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. Is it okay to start off with your introduction please?
1: Yes. So I'm Fei Sim,
the National President of the Pharmaceutical Society of Australia.
0: Thank you. And Fei,
can you please tell us what have been some of the successes for 2024 for
pharmacists?
1: Yes, of course.
Carlene 2024 has yet again been another year I would say of growth
and change.
There are a number of successes that I believe members of our profession should
feel proud of and should be celebrating. Of course the first,
the biggest thing is the signing of the eighth community pharmacy
agreement between the pharmacy unit of Australia and the Commonwealth
government. And at the very same time,
the signing of the very first strategic agreement on professional
pharmacist agreement between PSA and
the Commonwealth government,
essentially sharing a commitment where we would lift the bar and
ensure there's professionalism, consistency,
and a willingness continue to expand the scope and the role of pharmacists
across all areas of practice, including in primary care.
So I think that definitely there are a number of successes that we need to
celebrate. If you think about it, in the first half of this year,
so the first half of 2024,
our profession was still faced with uncertainty. There
was still many pharmacists were still quite anxious because that was when we
saw the second tranche of a 60 day dispensing and without an
agreement being signed,
there was still a lot of questions and nervousness in the first half of
2024, but I would say in the second half of 2024,
since the signing of these major agreements,
there have been some significant improvement in terms of the confidence
of amongst members of the profession.
And I would say the positivity,
there's obviously also a number of other things that we should be celebrating
that I would consider as successes in 2024,
we have continued to see the continued expansion of scope of practice of
pharmacist,
whether it's in immunization or in the prescribing and the
management of a range of common conditions,
whether it's acute or long-term conditions,
whether it's pilot or otherwise permanent across the jurisdictions,
including in Queensland. Then we saw further movements in New
South Wales, in South Australia, in Australia and also in Northern Territory.
So these are all absolutely brilliant news in terms of once again
cementing pharmacist core role in quality use of medicines and medicine
safety and how pharmacists can continue to improve patient access to care
and Carlene.
What I would also class as a success in 2024 is
the release of what we've all been
anticipating for a good 12 months already,
which is the scope of practice review,
also known as the unleashing the full potential of our health workforce review.
Your listeners would know that the scope of practice review commenced around
about 12 months ago and it was a piece of work that the PSA
has fully invested into.
It is a review that is commissioned by the federal government and being chaired
independently and led independently by Professor Mark Cormack. And it is,
as I mentioned at the very start,
if you rewind 12 months back this time last year, in fact when we were chatting,
I mentioned about the importance and the significance of scope of practice
review and what I anticipate this would bring. And if we rewind 12 months back,
we really invested into this journey because this is probably a once in a
50 year journey where we are really seeing an appetite
for change in health system administration and an
appetite to,
I would say remove any impediments that limits or impedes
all health professionals including pharmacists from practising to a full and top
of scope.
So the scope of practice review was released only just a couple of weeks ago
and it is a journey. As I mentioned,
PSA has participated through a multifaceted approach.
So I serve on the scope of practice review expert advisory committee
and we had regular meetings with Professor Mark Cormack and his
team as well as of course on top of that there is the
regular written submission and consultation of the members around
what we would like to see in the scope of practice review. And your listeners
would also be able to anticipate that this had been a journey that was quite
polarizing because every discipline would want different
things and would want the best for their discipline.
But PSA has very much come forward with the lens around this is all about
patient,
this is about how can we as a nation improve patients access the care in an
equitable,
timely and affordable manner and leveraging the accessibility and the
expertise of pharmacist to be able to do that.
So the report is out there and your listeners are very
welcome to go and have a look,
but there are multiple areas where the role of have been emphasized.
In particular,
it came out with 18 recommendations to
the government around how we can fully unleash the potential of our health
workforce, including pharmacist.
Whether that's in either of those three categories, for example,
how can we remove regulatory and legislative barriers,
how can we ensure that there's consistent funding and
funding policy so that health disciplines are adequately
supported and remunerated to do the role that they're meant to do.
And there is also the ongoing,
all of the recommendations that relates to calling on the government to
invest into health workforce design and development.
There are again, a number of I can keep going on, but there are just ongoing.
It's just literally absolutely a big year as well.
