0: Welcome to the AJP podcast,
a podcast for pharmacists by pharmacists where we discuss current events,
relevant topics, and emerging issues. I'm your host, Carlene McMaugh,
and together with the AJP I'm bringing you the opinions and expertise of
different pharmacists to discuss their views and insights on topics relevant to
pharmacists.
Please like and rate each episode and subscribe to the podcast so you don't miss
an episode. I always start with you introducing yourself,
if that's okay.
1: Sure, yes. I'm Chris Brooker, the editor of AJP,
the Australian Journal of Pharmacy, of which I've been the editor now for
actually, yeah,
longtime observer of the healthcare and especially pharmacy
industry in which I've worked for probably 16 of the last 20 years.
0: Thank you. Can you please describe from what you've seen this year,
what have been some of the successes that have been seen in pharmacy across
2024?
1: I mean, I suppose look,
the big story thinking of community pharmacy first is obviously
the eighth agreement.
Obviously when the year began,
we were still in this sort of state of kind of cold war really was it a
cold war or a warm war, I don't know,
between the federal government and the Guild and
community pharmacy owners in general where there was still uncertainty over
where things were going in terms of remuneration,
in terms of recompense for the effects of double dispensing.
So I think obviously that was a huge deal and I think pharmacy,
if you look at it with a degree of distance,
I suppose did very well out of the eighth agreement.
So I think that would have to be
a top success for pharmacy as an industry.
I suppose if you look at it as a business,
I think they've done very well out of it and I think pretty much all the
industry experts I've spoken to would have said the same. This was a very good
agreement that was much better than what many people were thinking.
So I think the Guild,
Mr. Tassone has done a great job with his negotiations and his team and
I think Trent and co. should be really pleased with what they've got there.
And I think all pharmacy owners particular should be thankful.
And I suppose the other thing that you can say is the success is the continued
expansion of scope of practice and the continued evidence that
pharmacists in general can do what they're now being
allowed to do. Obviously interestingly, I was,
before we started talking,
I was looking through a list we got a month or so ago of our top
25 stories for the year in terms of readership.
And the very top one further down the list than I thought it was the very top
one was pharmacies claim over 227,000 through NIPVIP in
January. So obviously the NIPVIP program for
vaccinations began at the beginning of the year and I mean that showed already
the level of interest in pharmacy, but also the level of,
well,
the sheer number I suppose the vaccinations that pharmacists or pharmacies are
now doing. I mean that was obviously that's been the banner,
the flagship or whatever you want to call it, of expanded scope of practice.
And I can still remember when that was kicking off and doctors groups saying
there was going to be people collapsing outside pharmacies because they wouldn't
be able to cope with it.
And obviously it's been a huge success and I think that's opened the doors with
governments and regulators to see what else pharmacy can do.
And I think this year,
2023 and 2024 probably as a flow on from the pandemic,
we've seen that
a whole range of different programs in different states and now kicking off
in a whole range of different areas, UTIs,
lots of other point of care testing and whatever that are all just sort of
kicking off around the place to show pharmacy or to show people what pharmacy
can actually do. And I think pharmacists are doing those very well.
So I think that would definitely have to be a huge tick,
but I think they're probably the biggest successes really.
I mean there's lots of other big stories,
but whether they'd consider them a success,
but I think they'd definitely be the top of my list.
I think from an individual pharmacist perspective,
the fact that you can now do so much more and so many more
things are being tested and are on the way.
Now there may be other issues that come from that of course,
but I think you're looking at the fact that pharmacists are proving they
can do these things safely and to patient benefit
is a massive success.
And then in the community sector that's been underpinned financially
by a very good agreement. So I think that'd be the top two for me.
0: Thank you. You've made reference to the top story,
but I guess I'd ask what some of the top stories have been throughout 2024 and
I guess you can link that to pharmacist questions or responses to the stories
and changes to pharmacy.
1: Okay, so well, what are the big threads through the year?
I mean obviously looking from the start of the year, I suppose again,
obviously the agreement and the lead up or the community pharmacy agreement and
the lead up to it,
obviously that's been an ongoing story until it was signed.
That's definitely one.
Obviously with that there's certainly been a lot of politicking
within the Guild.
Obviously there was a lot of pressure last year in particular from the CAPS
group
who were very vocal in what they thought should be happening.
And obviously in New South Wales they managed to unseat
a number of look quite long-term Guild state
councilors, including obviously the president David Heffernan,
which showed I suppose the volatility of the New South Wales pharmacy landscape,
but also the level of feeling among members.
