A national ‘one-size-fits-all’ approach to delivering pharmacy care discriminates against rural and remote communities, patients and pharmacies, says new group
In the lead-up to 7CPA negotiations, Rural Pharmacy Network Australia (RPNA) has penned a letter to rural MPs arguing that there is a deteriorating state of healthcare in the bush.
The new group says the national ‘one-size-fits-all’ approach to delivering pharmacy care discriminates against rural and remote communities, patients and pharmacies.
“Community pharmacists are chronically underutilised in rural healthcare despite having the highest patient contact rate of all rural Primary Health Care providers and having proven beyond doubt that community pharmacy can deliver a range of non-dispensing services, such as medication reviews, vaccinations, emergency contraception, continuing dispensing and so on,” says Fred Hellqvist, co-chair of RPNA.
“There is so much more that rural community pharmacists could be doing.”
The group also argues that rural pharmacies are disadvantaged by the current pharmacy remuneration structure that assumes an ‘average’ patient and contains no loadings for more complex patient care situations they routinely encounter.
“This is a major cost that creates real financial distress for many rural pharmacies, so much so that some are forced to reduce service levels despite the higher than normal needs of their community,” says Mr Hellqvist.
“This is unfair to both the affected communities and the pharmacies.”
RPNA calls for government commitment to a host of changes including:
- A “comprehensive suite” of rural and remote workforce incentives
- Reform of the Rural Pharmacy Maintenance Allowance
- Rural/remote loadings on government funded community pharmacy services such as Home Medicines Reviews, MedsChecks and Clinical Interventions
- Payments for Chronic Disease Monitoring and Management
- A rural Minor Ailments Scheme
- Financial support for medication reconciliation for patients transitioning back into rural community- and aged-care settings.
“We want to support our rural GP colleagues and friends through better opportunities to contribute to the care of more complex patients,” says Mr Hellqvist.
“By working with GPs in a more formal and ultimately much more productive basis than now, we can not only improve patients’ pharmaceutical care, but we can also help ensure massively overworked rural GPs are relieved from some of the workload that currently interferes with their ability to lead and coordinate Primary Health Care.”
On workforce incentives, the RPNA argues that a range of measures similar to those being put in place for doctors should be instituted, in order to attract and retain pharmacists in rural and remote areas.
“Rural communities need pharmacists who are actually members of the community, not endless locum rosters and fly-in-fly-out contractors who never fit in,” said RPNA founding member Peter Crothers.
“To attract and retain the sort of workforce we need to handle the sicker, poorer, less-educated and more access-disadvantaged patients we deal with however, rural owners are increasingly expected to offer better remuneration, extended paid leave, free housing and transport, relocation incentives and even family support incentives.
“At the moment these extra costs come out of our own pockets,” Mr Crothers said.
“They can easily double the cost of employing a pharmacist compared to the city and even then it’s not always enough.”
RPNA has asked to be included in the roundtable consultation of 7CPA stakeholders in Canberra in July.