Here’s an update on a few of the issues AMA Victoria is working on for members, including:

  • SafeScript review: AMA Victoria submission

  • Reducing restrictive practices: Safer Care Victoria framework.

 

SafeScript review: AMA Victoria submission

AMA Victoria has lodged a submission on the review of Victoria’s drugs and poisons regulations.

Thank you to all members who provided feedback. It directly shaped the submission.

The submission noted that AMA Victoria supports a regulatory framework that is clinically sound, proportionate to risk, and workable in practice. While we support SafeScript in principle, members continue to report concerns about its operability, workflow, limited clinical context, data gaps and administrative burden.

Our submission supported steps to improve oversight of medicinal cannabis prescribing, including stronger capture through SafeScript, subject to clearer drafting of exemptions.

The main concern raised was a proposal to require clinicians to take and document steps to contact other prescribers identified through SafeScript. AMA Victoria did not support this proposal.

Members were clear it is not workable in routine practice. It could require identifying prescribers, locating contact details, attempting contact and recording each step, often within short consultations or across fragmented care. It would delay decisions and add follow up work.

There were also concerns about broad and uncertain drafting, including terms such as “reasonable steps” and “relevant prescribers”, and the medico-legal risk this creates. However, we noted that even if more tightly defined, the proposal remains impractical.

The submission noted that the proposal does not reflect how care is delivered. Prescribing often moves between clinicians over short periods and that multiple prescribers do not, on their own, indicate a safety issue. Requiring each clinician to contact others is duplication, not coordination.

More fundamentally, the proposal seeks to address gaps in SafeScript by shifting coordination responsibilities onto individual clinicians. Our position is that coordination should be addressed through system design and integration, not additional manual obligations.

We also raised concerns about unintended consequences in hospital settings. If there is any ambiguity about whether voluntary use of SafeScript attracts additional obligations, clinicians may avoid using it.

The proposal was put forward by the Department to generate discussion, and it has done so. Member feedback was clear. The model is not workable in practice and should not proceed. That position has been conveyed clearly and firmly to the Department.


Reducing restrictive practices: Safer Care Victoria framework

SCV has released a new Governance framework for reducing restrictive practices in healthcare settings.

The framework sets out a system-wide approach to reducing, and where possible eliminating, restrictive practices across healthcare. It focuses on prevention, de-escalation, consumer involvement, workforce capability, and strengthened governance and reporting.

The intent is clear, and the direction is consistent with long-standing efforts to reduce reliance on restrictive practices, including those stemming from the Royal Commission. The objective is understandable, and some consider there is scope for services to improve. How this is pursued in practice will be critical. AMA Victoria has consistently made the point that progress in this area depends on appropriate staffing and resourcing, both in hospitals and in the community.

Some elements of the framework are lso likely to prompt discussion. This includes the statement that “restrictive practices have no inherent therapeutic benefit and do not keep staff safe compared with less restrictive alternatives”. Members may question the basis for this claim, both in terms of the clinical assertion and its consistency with WorkSafe and broader OHS obligations.

There are also practical questions about how the framework applies in day-to-day clinical care, particularly in time-critical situations involving risk to the patient or others, and how expectations will operate in current service conditions.

AMA Victoria is seeking member views to inform feedback to SCV and the Department of Health.

If you work in this area, we are interested in whether the framework reflects clinical reality and whether the proposed approach is workable in your setting.

Please email any feedback to Lewis Horton at [email protected].