I think in retrospect, David was doing a very good job,
and it's probably a bit ironic that not long after
the election results came in,
the New South Wales government announced again
a program of expanded scope of practice,
which was a large part due to his negotiation. So interesting.
But obviously that's been a volatile issue,
which has now I suppose died off since the agreement.
Another big issue that's been ongoing all year,
of course is the merger between Chemist Warehouse Group and
Sigma, which obviously has huge ramifications directly for a lot of pharmacies,
of course, who are in Sigma owned banner groups,
but also for the broader sector in general,
given what a massive powerhouse that promises to be.
I mean that certainly provoked a lot of comments from readers as you could
imagine,
some of which I probably couldn't recite and some of which we couldn't approve.
But no, I mean there's certainly been a lot of debate around that,
about what the significance of that will be to people who,
I mean obviously the entities themselves have said there'll be
no detrimental impacts. I mean that obviously remains to be seen.
Who knows what will be the end result of it.
But I mean it's certainly obviously a huge story for the future of the
community sector.
Well obviously again, scope of practice,
I think that's obviously one thing that's very volatile because it does
obviously, while on the one hand people are like, this is great,
we can now practise what we learnt at university and what
we think we are trained to do. On the other hand,
of course that brings the issue,
which a lot of our readers constantly point out of, well that's great,
but what about our remuneration? What about our working conditions?
Does that mean more work for the same pay or work that's more
complicated and time consuming?
How does that relate to the workflow in the pharmacy?
So there's all these other issues which are still very much to play out,
I would think. And that I suspect will a big story going forward.
And also I've recently been at the Medicines Management Conference and obviously
in the hospital sector there's a whole other range of issues there,
some of which are quite related. Obviously with charting,
giving, prescribing rights,
workflow,
the increasing specialization in that sector,
we do get quite a few comments from readers around the significance of those.
So yeah, I mean I think, I'm just trying to think what else.
There's been a lot of comments on this year. Oh goodness,
certainly been a lot on Chemist Warehouse and Sigma, but yeah,
I think they're probably the main ones that leap out at me that have been
ongoing issues.
0: So I might ask you what you have been most proud of seeing across
2024,
so both for the Australian general of pharmacy as well as for
pharmacists in the pharmacy world?
1: Yep. Okay. Well, in the broad pharmacy world,
I think I've already covered really what I'm most proud of.
I think I really welcome the fact that
pharmacists are now showing what a key role they do and always have played in
the health system and how that can be expanded.
I think that's something everyone in pharmacy should be really proud of. I mean,
we recently ran our reader vote campaign
on advanced practice pioneers and that as well as people
you'd expect to be mentioned like Professor Lisa Nisson,
people like that.
There was a lot of other people I'd actually not heard of who were mentioned in
there and you think, God, these people have done some really, really innovative,
amazing things.
And I think that's something that we often,
I think that's something that probably gets lost in the 24/7 run of
stories. We often hear the complaints and the negativity.
We deal with a lot of stories where someone's being suspended for something or
has happened or there's a fight over resources,
the usual stories you get in every field. And
I think it was an interesting thing to sit down and look at that
and to see the people that people voted for and nominated for that.
It was really inspiring to think that there's so many people out there who are
just going, look, I'm not interested in the politics of things.
I'm just going to get on and do what I think is important to do.
That's something that I think
having been in pharmacy or worked around the pharmacy space since about 2001,
to see where it's come to now from there is it's incredible really.
So I think that's something everyone in pharmacy should be really proud of
in terms of AJP look, I think
firstly, I hope that we're still meeting what our reader's needs are.
I hope they are. I think they are. Please tell me if they're not.
One thing we have tried to do and we're looking to do more in future,
is to target people more directly. I mean,
we've started that with our AJP Select Hospital and Credentialed
Pharmacist e-newsletter.
That was an area that we identified as
not being all that well covered in the AJP Daily.
Basically when you've got a limited range of stories,
it is unfortunate,
but you tend to sort of favour the ones that get the most clicks. And I know
that does sound like we're chasing clicks. It's not really,
but it's just what happens.
It's unfortunately the way of the world and there are lots of
worthy stories that do get lost in the mix because you've got to fill five or
six spaces and you might have 10 stories we often do.
And so that was an area of pharmacy we identified as not being well serviced
by anyone really including us.
So we launched that newsletter as a fortnightly and made it an opt-in newsletter
and it's now ballooned up.
I think we've got about 3000 people reading it every fortnight now.
It gets massive readership rates.
