceptive care extends beyond the supply of a medicine; it requires clinical assessment, discussion of available options, consideration of individual risk factors and ongoing review.
These consultations also provide a valuable opportunity to identify and manage broader sexual and reproductive health concerns, including the need for sexually transmitted infection screening and cervical screening, as well as the assessment and management of abnormal menstrual symptoms, endometriosis, polyendocrine metabolic ovarian syndrome, pregnancy planning, menopause-related concerns, family violence, and reproductive coercion.
Effective contraceptive care is unique to the individual. Responsible contraception prescribing requires a complete review of medical history, understanding the individual’s needs, and providing the individual with access to all contraception options. Protocol-based prescribing may not provide the same opportunity for comprehensive reproductive healthcare assessment as a consultation with a general practitioner (GP) or specialist. Some contraceptive options, including long-acting reversible contraception, require assessment and procedural care that sit outside of the pharmacist prescribing scope. Patients may not understand all options that could be available to them and suited to their needs.
There are also limited regulatory provisions that prevent perceived conflicts of interest, whereby pharmacists derive revenue from prescribing and supplying contraceptives rather than referring patients to a clinician for consideration of alternative options.
The College is concerned that protocol-based assessment for UTIs may not identify underlying conditions that present with similar symptoms and require medical investigation. UTI symptoms present similarly to more serious conditions, such as certain cancers, kidney stones or bladder obstruction. Consultation also requires exclusion of other underlying conditions, such as diabetes, renal disease, sexually transmitted infections or malignancy. GPs have knowledge of the patient’s full medical history as well as pathology results. They are also able to identify and refer symptoms for specialist consultation to rule out other conditions. Pharmacists do not have this same training or scope. This could result in increased UTI misdiagnosis and patients unknowingly delaying seeking medical care for a more serious issue.
While pharmacist prescribing models operate under clinical protocols, protocols cannot replicate access to comprehensive medical records, longitudinal patient histories, pathology results, broader diagnostic capabilities or specialist referral available in general practice. These limitations become increasingly important when patients present with atypical symptoms or underlying comorbidities.
Incomplete health documentation can create health risks.
Pharmacist prescribing also risks fragmenting care, which leads to poorer patient health outcomes. Pharmacist prescribing increases the touchpoints or transitions of care, which could increase medication-related errors and prevent timely communication between healthcare providers, which can delay care.4 Information sharing delays may mean healthcare professionals – who are responsible for the patient’s ongoing management – have incomplete and outdated information so they are restricted in the care they can provide the patient. Effective continuity of care relies on up-to-date health records for completeness and full visibility of a patients’ ongoing care needs.
Continuity of care is essential for quality healthcare.
GPs are the cornerstone for effective continuity of care. Health practitioner unavailability and limited-service provision restricts patient access to care. Instead of adopting pharmacist prescribing models, the College considers that there should be more investment in the primary and specialist health workforce services, especially in rural, regional and remote communities. This investment would improve access to care while mitigating risk and ensuring patients benefit from continuous, coordinated care.
The College calls for increased investment in the primary health sector to improve continuity of care and avoid patient harm.
All women in Australia deserve confidence that the care they receive is safe, evidence-based, clinically appropriate, and supported by robust safeguards. Expanding access to contraception and sexual and reproductive healthcare should instead be underpinned by sustained investment in the women’s health workforce, ensuring access to timely, comprehensive, and personalised care that meets women’s individual health needs.
1 The Pharmacy Guild of Australia. Patients to get improved access and care from autonomous pharmacist prescribing model. Barton (ACT): The Pharmacy Guild of Australia; 2025 Oct 26 [accessed 2026 Nov 9]. Available from: https://www.guild.org.au/news-events/news/2025/patients-to-get-improved-access-and-care-from-autonomous-pharmacist-prescribing-model
2 Avant Mutual Group Limited. New claims data highlights why prescribing expansion needs stronger scrutiny. Sydney (NSW): Avant Mutual Group Limited; 2025 [Accessed 2026 Nov 9]. Available from: https://assets.avant.org.au/cdf6134c-01d7-0292-26f5-2f5cf1db96f8/5007122a-24e0-40fc-bbc4-7eb104014f1e/New%20claims%20data%20highlights%20why%20prescribing%20expansion%20needs%20stronger%20scrutiny%20.pdf
3 The Pharmacy Guild of Australia. Scope of Practice. Barton (ACT): The Pharmacy Guild of Australia; [Accessed 2026 Nov 9]. Available from: https://www.guild.org.au/programs/scope-of-practice
4 Avant Mutual Group Limited. Prescribing and patient safety report. Sydney (NSW): Avant Mutual Group Limited; 2024 [Accessed 2026 Nov 9]. Available from: https://assets.avant.org.au/cdf6134c-01d7-0292-26f5-2f5cf1db96f8/321e90cb-8e2e-40ae-b826-41eb2cf3b7d0/Prescribing%20and%20patient%20safety%20report.pdf
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