The new normal

As Australia starts to look at life in a COVID-normal environment, Steph McGrath explores how pharmacists, their colleagues and employees are adapting to the consequences of the pandemic

As the proverb goes, “necessity is the mother of invention.”

Perhaps the most positive innovations to come out of life during COVID has been the quickly implemented technological advances for the provision of efficient healthcare.

We’ve seen:

  • E-scripts

As reported in the AJP article ‘Lockdown sees e-script boost’: “as at 22 October 2020, more than 400,000 original electronic scripts have now been created in Australia, driven by rapid uptake in Melbourne and Victoria over the past six weeks”.

The availability of this method of attaining scripts in isolation has been invaluable to Australian patients.

  • Telepharmacy

The delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist is not new (as reported in AJP article ‘Telepharmacy growing in Australia’) but has become more relied upon than ever this year.

This includes phone consultations with patients, online prescription of medical certificates and remove video consultations where attending health care professionals and patients may be in multiple locations.

It would come as no surprise that Zoom has reported remarkable growth this year with the number of customers at the end of the September 2020 quarter being 988 customers, contributing more than $100,000 in trailing 12 months revenue, up 112%.

  • HMR telehealth

The Rules governing the Home Medicines Review Program have been adapted to permit HMR by video and audio conferencing.

While telehealth services are the preferred alternative to in-person consultation, the Rules provide that if video is not available, service providers are permitted to offer audio-only services via telephone, and where required (e.g. a patient isolating at home for confirmed COVID-19 cases) in consultation with the patient’s referring medical practitioner.

Front line observations

We sought feedback from our clients as to how the pandemic has affected the day-to-day running of the pharmacy and provision of healthcare to patients.

This is what we were told:

  • For those pharmacies doing it tough, it has meant some hard decisions having to be made regarding their employees including a significant reduction in hours. To date, we have not received enquiries regarding the need to terminate staff.
  • Pharmacies are experiencing an increase in faxed scripts.
  • Some pharmacists and their staff have experienced more frustration or aggressive behaviour this year, and a ‘panic mode’ mentality. While frustration and panic was at its worst at the start of the pandemic earlier this year, aggression unfortunately remains a present risk as reported in this AJP article.
  • A particular difficulty some pharmacists have faced, is being seen. Due to extended isolation (e.g. Victoria) or in regional towns generally, it can be difficult to reach patients to let them know the pharmacy is open and safe to attend.
  • CBD and shopping centre pharmacies have experienced a significant decrease in foot traffic over the course of the year subject to relevant lockdown and isolation restrictions across Australia. It was good news for Victoria this week with the announcement that the 25-km limit on movements and restrictions on travel to regional Victoria would be lifted on 8 November and retailers opening back up on 28 October provided they have a comprehensive COVID-safe plan.
  • Our clients have told us how they have adapted their business to meet the growing needs of patients, including expanding or commencing deliveries of medications as a result of isolation. Many of our clients expect this delivery service will be kept going even once isolation has ended, as it works well and allows patients (particularly the elderly and severely ill) to have greater access to their pharmacist and medicinal needs without having to leave the house.

Biggest hurdle

By far, the biggest hurdle to overcome as a consequence of COVID is being a tenant in the current environment.

The recent closure of the Elizabeth Street Pharmacy as reported by the AJP in this article serves as a caution that not all landlords will be willing to negotiate, and a timely reminder that the rent relief legislation is not black and white.

To recap a previous article, generally speaking, in Victoria, Queensland, New South Wales and Tasmania, if you 1) have an eligible lease in effect at the date the legislation came into effect; 2) are a small- to medium-sized tenant with an annual turnover of less than $50m and; 3) participate in the JobKeeper scheme, you should qualify for rent relief.

Criteria 1) is reasonably straight forward and at this point in the year perhaps not likely to be a contentious issue.

However, Criteria 2) and 3) may not be as easy to satisfy.

In some cases, the landlord leases the premises to a third party who is not the pharmacy owner e.g. a franchisor (who is not related to the pharmacy owner) or more commonly, a service company of the pharmacy owner (usually related to the pharmacy owner). The franchisor or service company would then sublease or licence the premises to the pharmacy owner for the conduct of the pharmacy business.

The JobKeeper program has been modified during the year to accommodate service entities in limited circumstances. However, while the rent relief legislation in Victoria was amended so that the requirement to be an employer has been removed, the tenant in Victoria must still be entitled “under section 6, 11 or 12A of the JobKeeper rules to a JobKeeper payment”.

As a result, a seemingly simple claim for rent relief becomes more complex.

For those pharmacy owners who lease their premises directly from the landlord, different hurdles are being experienced, usually to do with the provision of evidence to satisfy landlords of the tenant’s participation in JobKeeper and the decline in the tenant’s turnover.

Where tenant’s advisors have failed to provide the appropriate documentation, claims for rent relief have been unsuccessful. We have also acted for landlords where tenants are refusing to provide turnover information and as a result, the landlords have no option but to refuse a claim for rent relief.

How has COVID affected you or your pharmacy? Comment below.

Further information

If you require any specific information or assistance to protect your interests, please do not hesitate to contact the writer on 0488 00 24 24.

Stephanie McGrath is a Senior Legal Advisor practising in commercial law with a focus on health, business and property across Australia.

Stephanie’s significant pharmacy experience includes assisting pharmacy owners in responding to audits and investigations, buying and selling interests in pharmacies Australia-wide, advising clients in relation to compliance with the requirements of different State and Territory Pharmacy Regulators, applications to Medicare, applications and objections under the Pharmacy Location Rules and Ministerial Discretion Process, partnership disputes and much more.

Disclaimer: The content of this article is intended only to provide a summary and general overview on matters of interest. It is not intended to be comprehensive nor does it constitute legal advice. You should seek legal or other professional advice before acting or relying on any content of this article.

Previous The work dilemma
Next Clinical tips: Antimicrobial resistance and stewardship

NOTICE: It can sometimes take awhile for comment submissions to go through, please be patient.

No Comment

Leave a reply