Rural pharmacies fill gap left by doctor shortages

Temporary measures allowing community pharmacists to provide one-month supply of a patient’s regular medication when they can’t get a script should be made permanent, argues rural group

While COVID-19 and the earlier bushfires have led to some positive measures across rural healthcare, “much more can be done” says the Rural Pharmacy Network Australia (RPNA).

For example, the group highlights temporary measures that allow community pharmacists to provide patients with a one-month supply of their regular medications if they cannot get a prescription.

These emergency supply measures were originally passed during this year’s bushfire crisis, then extended until later in the year as the COVID-19 pandemic took hold.

“Given the shortage of doctors in rural areas this is a measure that should be made permanent,” argues RPNA.

According to the AMA, the shortage of medical practitioners in rural and remote Australia has been a problem “for a long time”.

Rural patients rely heavily on their local community pharmacy for healthcare advice and triaging, and even more so now with GPs delivering consults via telehealth rather than face to face, argues RPNA.

“Pharmacists are involved in the monitoring and management of patients with chronic disease as well as treating minor ailments. Governments must look at formalising this role and ensuring that pharmacies are appropriately supported to provide this care,” says the group.

Additionally pharmacies should be supported to provide ongoing telehealth, including by acting as hubs for GP services via telehealth, they add.

“The development of rural community pharmacy as a telehealth hub would also improve access to vital healthcare services for rural patients,” says RPNA.

“Pharmacies located in towns without a permanent doctor should be supported to provide GP services via telehealth within the pharmacy. Rural community pharmacies should also be supported to provide pharmacy services via telehealth where appropriate.

“This might include such services as HMR follow-up consultations with remote patients as well as telehealth consults as part of team-based care arrangements to remote ACCHOs, for example.”

In April this year, the government announced that pharmacists would be able to undertake MedsChecks, Diabetes MedsChecks, HMRs and RMMRs via telehealth.

It also announced that accredited pharmacists would be allowed to provide two additional follow-ups for HMRs and RMMRs with patients within nine months of the initial review.

Consultant pharmacists have told AJP that they hope the measures will remain post-pandemic in rural areas.

“Especially for rural areas (PhARIA 4-6) the follow-ups could be done in a telehealth format,” said Karalyn Huxhagen.

Brisbane-based consultant pharmacist Debbie Rigby said: “I’d like to see telehealth consultations for HMRs and RMMRs continue post-COVID in rural and remote areas, under specified conditions.”

Rural community pharmacies are “well positioned” to help the government save healthcare dollars, says RPNA.

It suggests capitation payments tied to pharmacy service obligations would provide the expenditure control governments desire and the flexibility that rural community pharmacies require to adapt service delivery to meet local needs.

“If ever there was a time for governments to better utilise rural community pharmacies within primary healthcare – that time is surely now,” it concludes.

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