A long history of misunderstanding


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Pharmacists should be able to access the MBS when delivering services regardless of where they practise, says the Guild

In this week’s edition of Forefront, Guild executive director Pam Price outlines the Pharmacy Guild’s submission to the Government’s Allied Health Reference Group inquiry into the Primary Care Reference Groups Consultation – Medicare Benefits Schedule (MBS) Taskforce Reports.

Ms Price writes that there is a “long history of confusion or misunderstanding as to where ‘pharmacy’ sits in the healthcare system, and more often than not the sector is included as an allied health profession”.

This results in lowered recognition of pharmacists’ unique expertise as medicine management experts, she warns.

But she also says that this reduces pharmacists’ access to funds specific to their role and activities in the health system.

The Guild makes a number of comments in the submission, including:

  • That it agrees that it would be appropriate for pharmacists to access the MBS when delivering services to consumers irrespective of where the pharmacist is practising.
  • That it does not believe the concept of “non-dispensing pharmacists” accessing the MBS should exclude community pharmacy, or be exclusive to GP surgeries. “Pharmacists who are not dispensing can practise wherever there is a consumer need for such services as medicine reconciliation, medicines reviews, counselling and education services.”
  • Pharmacists involved in the collaborative care of a patient as part of the health care team should not be excluded from the MBS due to their location. “Pharmacists practising in community pharmacies are an integral member of a patient’s multidisciplinary healthcare team and should be involved in, and remunerated for activities consistent with other members of the team, such as case conferencing,” it says.
  • “A patient accessing health services should not be disadvantaged by where they choose to access those services or by which health professional delivers them,” the Guild warns in its submission. “Pharmacists currently have no option but to charge the patient a service fee for items that other health practitioners may be claim an MBS item for. The Guild supports the addition of pharmacists to the list of eligible health professions that can claim against specific items on the MBS, as set out in the Health Insurance Act 1973.”
  • The Guild says it supports access to the MBS under expansion of allied health categories; it also suggests that pharmacists should be eligible for MBS items for provision of primary care health services to patients recognising equivalent competencies of pharmacists to other health professionals, such as nurse practitioners. It says this would be particularly valuable in areas of reduced access to GPs or other health practitioners such as afterhours or in rural and remote Australia, where pharmacists could deliver equivalent services at equivalent costs.
  • “Pharmacists should also be eligible for MBS items relating to chronic disease management and case conferencing activities,” it submits, giving examples such as vaccination administration, wound management, chronic disease management and asthma education. “This recognises that pharmacists are integral to the collaborative care of a patient with chronic disease including all aspects of medication management. Integration of community pharmacy into the health care team through case conferencing and monitoring of aspects of care is vital for the holistic management and health outcomes for patients.”

Ms Price points out that one of the recommendations which came out of the review relates to the expansion of allied health involvement under team care arrangements.

“This is where categorising pharmacists as an allied health profession fails to do justice to the work community pharmacists undertake on a daily basis,” she says.

“The recommendation is that pharmacists should be recognised as a discipline in their own right similar to medicine, nursing and dentistry, rather than being grouped with allied health disciplines.

“We agree with this recommendation and believe that pharmacists should be included as one of the health professionals that can contribute to the care of a patient.

“Pharmacists can and do contribute to a patient’s care plan as a member of the primary healthcare team. They are often in communication with a patient’s GP or other health professionals regarding the therapeutic management of their conditions, and directly refer to the GP when issues are identified.”

She says the Guild believes pharmacists are an “essential” part of the multidisciplinary team and should not be left out of team care arrangements.

A pharmacist can and should be involved in the care of the patient, regardless of where the pharmacist is working.

Whilst these services can be performed by a pharmacist at a GP’s surgery or a residential care facility, we believe it is most appropriate for a pharmacist to be involved in the healthcare team in an “outreach” capacity from the local community pharmacy.

We do not believe that the pharmacist has to be physically co-located to be part of a team. In fact, it is probably the pharmacist from the local pharmacy that supplies the medicine who is best placed to be involved in this arrangement.

Pharmacists should be one of the health professions a GP can refer to (for specific medication education/ administration/ device/ adherence and assessment). We do not believe that the pharmacist needs to be in a GP practice to do this. A GP should be able to refer to a pharmacist for a longer education consultation.

View the Guild’s full submission here.

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