It is been a real success and I'm really proud of the way that's grown and it's
opened up whole other avenues of readership for us and also other
avenues of commenters for us that we've met a lot of people who
we probably wouldn't have dealt with very often before that came to pass.
So I think that's something I'm very proud of with AJP and I think that's
something we're looking to do hopefully more in the future.
I think there's other areas that we could address people who are doing
innovative things in the pharmacy business space or
looking at it and areas like that.
So I think there's lots of other areas we can look at. But yeah,
that's something I'm definitely proud of for AJP and we're always looking to
identify and meet what we think our readers need. So yeah.
0: Thank you. When you think back on what you predicted for 2024,
so when you think about the end of 2023,
has the year turned out how you expected?
1: No, I think most people are saying that about 2024. Actually,
no, I don't think so. God,
what did I predict? I did predict that. Well,
I think I hoped there'd be a good agreement coming out of it and there was
yes and no. I suppose I'm sorry to change my answer halfway through
with most things. I mean, you just don't know what's going to happen,
do you over 12 months?
I don't know what's happening from week to week to be honest, Carlene. But no,
I think some things have come to pass as I thought they would,
but I honestly did think there would be more argie-bargie over the
agreement and I did not think that pharmacy would get some of the
outcomes it did get from that. I think I
really did think it would be a lot tougher.
I thought the relationship with the government was bad
and that it wouldn't have come to pass as it did. It's
interesting the way it did come about. I mean, it kind of almost,
I don't know if I should be saying this or not,
but it seemed to me after a while it was kind of like the government were like,
well, we need to just get this one done and out of the way.
And I don't know,
obviously the Guild had made a very good case and they got a good result out of
it. I mean, I know there's still in that space,
there's more to come with agreements and I suppose we'll talk about that later
when we look forward to 2025. But yeah, I think that was probably,
if I'm to think about anything, that's the thing I'm most surprised about.
I really did think there'd be a lot more to-ing and fro-ing over that.
It did seem to be,
I'm sure it wasn't very easy to Anthony and his team,
but looking from the outside,
it did in the end come to a really good outcome and I think it seemed to be a
lot smoother than I would've thought it would've been.
0: Thank you.
What are your thoughts about what pharmacists can anticipate in 2025?
1: Well, firstly, I mean while we're talking about agreements,
I mean I know there's two more agreements currently being negotiated or
soon to come to fruition, maybe even before 2025, who knows?
I know there's obviously the agreement with the wholesalers, which is
separate now from the CPA and obviously the agreement
being negotiated on professional pharmacy programs.
So I think that's definitely something which will make a difference next year.
I mean, obviously the fact that PSA obviously now has
ownership's probably not the term, but responsibility I suppose,
for administering those non CPA programs like NIP V and
various others. I mean, it'll be interesting to see what comes from that.
I think that's definitely something which will make a big impact on people going
forward. Obviously when you think of,
there's been lots of questions over the H-M-R-R-M-M-R program and its level of
funding.
So now that's removed from where it's been for the past few years and is
under the auspices of PSA in this new soon to be
negotiated agreement or currently being negotiated agreement. It'll be
interesting to see what comes to that next year.
And that's definitely something that will be a huge impact. Think, I mean,
obviously as I mentioned before too, Sigma and Chemist Warehouse,
I think it will be interest really fascinating to see what plays out from that,
what will be the ramifications because obviously it does seem in the community
pharmacy space that we're seeing the development of
two or three super banner groups. Is that a term? I don't know,
can I coin that one? But where there's going to be these
entities almost,
and I think we'll probably see increasing fragmentation between those,
some pharmacies moving into those big groups like the expanding Terry White
Chemmart group and those groups that are part of the
Sigma and Chemist warehouse camps.
And then you sort of, I suppose,
innovative smaller banners like Pharmacy 777 Group and Capital
Chemist and people like that. And yeah,
it'll be interesting to see how that landscape plays out going forward, I think.
What else can we look forward to in 2025? Well,
I think another thing it'll be interesting to see certainly will be the,
as we get more and more results through from the expanded scope of practice
trials in different states.
And I have heard, I don't know how true this is,
but I have heard in some cases there's been issues in recruiting
people into those or pharmacies. I mean,
hopefully people are on board and want to get involved, but yeah,
we'll be fascinating to see how they come through.
I know at Medicines Management there were a couple of posters that
illustrated the results of some trials in South Australia and they seemed really
positive looking at those. So yeah,
I mean that'll be fascinating to see what comes from those because obviously
that will inform then the next steps in terms of funding for those programs at a
state level
and possibly at a national level and whether other trials are performed.
