Hospital pharmacists in the ACT’s public system are heading towards industrial action, as understaffing puts patients at risk, says PPA
Significant understaffing is leading to conflict with other health professionals, and mistakes are being reported, says Professionals Australia ACT director Dale Beasley.
The union has written to ACT Health Minister Meegan Fitzharris warning of impending industrial action, while a number of pharmacists are ready to walk off the job for good, he said, despite not having jobs to go to. Some have already left.
The action comes against the backdrop of an Independent Review into the workplace culture of the ACT public health system, announced by Ms Fitzharris this month following allegations of bullying.
The ACT has three public hospitals: Canberra Hospital, which Mr Beasley says is the epicentre of the problem; Calvary Hospital, run by the Catholic Little Company of Mary; and the new University of Canberra Hospital, a purpose-built rehabilitation facility.
“There’s definitely conflict in the workplace,” Mr Beasley told the AJP. “There’s nurses and doctors expecting certain services to be delivered, and the pharmacists just can’t do it: there’s not enough of them on the ground.”
The public hospital system has only around half the pharmacists it needs, the union says; these ratios “are slightly better at Calvary,” but attraction and retention issues are across the entire system.
“Hospital pharmacists are underpaid and not given the recognition they deserve and it means we’re bleeding staff to the Commonwealth and other jurisdictions every week,” Mr Beasley says.
“Some members have even left with no job to go to at all, such is the stress they are operating under.
“This is now a major crisis in Canberra hospitals with mistakes being reported that put patient health and safety at risk.”
The lack of ability to consult with patients on discharge is leading to readmissions, the union alleges.
Mr Beasley says some pharmacists have already walked out on their jobs for good, and more are talking about following.
“They’re dedicated health professionals, and they want to deliver to the patient the level of clinical service they deserve – but they can’t do that,” he told the AJP.
“The other issue is lack of hope. They can’t see it getting better. We’ve gone around in circles with the Minister and the Department for literally years, talking about attraction and retention, and we’re now at a point where pharmacists are going to start industrial action over this.
“There is no other hope to be heard.”
Pay is also an issue, as is lack of recognition, which Mr Beasley says means the ACT is “bleeding” pharmacists to the Commonwealth and other jurisdictions.
He says that PPA has conducted an analysis of pay across all states and territories, and that while there are some levels and classifications where the ACT pays reasonably well, other hospital pharmacists may be up to $14,000 worse off each year compared to a pharmacist taking on a similar job elsewhere.
“There are some levels where it blows out to that figure,” he says. “The thing is, when you’re trying to attract and retain staff, especially in a health system that’s plagued with issues like ACT Health, being as good as or less isn’t going to cut it.
“It’s bot pay and culture. If the pay issues themselves were rectified completely, we’re still going to have big issues with culture.
“We’re not just talking about tension with other disciplines, but the biggest issue in the existing workforce is that it has no faith in the existing bureaucracy, and it’s going to take a long time to turn this around.”
A spokesperson for ACT Health told the AJP that the organisation was aware of “workload issues that are currently being worked through with staff and their representatives”.
“This has followed significant staff turnover and is of concern,” the spokesperson said.
However, it should be noted that there are no mandated pharmacy staff to patient ratios in the ACT, they pointed out.
“ACT Health takes medication safety extremely seriously, and is not aware of any increase in medication mistakes due to pharmacy staffing levels and the Canberra Hospital is not aware of any data suggesting that unplanned readmissions are occurring due to lack of pharmacist involvement in the discharge process,” the spokesperson said.
“Ensuring patients are sent home with appropriate information about medication is key part of the discharge process. This function can be carried out by a pharmacist, a doctor or a nurse, as part of the patient’s treating team.”
They said that as part of the Canberra Hospital’s accreditation process, a documented guide for risk rating of patients has been developed to assist medical staff and pharmacists to identify priority patients who require a Medi-List, a practical resource to assist patients and carers in managing their medication.
“The final accreditation report also links improvements in this area to improvements in timeliness of patient discharge summaries to General Practitioners and patients.
“The hospital has established policies and procedures in place to monitor compliance and to ensure the safe storage and security of medications. There is a requirement for all relevant clinical teams and staff to understand these processes and adhere to them.”
The spokesperson said that through the accreditation process this year, Canberra Hospital has also made improvements to medication management.
“These improvements were described as innovative and commended by ACHS surveyors as demonstrating the organisation’s commitment to ensuring the safe and secure storage, distribution, prescription and administration of medicines.”
While ACT Health is aware that some pharmacists are concerned about heavy workloads, these issues are being worked through, they said.
“In terms of remuneration, ACT Health matches the NSW market rate for pharmacist salaries and therefore, our rates are believed to be competitive.
“Through the Enterprise Bargaining process, ACT Health has committed to undertaking a review of the health professional structures, including pharmacists as a priority. This is timely and as per the current health professional classification, will look at the relevant work level standards.
“ACT Health is focussed on maintaining an appropriately skilled workforce to meet the needs of our patients and demand on our services. As part of this, we are always looking at better ways to attract and retain staff. We work closely with unions and other staff representatives on this through process like Enterprise Bargaining.
“ACT Health is constantly looking at different workforce strategies to ensure we are in the best position to recruit and to attract and retain staff.
“The proposed changes to the Enterprise Agreement, which will clarify the pay rates for pharmacists and the review of the health professional structure, will ensure that ACT Health is in a better position to attract and retain pharmacists.
“ACT Health continues to discuss these matters with Professionals Australia and other relevant staff representatives, both through the Enterprise Bargaining process and establishment of workplace consultative committees.”
Mr Beasley says that the next step is a protected action ballot application, which is currently underway and is expected to take “a couple of weeks before action actually starts”.
“We need strong action on this,” he says. “We’ve asked for monthly meetings with the Minister, we’ve heard from Health and will get a special consultant body set up, which is good, but that’s only as good as what it delivers.
“We need some pretty strong leadership from Health and the Department to deal with the culture.”