Stepping up the focus

We spoke to new PSA national president Dr Chris Freeman about your pay packet, PSA influence over the 7CPA and why the MBS is not a funding silver bullet

On past president Dr Shane Jackson

“It’s been an absolute honour and privilege to serve under Shane’s leadership,” says Dr Freeman.

“His energy, his enthusiasm, his unwavering commitment to not just PSA, but the profession more broadly, is unparalleled. He has the ability to so clearly articulate his vision and to inspire people to come along the journey with him – he was and still will be an outstanding leader.

“I’m very fortunate that Shane has been able to maintain his Vice Presidency of PSA, and importantly, his role as Chair of the Policy and Advocacy Committee. You’ll see our advocacy and policy work will intensify next year and Shane will play a pivotal role in that.”


On his plans as President

Dr Freeman says he is “really excited” about taking on the role of PSA National President.

“I know this term is overused in the profession, but we are at a turning point, where we are seeing meaningful, rapid transition in pharmacy practice. So I’m really excited to be able to contribute to that, and collaborate with other professional bodies and groups to make sure that’s steered in a positive direction.

“I think Shane has fundamentally stepped up the focus of the Society, focused on roles, recognition and remuneration for pharmacists, and I am equally dedicated to seeing those things progressed, as well.”

PSA’s action plan for the immediate future, focusing on recognition, remuneration and roles will help provide the profession with opportunities to meaningfully engage with patient care, says Dr Freeman.

“We can do that by delivering care to our full scope of practice.

“But unless there is a genuine funding framework that facilitates that—so we can shift the focus in engaging the patient from supply of medicines and volume of supply to one of delivery and lifting the quality of the care we deliver—it’s unfair of us to expect the profession to move that way if the model is not sustainable.”


On the 7CPA – and its negotiations

“It’s been flagged, in multiple reviews that have occurred over the last five to ten years, that groups like PSA have a genuine role in helping to shape what the upcoming Community Pharmacy Agreement looks like,” says Dr Freeman.

“What form or shape that will look like, is hard to predict.

“The other complexity in this environment is that we’re less than six months away from a federal election, and all those things need to be considered, moving forwards.

“I think we see ourselves as having influence over what the Agreement looks like, and helping shape the Agreement, so that pharmacists are recognised, are remunerated and have the ability to take on roles that basically help pharmacists practise to their full scope.

“If we are unable to set the funding framework to allow that sort of practice to occur, then we are not going to see the transition in practice that I think the profession is calling for.”

Dr Freeman said that the profession needs to continue generating evidence regarding the effectiveness of professional programs which sit within the CPAs.

“Those programs need the evidence-based support that is required to assure the funders that there is value in providing that funding.

“Also, the CPA is only one potential funding source for pharmacy and pharmacists’ practice, so we’ve got to consider the Agreement in the context of other funding opportunities.”


On pay

Dr Freeman says that PSA surveys its members each year to gauge the issues which concern them.

“For several consecutive years the number-one priority has been the level of remuneration they’re getting,” he says.

“The amount of money they’re being paid for delivering high-value care does not match the recognition they should be getting. We are absolute in wanting to see pharmacists remunerated to the level that reflects their training and expertise and integral place in the health system.

“However, we’re not naïve, and understand how pharmacists are paid, and that this stems from how pharmacies are funded themselves.

“With an environment where the major sector, community pharmacies, is being squeezed through accelerated price disclosure and other pressures such as rent, the margins that pharmacies are operating with become very, very small and this makes it extraordinarily hard for employers to increase the wages of pharmacists.

“I’ve spoken to many pharmacy owners who would dearly love to pay their pharmacists far more than they’re currently getting, but know that if they did, they would put the viability of their business at risk.

“So while remuneration of individual pharmacists is our utmost focus, there is a requirement to also see improved funding to the pharmacy sector to allow that to happen.”


On MBS access

Dr Freeman told the AJP that while many pharmacists look towards the MBS as an alternative funding source for service payments, it’s not a perfect system.

“If you asked GPs and allied health practitioners how satisfied they were with the level of remuneration and the ability to practice the way they want to, my strong sense is they would be dissatisfied,” he says.

“I’m conscious of focusing our attention just on the MBS because I don’t think it is the silver bullet some people think it is. That said, there are some items on the MBS which allow every other health practitioner regulated by AHPRA to engage with, and these are the chronic disease management items.

“Pharmacists are the only AHPRA-listed health practitioner that can’t have referrals from GPs to access those items. It’s a huge gap that we’re not on there and an obvious one.

“It was even advocated in the context of the MBS review that pharmacists should be considered for access to MBS funding for those chronic disease programs, upon referral from GPs.

“If we’re to be seen as integral by Government, we need to be on that list.”


On full scope of practice

Dr Freeman agrees with other stakeholders such as the Guild’s David Quilty that language matters when it comes to pharmacist scope of practice.

“Language is important,” he says. “It is about fulfilment of scope rather than extending our scope.

“It’s an acknowledgement that many things we’re talking about are within the scope of pharmacy practice. That’s clearly set out in our competency standards and the professional standards PSA are custodians of.

“We have already-clear documents that have been endorsed profession-wide that suggest pharmacists have significant room to attain fulfilment of scope.”


On mentorship

“Something I’d like to focus on for the next couple of years is the critical role of leaders of the profession, and the need to start mentoring and guiding pharmacists around them to have an influential impact on health care,” says Dr Freeman.

“If I turn my attention to our medical colleagues, there is a real culture – and actually some funding – to allow structured clinical mentorship, and I think that’s something that’s really missing from our profession.

“I hear from pharmacists that they feel isolated in their clinical practice, so there’s a role for the Society to start thinking in that direction, and to start some advocacy around some remuneration to allow that to occur.”

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