So I think they're probably the main things that are top of mind.
I suppose the other thing, one thing that, it's interesting,
it's an issue that we always think is really important,
but the story never really clicked that well. But
I think is it related issues, particularly IT safety? I think,
I don't know. It's something that always freaks me out,
but it doesn't seem to resonate very well with our readers,
but I think it probably should more and more every year because there are so
many growing security concerns and healthcare is the
most highly targeted area,
and I think that's definitely something people should be on top of more and more
is, it's a bit of a downer,
but I think we definitely need to be on top of that because all sorts of
ramifications that can come from an IT breakdown.
So I think probably something else I'd mention, but yeah,
it's interesting people never really read those stories.
Maybe we need to look at the headlines. I don't know.
0: I guess I might ask you what you think or any advice you might have for
pharmacists about how they can prepare for what's next to come and yeah,
for 2025 as we close off another year.
1: Well read AJP. We've got all the experts doing now.
I think it was definitely lots to learn from the experts. We do run,
probably not what I write, but look, I think really, I suppose, yeah,
actually I was being facetious, but look, keep up to date with things.
Keep reading the advice coming from everyone from the guild,
the advice that comes from PSA from AdPha,
which is something I haven't actually mentioned.
And that's another big step which I should have mentioned before actually is the
changing in nomenclature of the SHPA to AdPha,
which is a big step. Sorry to step back,
but I probably should have mentioned that earlier. It wasn't my notes.
I don't know why I didn't mention it. But yeah,
I mean think that's a huge step and that speaks again to the
expansion of scope of practice and the opening up of all these sort of areas of
pharmacy. Also, it does tie into it how to prepare for 2025. There you go.
Because obviously an ever expanding area is going to be
that sort of middle ground I suppose if you want to call it that sits between
the hospital pharmacy camp and the community pharmacy camp,
these whole areas of people working in general practice,
working in aged care people doing things like H Rs
and all that sort of all those
extra services and newer areas of practice for pharmacy.
And obviously that's informed the move of SHPA
into AdPha and the opening up also of their college where they're awarding
post-graduate
qualifications for expertise in particular specializations.
So obviously that's something I think that's going to happen more and more.
It's interesting because I think going forward I do get the sense,
and a lot of people have told me this,
on the one hand you are going to have all these increasing areas of
specialization for pharmacists to move into,
but on the other hand also,
there's going to be more and more in the future people who are moving between
all these different areas of practice who are going to be working
in a hospital but also may do some community pharmacy work who are also working
in aged care. I think there's going to be,
the flexibility is going to be there increasingly in the future.
And I think probably from what people tell me, that's definitely something that
younger pharmacists are increasingly aware of,
and I think that's something that's going to be there in the future.
You probably won't spend all your life in a community pharmacy or looking
to go and buy a pharmacy. Less and less people are doing that,
but more and more people are looking to around different areas of practice,
and I think that's going to be something that everyone's going to have to get
used to going forward and prepare for. And I think that's probably a good thing,
really. I mean,
perhaps not if you're an owner looking for staff who want to stay there, but no,
I think it is going to be a good thing for pharmacists.
I mean the options of work are going to
increasingly expand and I think you just have to be versatile and
flexible and interested in working in lots of different areas. I mean,
I think that's the same for everyone.
It's certainly the same for those of us in media these days as well. I mean,
I think just be flexible and be aware of where the
opportunities are.
I think that's probably the key thing on an individual level that I'd end on.
And as I said before, worry about your IT security.
0: Thank you.
And the only other question I have is to go back to the one about yes,
just in case you had anything you wanted to add.
1: What was that again? It.
0: Was about the challenges that were seen in pharmacy across 2024.
1: Yeah, look, I think I've pretty much covered it really. I mean,
I think probably the big thing really was
one thing I will say I've noticed,
I think a lot of people have said this to me as well,
and we've had quite a few comments and discussions about this with people.
The mood within pharmacy did change around the time the agreement was signed.
I think there was a lot of uncertainty,
which has been largely eased by that. I mean, look,
we still got a lot of comments from readers.
I was looking at some overnight where people were,
the sectors kind of on its last legs and it's fine.
People always say things like that,
but I think the mood definitely picked up and I know the UTS barometer
picked that up as well. I think
it gave people some renewed certainty.
So I think that did answer some of the challenges. I think probably a lot of the
challenges are what I just spoke about before, really in terms of flexibility,
it's always difficult in a workforce, isn't it?
