The PSA has renewed its call for pharmacists to be placed on the list of eligible allied health professionals for chronic disease management

It’s been nearly three years since the PSA first wrote to the Medicare Benefits Schedule (MBS) Review Taskforce, submitting that pharmacists should be included as eligible allied health professionals to access MBS items.

The call is yet to be answered.

“We’ve been calling for access to MBS for a long period of time,” PSA National President Dr Shane Jackson tells AJP.

“And specifically in that, there’s a specific component of access to the Chronic Disease Management items associated with Team Care Arrangements.”

Dr Jackson says that it’s “extraordinary” and “staggering” that pharmacists are left off the list of eligible allied health professionals within Team Care Arrangements for Chronic Disease Management items.

Under the Chronic Disease Management scheme subsidised by Medicare, GPs can determine whether a patient’s chronic medical condition would benefit from allied health services. The patient can then be referred to allied health providers for up to five consultations by their GP for services recommended in their care plan.

Currently, eligible allied health providers within this scheme include:

  • Aboriginal Health Workers or Aboriginal and Torres Strait Islander Health Practitioners
  • Audiologists
  • Chiropractors
  • Diabetes Educators
  • Dietitians
  • Exercise Physiologists
  • Mental Health Workers
  • Occupational Therapists
  • Osteopaths
  • Physiotherapists
  • Podiatrists
  • Psychologists
  • Speech Pathologists

Pharmacists are the only AHPRA-registered allied health professionals who are not eligible to provide allied health services through the Chronic Disease Management items.

“Every other allied health professional except for pharmacists is included on the list. It’s extraordinary to us that pharmacists aren’t included on the list, so that GPs can decide who to include as part of that team for that person with chronic disease,” says Dr Jackson.

“They might say, ‘Okay, for this person who has significant medication management issues, we want the pharmacist to be able to do five visits over a 12-month period with the patient’. Or it might be one visit with a pharmacist and four visits with a physiotherapist, for example.

“What the worst thing about this is, when GPs think of allied health professionals to help a patient with chronic disease, pharmacists are excluded off the list.

“What does that tell you? It reinforces that perception that pharmacists aren’t part of the team. And that shouldn’t be the case. So let’s get the structure so that they can be part of the team.”

A step in the right direction

PSA welcomed the 2018-19 Federal Budget announcement for a new Workforce Incentive Program, which it said will further facilitate clinically meaningful interaction between GPs and pharmacists.

Under the new program, the government will provide financial incentives to support general practices to employ allied health professionals, including non-dispensing pharmacists.

Around 5,000 practices will be eligible to receive incentives payments of up to $125,000 a year under the scheme.

PSA says this announcement should be the “first step” in the diversification of funding opportunities available to pharmacists to improve medication management.

“Without continued investment in the pharmacy professional to address medication-related misadventure, we will continue to see the adverse outcomes that are evident in everyday practice,” says Dr Jackson.

“It is high time that pharmacists had access to the MBS to be able to be formally included as part of the Team Care Arrangements and to be able to apply their skills and expertise to address medication management issues.

“This anomaly for pharmacists’ contribution to chronic disease management must be fixed as a matter of priority and the time is now.”

Dr Jackson says “there’s no better time to again highlight the need for a shift in thinking”, having again written to the MBS Review Taskforce calling for inclusion of pharmacists in the scheme.

“On the back of the Workforce Incentive Program that has pharmacists being able to be employed in general practice from July next year, it’s the same analogy,” he tells AJP.

“All the government’s done with that Workforce Incentive Program announcement is add pharmacists to the list.

“They haven’t increased the budget allocation necessarily for the program, but what they’ve said is, let’s allow the general practice to decide how to construct the team to assist our patients with chronic disease, assisting quality use of medicines.

“We’re not saying allocate more in the Budget. Just allow some more flexibility to construct the team as the general practitioner sees fit. We’re not asking for more money, just add pharmacists to the list and let GPs decide.

“That’s exactly the same analogy that we’re calling on the MBS Taskforce Review on the back of the announcement with the Workforce Incentive Program to consider as well.”

View the PSA’s original submission to the MBS Review Taskforce here.

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