The next five years will be critical to lay the foundation for change, say pharmacists
The 7CPA and the government’s 10-year Primary Health Care Plan will determine the profession’s sustainability and viability, say researchers.
Negotiations for the 7CPA are set to wind up imminently with the 6CPA due to expire on 30 June, with the Government committing to conclude negotiations with a focus on allowing pharmacists to practice to full scope.
However the current state of remuneration for services is a “significant barrier” to pharmacists achieving contribution as integrated members of the health team, say researchers Sarah Dineen-Griffin, Shalom Benrimoj and Victoria Garcia-Cardenas in Pharmacy Practice.
“The right incentives must be provided for all health practitioners, like GPs, nurses and pharmacists to integrate services effectively, with clear responsibilities contributing to overall health outcomes,” they say in their article on the vision for community pharmacy and pharmacists in Australia.
Suggested funding structures include practice incentive payments linked to quality measures, revising remuneration structures to account for complexity, or moving to a time-based fee structure.
“Without adequate funding and recognition of pharmacist’s contributions to primary care, it will be difficult to ensure integration,” say the authors.
“It is clear that the next five years will be critical to lay the foundation for change that is needed to support further integration of community pharmacy into primary care.
“The [7CPA] and the Government’s 10-year Primary Health Care plan will become the determinant of sustainability for the profession.”
The authors also highlight that while medication management and adherence programs form the core of services delivery remuneration funded by the government, this still forms a relatively small percentage of total revenue for a community pharmacy.
They listed the many unremunerated services or those conducted with a fee paid by the patient, including immunisation services, chronic disease management support, health checks, wound care services and more.
New Zealand researchers recently explored this topic, finding that time spent delivering services for no remuneration across community pharmacists in their study was estimated to be between 15% and 50% of daily activities.
Medicines-related phone queries from patients and health providers were also described as contributing to a substantial amount of pharmacists’ daily activities, with no result in remuneration.
Another unfunded area was patients requesting advice and recommendations for medicines to treat common and minor ailments.
In Australia there are a variety of funded trial programs currently underway, with further additional funding provided for embedded or general practice pharmacists through the PHNs or the Workforce Incentive Program.
However while the latter may promote follow up, collaboration and integration into primary health care, they potentially marginalise community pharmacies, say the authors.
Future potential services that are heralded as expansion of the pharmacist role include a minor ailment service and pharmacist prescribing.
“The challenge for the future in Australia will be determining which professional services are envisaged by payers to be delivered via the community pharmacy structure, and which services will be delivered by other types of pharmacists, not linked nor employed by community pharmacies,” say the researchers.
Negotiations for the 7CPA are continuing despite the added difficulty of COVID-19, the Pharmacy Guild has confirmed, although national president George Tambassis admitted that “it’s been very heavy going.”
“But I can assure you, your Guild is doing everything possible to achieve a fair and reasonable outcome for you, our members,” he added.
Mr Tambassis also noted that 2020 has to date been a very difficult year, and thanked members for their hard work, as well as their “courage and commitment”.
“We’ve had bushfires in multiple states causing pressure and stress and now, of course, the global pandemic which has absolutely pulverised our economy and our society,” he said.
“I want to say congratulations and thank you for the commitment all Guild member pharmacies have shown, stepping up at a time of crisis and making us all proud to be part of such a vital part of the health system, serving patients daily.”
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