Clinical Intervention: a clinical or financial scheme?

Capsule with dollar signs spilling out

This week’s contributor wanted to remain anonymous: here, our Guest Author asks whether the Clinical Intervention scheme should exist in its current form at all

A brief overview

Let’s begin with the basics: what is a clinical intervention (CI)? According to Pharmacy Guild:

A Clinical Intervention (CI) is a professional activity undertaken by a registered pharmacist directed towards improving quality use of medicines and resulting in a recommendation for a change in the patient’s medication therapy, means of administration or medication-taking behaviour.

Or, in general terms, solving drug-related problems (DRP). An example would be a drug duplication problem where a consumer is taking two different drugs, both containing paracetamol, at the same time. This is a DRP, and by solving this problem, the pharmacist is conducting a CI.

Here is the important part: by conducting CIs, under the 6CPA accredited pharmacies are able to claim money from the Government. The exact amount per CI is not known, where some said it is ranging from $1-5 dollars per CI.

Similar to MedsChecks, many pharmacies are setting CIs as a KPI target for staff where they have to submit a certain amount per day (3.5% of prescription volume) as a daily task.

Problems associated with CIs

Helping patients and earning extra cash to pocket? Sounds great, doesn’t it? But wait, here is a question: Isn’t solving clinical problems a core and regular duty of pharmacists?

PSA defines pharmacist duty as including the duty to “advise patients on how their medicines are to be taken or used in the safest and most effective way”.

So since when it is appropriate to claim extra money to do our daily tasks? Pharmacists should intervene and help patients with or without the financial rewarding scheme.

Pharmacists do not need a “tip” for doing our job properly.

Do doctors or nurses or other healthcare professionals submit clinical interventions after they help with patients? Not to mention that the money is going into the pharmacy owner’s pocket, not the actual pharmacist who did it.

Some might argue that if the pharmacy is making more money, they will (hopefully) give us a raise and reward their pharmacists.

First, CI has been around for six years, and have pharmacists pay improved at all? Not to mention again that this is your job, to solve clinical problems, and your salary should have included that already.

The whole CI scheme should not exist in the first place. Before this is established, do pharmacist NOT know how to solve problems and help patients?

On top of that, most CIs are NOT being conducted in a professional manner. 

Unqualified submissions are being sent every day, and there are no mechanisms or intentions to prevent it.

Despite the fact that the 6CPA clearly states that routine prescription-related counselling and CMI provision are NOT CI, a lot of claims are simply nothing but companion selling: recommend probiotics for antibiotics prescription, recommend sunscreens for drugs with Label 8, etc.

Audit reviews also show and criticise that some pharmacists are claiming CI by sending a HealthNote text to remind them the script is ready. Those are “interventions” that retail pharmacists today have to do in order to reach the quota.

How would the public think of pharmacists if they know their taxpayers’ money are being spent this way?

I am aware of that retail pharmacy is in a desperate and dreadful situation where a lot of us are struggling to survive. However providing a high standard of healthcare services is a pharmacist task and financial incentives are not required, especially when the system is being abused.

Do you think pharmacists are feeling satisfied and accomplished after being forced to submit those claims? I think CI is not clinically relevant and should be removed (not that it is going to happen soon).

I am not saying the Government should allocate less resources to pharmacy, however taxpayers’ money should and can be used in a better way.

What distinguishes a good pharmacist from an average one is that a good pharmacist CARES for patient health instead of chasing KPIs like CI or selling CAMs.

Please share your stories or experiences with Clinical Interventions.

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