Home' Australian Pharmacist : Australian Pharmacist November 2016 Contents According to the RACGP submission, there ‘are necessary
boundaries to the role that pharmacists should play in our
health system. Services outside the scope of pharmacology
should not be provided by pharmacists.’ It said that further
integration of pharmacy into the primary healthcare system
should be considered as part of the Pharmacy Review.
The Australian Self Medication Industry (ASMI) submission
pointed out that ‘healthcare resources in Australia are scarce
and all sectors agree that they should be used rationally and
effectively to achieve best health outcomes with best value
for money for individuals and for the community as a whole.’
ASMI said pharmacists were ideally positioned to provide
‘population health support services to consumers with
some of these services already in place such as influenza
vaccinations, weight loss management and smoking
cessation.’ However, ASMI believed there was scope for
expanding primary healthcare services into other areas, citing
the management of common minor ailments.
‘ The standards of delivery of these programs vary widely in
quality and content between pharmacies across Australia.
The opportunity is for government to work with pharmacy
to identify and accredit evidence-based population
health intervention strategies and potentially remunerate
pharmacists for delivering these programs, provided the
appropriate accreditation was obtained by the pharmacist
providing the service.’
Further, ASMI said, it was generally acknowledged that
general practitioners (GPs) were overstretched and ideally
needed more time to dedicate to consumers with one or
more chronic diseases and to the management of acute
illness. ASMI cited a study by IMS in 2009 which demonstrated
that 7–15% of visits to GPs were for minor ailments.
‘If this time were made available to GPs, benefits would
include better use of both doctor and pharmacy resources
and could include improved satisfaction for consumers with
respect to travel and waiting times.’
In this instance minor ailments were defined as self-limiting
conditions where the management was the same through
general practice, pharmacy or self-care and included
conditions such as, but not limited to, common colds, strains
and sprains, acute diarrhoea, constipation, muscle aches
and pains, allergies, headache, rash, dermatitis and eczema,
fevers, foot conditions such as corns and callouses and others.
ASMI also called for further research to be conducted with
a view to developing and testing models of professional
programs and services, such as minor ailment schemes,
that could deliver benefits to consumers and also expand
provision of services to the community by pharmacists.
In its submission, the PGA also went into some detail
(Recommendation 14) about professional services including
urging funding for a fee-for-service minor ailments program.
It also called for the Federal Government to allow community
pharmacies to order a standard range of pathology tests ‘in
line with best practice for patients receiving ongoing stable
therapy for chronic conditions’.
Further, it called on the Federal Government to also provide
incentives for community pharmacies to become local health
hubs in areas of demonstrated need and to fund a fee for
service health check, risk assessment and referral program
through community pharmacies.
An interesting supporter of extending pharmacist
involvement in professional services was the Grattan Institute.
It recommended allowing pharmacists to ‘provide a much
broader range of health services, including vaccinations,
prescription repeats and chronic disease management.’
‘ The change would improve consumer access and
convenience while reducing costs and some of the burden
on general practice. It would also partially offset the fall in
average pharmacy income that is likely to follow deregulation
– a fair compromise,’ the Grattan Institute submission said.
The member feedback PSA received, as already mentioned,
included much comment of pharmacist remuneration. While
a number of questions posed by the Discussion Paper were
about remuneration they focussed more on the mode of
remuneration rather than pharmacist pay rates.
For example Question 30 asked – Would it be preferable when a
medicine is dispensed if advice given to consumers is remunerated
separately; for example, through a MBS payment? Would this be
likely to increase the value consumers place on this advice?
PSA responded that it believed an MBS payment was
an appropriate remuneration mechanism for providing
medication management services provided by pharmacists,
in the same way that GPs and other health professionals’
clinical services were recognised.
PSA also pointed out that paying pharmacists through
the MBS would bring them into line with other health
professionals. Pharmacists were currently the only AHPRA
Australian Pharmacist November 2016 I © Pharmaceutical Society of Australia Ltd.
" The Grattan Institute rec ommended allowing
pharmacists t o ‘pr ovide a much br oader range of
health services, including vaccinations, prescription
repeats and chr onic disease management."
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