The SHPA submission to the King Review has called for substantial change to medicines management and the remuneration of pharmacy services
“SHPA consulted widely for the submission,” says SHPA President Professor Michael Dooley, “to draw on the expertise of our members and ensure the Review received an informed perspective not only focused on community pharmacy but which also considers the impact of the 6CPA on hospital outpatient funding and services.
“The SHPA submission builds on the principles of the Australian Charter of Healthcare Rights as Australians deserve,” he says.
“Healthcare services by healthcare practitioners, in this case pharmacists, must be provided in settings conducive to the delivery of professional services.
“To deliver high quality and safe care an appropriately skilled pharmacist, practicing in the appropriate setting, with the correct clinical information and collaborating with patient, carer and medical team is vital.
“This is often in a community pharmacy, but also needs to be in the home, in hospital and in General Practice settings.”
Prof Dooley says that while all practising pharmacists can be considered experts in pharmacy, not all can be considered medicine specialists, and further credentialing and accreditation is required for delivery of more comprehensive cognitive services.
“SHPA fully supports the excellent contributions to patient care that thousands of pharmacists provide in community pharmacies across Australia every day,” he says.
“However, constraints in existing funding models and the commercial priorities of some are factors that must be acknowledged as barriers to the practice of pharmacists and the delivery of care. The community retail pharmacy setting must be significantly reformed to enable this to consistently occur.”
SHPA CEO Kristin Michaels says that there must be changes to the existing model for remuneration of community retail pharmacy services if we are to foster settings conducive to the delivery of best-practice professional pharmacy services.
“Without those changes, we will find it hard to make inroads into the 230,000 medications related hospital admissions each year,” she says.
SHPA has made the following fundamental recommendations in its submission to the Pharmacy Remuneration and Regulation Review:
- Funding for services provided by pharmacists should focus on the delivery of health outcomes rather than the processes to provide the service.
- Policy and remuneration planning should incorporate the significant linkages of hospital and community pharmacy, and hospital pharmacy’s contribution and role in clinical innovation.
- SHPA represents the expertise and experience of the hospital sector where more than 20% of the PBS is expended. SHPA is a key stakeholder in contributing to further agreements associated with remuneration of services.
- Remuneration for pharmacy services must reflect the four key elements of the model for clinical care: appropriately skilled pharmacist, appropriate setting, correct clinical information and collaboration with patient, carer and medical team.
- Healthcare services by healthcare practitioners, in this case pharmacists, must be provided in settings conducive to the delivery of professional services. The community retail pharmacy setting must be significantly reformed to enable this to consistently occur.
- Remuneration of cognitive services must include recognition that not all practising pharmacists can be considered medicine specialists and further credentialing and accreditation is required for delivery of more comprehensive cognitive services.
- Cognitive pharmacist services should not be linked to the supply of medicines and should be remunerated separately.
- Individual pharmacists should be remunerated directly as a provider of a cognitive service in line with other health professionals.
- The dispensing of medicines has three distinct components: clinical review, medication labelling and patient education and these should be recognised and remunerated as distinct activities.
- Any review of hospital and community remuneration within the PBS should acknowledge the differences in existing hospitals remuneration and deliver a single funding model.
- Where need exists hospitals should not be prevented from dispensing to the community.
- Manufacturers should provide a guarantee of continual supply of a PBS medicine.
- All remunerated services must be evaluated periodically to ensure quality of service delivery and achievement of outcomes.
- SHPA believes that it is imperative for the profession that future programs and services seeking to optimise the contribution of pharmacists should build on the unique expertise of the profession and healthcare needs of the community.