Home' Australian Pharmacist : Australian Pharmacist Nov 2013 Contents Australian Pharmacist November 2013 I ©Pharmaceutical Society of Australia Ltd.
Grattan report supports pharmacies
as health destinations
Grant Kardachi MPS
A model proposed by a Grattan Institute report for providing access to health
services in a number of specified remote areas by better utilising the skills of
pharmacists is one which echoes much of what we at PSA have been saying for
Basically the model acknowledges
that many of the pressures on doctors
could be eased by using pharmacists to
work collaboratively to provide a range
of services in some rural and remote
Medicare Local areas where there is no GP
or where GP services are very limited.
The report, Access all areas: New solutions
for GP shortages in rural Australia, authored
by Stephen Duckett and Peter Breadon,
says the number of GP services per person
in the lowest-access rural areas is less than
half that of the major cities in Australia.
It sensibly proposes using pharmacists to
help fill the void and provide services for
However, while this report is aimed at
specific Medicare Local areas, I believe it is
applicable across all of Australia where long
waiting lists in many GP surgeries exist.
It raises the issues of remuneration for
pharmacists' professional services and the
need to change the way we do business
to meet the changing health needs in
'When people can't see a GP, they get sick
with conditions that could be prevented,'
the report says. PSA believes these
include minor ailments which at present
pharmacists treat and advise on and these
services, as proposed by the report, I believe
could be expanded to include services to
meet the needs of the community with
It then goes on to offer a solution:
'By using pharmacists' skills better, and
by introducing physician assistants,
the primary care gap in the lowest-access
rural areas can be filled in only five years.'
Interestingly, the report then focusses on
three areas which PSA supports and has
long been examining and discussing as
offering potential for greater pharmacist
involvement -- vaccinations, reissuing
prescriptions and being integral members
of the chronic care team.
'Vaccinations in pharmacies have the
potential to dramatically reduce costs
associated with immunisation, including
waiting times for patients. Easy access to
immunisations makes it more likely people
will get their vaccinations,' the report says.
Our profession is ready to move into this
area following the release of PSA's Practice
guidelines for the provision of immunisation
services within pharmacy.
On the subject of reissuing prescriptions
for long-term conditions it points out that
'medication continuance' is used in the
UK and some Canadian provinces where
doctors can authorise pharmacists to
continue dispensing for an agreed period
of time. This has led to a more efficient use
of pharmacist and GP time and expertise,
and reduced costs to patients.
And on the topic of pharmacists being
members of a chronic care team it
highlights that pharmacists have a range
of roles in chronic disease management
as has been illustrated in Canada, the UK,
New Zealand and the US. 'In most cases,
a doctor makes a diagnosis and initiates
treatment, and a care plan is shared with
the pharmacist. These measures have
improved patient safety, compliance and
have reduced costs.'
The report then goes on to say: 'These three
changes to pharmacist roles would all
improve care while maintaining or increasing
patient safety. Overseas, pharmacists have
taken on even greater responsibilities in
prescribing for some conditions. However,
this report does not propose that pharmacists
diagnose conditions independently.'
Why pharmacists need to have a greater
role is underscored by research that shows
some 20% of GP visits are for 'less complex'
reasons; in other words visits which may
under a better structured system be
handled or initially addressed by other
In fact the report finds that 5% of current GP
visits in the lowest access rural areas should
be handled by pharmacists and I think this
figure could be translated across the broad
spectrum of healthcare across Australia.
The fee structure, the appropriate
remuneration for pharmacists as well as
what services may be covered by the MBS,
has been referred to in the report but need
further debate and examination.
But what this report has done is support
PSA's long and continuing campaign to
have pharmacists' skills and knowledge
better utilised -- and for pharmacists to be
remunerated for these services.
No doubt the Grattan Institute report will
provoke heated debate among all sectors of
the health area, but it is a debate that is much
needed and one that can only help pave
the way for a better health system to serve
This is an important report which raises a
number of issues for pharmacists in regard to
expanding services, introducing new services
and providing appropriate remuneration,
and I would be interested in your views as we
Please send your comments to
THE NATIONAL PRESIDENT SAYS
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