Community pharmacists need key HCH role: Guild

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The Pharmacy Guild of Australia has called for a central role for community pharmacists in Health Care Homes

The Guild issued a position statement today following the announcement of the rollout of Health Care Homes in 10 regions, urging a central role for community pharmacy and expressing concern that GP-based pharmacists could fragment care.

“The Guild supports greater collaboration and coordination of the primary care of patients with complex and chronic health needs,” it said today.

“We strongly support a central role for community pharmacy in the teams caring for these patients, as invariably the effective management of their health conditions depends upon their compliance with often complex medicines regimen.

“As the Minister for Health has acknowledged, the community pharmacist, along with the GP, is central to the care of patients with chronic health conditions.

“Unfortunately the criticality of the role of the community pharmacy in working collaboratively with GPs and other health care professionals in delivering Quality Use of Medicine (QUM) outcomes for patients is not always sufficiently recognised or remunerated in collaborative care models.”

In its statement the Guild points out that patients with complex and chronic health conditions are likely to require a range of medicine-related support delivered through community pharmacies as part of their care plans.

“This support may include medicine packing, reminders in relation to repeats and the writing of further prescriptions, regular counselling, medicine education and medicine reviews, liaison with GPs and other prescribers and possible point-of-care testing and home deliveries.”

The Guild says it believes that the Health Care Homes initiative will only succeed if it fully recognises and incorporates the medicines-related role of community pharmacies in the eligible patients’ tailored care plans. 

“Quality Use of Medicines outcomes should be a primary objective of each patient’s care plan with a requirement for each care plan to include an agreed strategy between the patient, their GP and community pharmacist to achieve this outcome.

“Furthermore, the tailored care plans should not bypass the patient’s supplying community pharmacist by introducing new GP-based, independent pharmacists into the care team.

“Such an unproven approach will only fragment and complicate the medicine-related care of patients while, at the same time, duplicating the established role of community pharmacies.

“The HCH approach should utilise established local health care providers wherever possible and only consider the use of additional providers where there is clear evidence of unmet need.”

The Guild says it plans to advocate strongly to the Federal Government, to Primary Health Networks and to representatives of other health professions including the AMA and the RACGP about the criticality of including community pharmacy based medicine-related support in patients’ tailored care plans under the HCH, in order to ensure that their QUM outcomes are achieved.

It will also continue to push for a more flexible approach to the HCH model based on the needs of individual patients, while recognising the central role of GPs in primary health care service provision.

“A more flexible approach may involve community pharmacies having a coordinating role for patients who do not have ready access to GPs,” it says.

“We will also continue to support patients having maximum input into the development of their tailored care plans.

“More broadly, the Guild will consider any proposals for capitation or outcomes based medication management funding models on their merits. 

“However we will not support the use of such models if they undermine the remuneration paid to pharmacies for their core clinical role of dispensing medicines or divert funding from community pharmacies to other providers.”

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1 Comment

  1. Drugby

    GP-based practice pharmacists will improve collaboration between GPs, practice nurses, allied health professionals and community pharmacies, not fragment it.

    I agree with this statement:
    “patients with complex and chronic health conditions are likely to require a range of medicine-related support.”

    Community pharmacies have a range of programs funded through the CPA which support patients in medication management. With the exception of HMRs and RMMRs, the programs are not overtly collaborative with general practitioners.

    What is missing is team-based care between community pharmacists and GPs. Collaborative care modeled in health care homes is based on a patient going to one GP in one practice. A practice pharmacist can provide care, advice and support beyond that provided by community pharmacies as well as refer patients to pharmacies that provide specific disease-based support and products. Improved liaison and communication will only benefit patients with complex chronic diseases. This support needs to be individualized to suit the patient’s preferences and needs.

    The benefit of having access to the patient’s medical history should not be underestimated. Community pharmacies can access a patient’s health record via My Health Record now, but registration by pharmacies has been very poor. A practice pharmacist will have this access and opportunity for ‘corridor conversations’ with GPs as well as formal clinical meetings and drug information advice.

    The opportunity for pharmacists to be an integral part of the team in HCHs should not be jeopardised by negative statements from our representative organisations. Let the profession expand roles to better help consumers in their medication management.

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