‘Patients can access a range of other services when they visit their GP.’


doctor pharmacist collaboration consultation pharmacists in general practice GP

How many general practices employ pharmacists, and how many pharmacies are co-located with general practices across the country?

GPs work predominantly in group practices and many also work alongside other health professionals, according to the RACGP’s General Practice: Health of the Nation report released on Thursday.

Eighty-six percent of GPs surveyed (n = 1174) reported worked in a group practice, with only 4% working “solo”.

However just 13% of GPs indicated that pharmacists were employed in their practice.

Meanwhile 92% reported having a practice nurse (with an average of three per practice), 64% employed allied health professionals and 26% employed other specialists.

Seven per cent respondents said they had an Aboriginal and Torres Strait Islander health practitioner or health worker on staff, while 5% had none of the above.

“The makeup of practice teams varies considerably from practice to practice,” says the RACGP in its report.

“In addition to GPs, general practices often employ nurses, allied health professionals, pharmacists and administrative staff … A well-resourced general practice team facilitates collaborative care.

“As the number of non-GP health professionals in a general practice increases, GPs become more likely to consult with others about the management of patients,” it says.

“GPs working in larger teams are also more likely to report that formal structures are in place to encourage communication among practice staff.”

PSA says it is pleased to see strong initial uptake of the pharmacists in general practice model of care, particularly without a current dedicated funding framework.

“We expect further uptake following the commencement of the workforce incentive payment in January 2020, which is a good first step to seeing this model becoming sustainable and commonplace,” national president Dr Chris Freeman told AJP.

“We encourage all pharmacists to consider how they might better engage with general practice, particularly community pharmacists with an established relationship with their local GPs.”

As the number of non-GP health professionals in a general practice increases, GPs become more likely to consult with others about the management of patients.—RACGP

Many general practices are also co-located with other health services, according to the RACGP report.

More than two-thirds (69%) of GP respondents indicated that their practice was co-located with a pathology collection centre, and 42% said there were psychology services provided.

However less than a third (28%) of GPs said their practice was co-located with a pharmacy.

More GPs reported co-location with physiotherapy services (38%), dietary services including access to a dietitian or diabetes educator (38%) and podiatry (34%).

Fifteen per cent reported no co-located services at all.

General practice is Australia’s most accessed form of healthcare, but out-of-pocket costs are increasing at double the consumer price index, says the RACGP.

Medicare data show the average patient co-payment to visit a GP in 2018–19 was $38.46, an increase from $37.39 the year prior.

“Current Medicare structures, which tend to better support shorter consultations, make it difficult to provide the necessary care in a viable way,” says RACGP president Dr Harry Nespolon.

“This report reveals that bulk-billing rate increases continue to slow and, for the first time, all areas outside major cities have seen a decline in bulk billing,” he says.

“This has a major effect on the seven million Australians who live in regional, rural and remote areas, and is a challenge the RACGP will support the government to address.”

The Pharmacy Guild has argued recently that GP waiting times, GP shortages and high-out-of-pocket costs are leaving “many Australians and their families feeling frustrated” and that pharmacists are in a “unique position” to take on some of the workload.

“The benefits of pharmacists practising to their full scope is most pronounced in rural and regional communities,” they say in their policy paper, calling for further prescribing and vaccination rights.

Read the RACGP’s full report here

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7 Comments

  1. Kevin Hayward
    20/09/2019

    I would like to know what other pharmacists in working in GP practice have been doing.
    Currently I am involved medication reviews, in tandem with the cycle of care for targeted patients groups eg DM2, asthma, COPD. I recently commenced review of opioids and patients identified taking CAMs. I try to see as many secondary care discharges as I can.
    I am also involved in patient health education, and of course regularly accommodate students.
    I participate in team care arrangements and case conferences.
    Previously I have been involved in audit, prescribing analysis, commissioning and project management.
    What are others up to?

    • Jarrod McMaugh
      20/09/2019

      That’s seems to encompass the majority of the activities being undertaken with those pharmacists I am working with.

      with the medication reviews, are those privately funded/costs absorbed by the clinic?

      • Kevin Hayward
        20/09/2019

        Partly private, mixed funding

        • Jarrod McMaugh
          20/09/2019

          Do you get referrals from other clinics for claimable Times?

          • Kevin Hayward
            20/09/2019

            Currently I work with a number of GP practices, different services for each according to local need, usually one day per practice per week is sufficient. In a previous life as a health services funded primary care support pharmacist, I found that unless a practice had issues 1/2 – 1 days per week was all that was needed.

          • Jarrod McMaugh
            23/09/2019

            Sorry Kevin, my last question to you got garbled… I assume from autocorrect of some kind from my phone.

            Do you find you are able to participate in services that the GP can claim – group care arrangements for instance?

            For your Home Medicine Reviews, where do your claimable referrals come from?

          • Kevin Hayward
            23/09/2019

            I am able to contribute to a number of GP items in addition to medication reviews. Case conferences for example.
            I participate in team care arrangements for patients.
            I contribute to the cycle of care for chronic disease states.
            I have been asked to do older persons health assessments, but not done these yet.
            Health education funding is provided by the state.
            My referrals come from a dozen or so practices I have worked closely with over the last 15 years.
            The work done with a practice depends on their individual need. In the past I have found a GP practice will generate enough work for a practice support pharmacist between 1/2 – 1 day per week, unless there is an audit or project to be run.

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