And if I can put my media hat on here,
I was probably in the early to middle part of my career when
digital media started happening and you get training in
one area, which was print journalism or broadcast journalism.
When I was at uni and starting my career,
if you started in print, you were writing for print,
it was a pretty structured path of what you did and where you went.
And then all of a sudden this huge great bloody disruptor got thrown into the
middle of it and everyone was doing a bit of everything after that.
You're writing for a magazine, but you're also writing for a newsletter.
You spend all your day doing newsletter stories,
then you have to find time to do a longer piece for the magazine. Then you're
doing social media,
then you're doing these days podcasts or videos or whatever
it is been hugely disrupted. And
how do people respond to disruption? Some people get despondent,
some people leave, some people embrace it,
others just batten down the hatches and push through.
And I think pharmacy has had that as well, of course. And I think in particular,
it's probably hit a little bit later than it did with media,
but I think we are sort of still at the end. No,
the end's not the right term is it?
We're still in the middle of that process now where things are changing.
There's been disruptors and there are going to be more and more disruptors in
health. And I think that that has created that sense of, like I said before,
whereas people, once I'm a hospital pharmacist, I'm a community pharmacist,
I'm now going to buy a pharmacy. There was those areas where people
went into and that is being thrown around
and thrown up in the air. And
you'll get some people who have embraced the flexibility of being able to travel
and be locums or do some work in a community pharmacy,
but also do a couple of days wherever.
People who want to work in aged care or are doing RS who want to work
independently and be contracted.
That is still working itself out.
Obviously you've got factors within pharmacy that fight against that.
I think you've got the general move of society and of the health system
will end up in a more flexible workforce than it is now.
And I suppose that's just how people respond to that in pharmacy.
That's even more magnified, I suppose,
by the increasing feminization of the workforce. I mean,
you yourself have young children and you have to had to deal with the
implications of
pregnancy and maternity leave and whatnot. And obviously
in a workforce, what is it now, 61% female. I mean,
that's obviously a huge factor. And I suppose what I'm saying,
the challenge there is the whole of pharmacy needs to,
how does it approach this? I mean, I think there's been a kind of,
I sense some reluctance to face some of the implications of that.
And I think that will definitely play out over the next few years.
We already have workforce challenges in this sector,
and I think unless the implications of
the changing nature of work,
the increasing feminization of pharmacy and the increasingly
unstructured nature of, I suppose,
pharmacists careers in terms of being able to move around
and probably needing to move around more than they ever did in the past,
I think those things are yet to play out. And we're in the early days of that.
So I think that's going to be a challenge for a lot of people going forward. I
mean,
obviously a lot of young pharmacists who come into this space won't know any
different, will be like, great, this is fantastic. I can do a bit of this.
I can do a bit of that, be brilliant.
But if you're a bit older or sort of partway through your career,
sometimes these things can be a massive issue for you, can't they?
So I think that would be one of the biggest challenges I think pharmacy needs to
face. And I think there has been quite a lot of
heads in sand over that issue or those issues. It's not one issue is it?
But I think, yeah, that's definitely something that needs to be looked at.
0: Wow, look at you. That was a very big picture. Loved it.
I haven't had that response. Thank you. Very big picture.
1: Well, do you know something, Carlene? Funnily enough,
when I was thinking about this the other day,
that was actually one of the first notes I wrote down that was talking about
that, and I completely forgot about it until then. I mean, it is a big issue.
I sort of was just sticking to issues that people had talked about,
but when I was thinking about it,
that is kind of a much bigger issue than a lot of the nitty gritty stuff really.
I mean,
it iss a massive issue and it's going to be a massive issue going forward.
And it's so weird, isn't it? I mean, you think, again,
a profession that's now heavily majority female and increasingly with
females in senior roles,
and it still doesn't seem to have generated much more talk.
It's in a strange, really, I don't know.
0: Yes, it is, but I am still putting a comma there. I'm still
advocacy and support and opening people's minds. But you're right,
there's a lot less talk.
And when people get confronted with things that they haven't thought about,
they can become defensive or it's definitely not an area of comfort.
So they definitely retreat.
1: Yeah, I think so. Yeah. So I think that one is, I'm pleased.
I did think about that one. In the end,
it is a big issue and I think it is important to talk about those bigger picture
sort of things.
0: We hope you've enjoyed this episode of the AJP podcast.
If you have any thoughts, comments, or suggestions about this episode,
please visit the ajp website forum@aj.com au and join the
conversation.
If you have any suggestions for future topics or would like to participate in
the podcast, please follow us on Twitter at ajp podcast and send us a message.