Another area that your listeners may also be aware of is on the 1st of July
this year we had the launch of the aged care onsite pharmacist
program, which was a program that was,
I would say committed around about two years ago
in response to the Royal Commission into age care around how
medicine safety and governance of medicines can be improved within residential
age care facility by integrating and having
a pharmacist onsite to be able to help improve
QUM. And
that started on the 1st of July this year.
And obviously it's ongoing and of course the ongoing multiple
innovative projects as well that has been going on around the country.
0: Thank you. So you've referenced some of these,
but I thought I'd ask you about any others you wanted to mention as well.
But if you please go through some of the other changes that pharmacy has
experienced throughout 2024.
1: Yeah, indeed.
So I mentioned about it really 2024 when I reflected it is a
year of growth and change because the scope of our practice
as a pharmacist across all areas of practice are
continue to involve. We mentioned about,
I mentioned earlier around the continued expansion of scope in immunization.
So of course there was pharmacists are now able to provide vaccination under the
National Immunization Program, vaccination in pharmacy program or the NIPVIP
and we are continuing to see the prescribing scope continue to be
expended.
Started from pharmacists prescribing and management of uncomplicated urinary
tract infections in women to then the resupply of or cord deception across
jurisdictions to then now management of skin infections,
for example in New South Wales and Victoria.
And also seeing other states and territory governments subsequently
making commitments around full scope of practice,
whether it's in Western Australia, in New South Wales,
in South Australia and otherwise. So I think those are all the changes that have
continued to occur throughout 2024 but will continue to occur into
2025. And in terms of other changes,
we are also seeing increasing amount of innovative projects
that are happening across the country. About three weeks ago,
the PSA released an inaugural report called the PSA
impact report.
And the reason for launching this report is to showcase the
importance of pharmacist role in qualities of
medicines, but
through PSA support of a number of these important QUM
projects. Now these are obviously all projects and pilots,
but projects and pilots,
pilots are so important because they actually provide the
evidence that is required before any white scale implementation
of any work can occur.
But it also allow local innovative ideas to be trialed,
validated and tested and to be used as evidence as we continue to
advocate for wider implementation.
So over the financial year 24,
over a 12 month period, PSA participated and supported over
40 QUM projects across
the country and we continued to work collaboratively with
stakeholders, whether it's government, the department,
the PHNs or universities and other stakeholders to be able to
undertake this work and including other stakeholders such as
when it comes to transitions of care,
palliative care and of life management and the lease goes
on. So all of these things are continued changes,
but I would say that they are actually good changes that are
ongoing.
0: Thank you.
Can you please describe pharmacist questions and responses to all of these
changes? What have you had?
1: I should also mention not to forget that another big change that affects what
pharmacists do on the ground this year is the introduction of
the new vaping reform.
And of course across jurisdiction we're not seeing harmonization in terms
of scope and in terms of the scheduling of
vaping products and pharmacists role on the ground in particular
in community pharmacy and amongst all the other policy changes.
So what has pharmacist response been this year?
I would say it really had been quite diverse.
And as you would know, PSA, we represent all pharmacists,
all of the 39,000 registered pharmacists in Australia across all areas of
practice.
And it is something that we are in a unique position where we are
hearing the diverse views from pharmacists.
So on any single policy topic we always get
divers very, very diverse views across the whole spectrum,
all the way from fully supportive to being in full disagreement. But
as always,
PSA has always taken an approach where we felt strongly
that regardless of policy changes,
because we can't always control policy changes and
doesn't matter what policy positions there may be,
we've always taken the approach in terms of being fully supportive of
pharmacists on the ground. So all policy would have its pros and cons,
but PSA's view is that we would continue to be on the ground and support
pharmacists so that for those who wish to participate in any
policy or any programs,
they can feel fully supported to undertake those basically to
practice.
0: Thank you.
And what have been some of the challenges that 2024 has brought about for
pharmacists that might not have even been anticipated?
1: Look, I think there are, as much as we celebrate it,
we should be celebrating the successes.
There are also ongoing challenges and ongoing work.
I mean none of the work is finished yet.
I mentioned at the start of this podcast that we have seen the signing of the
eighth community pharmacy agreement and the strategic agreement on professional
pharmacist practice. However,
members of the profession would know that there are a number of programs that
will no longer be governed within a community pharmacy agreement.
That being a whole range of workforce incentive programs,
some of those programs like the N-I-P-V-I-P, O-D-T,
some of the other programs that our credential pharmacists undertake,
like HMRs, RMMR, ACOP and other emerging areas of practice,
all of these would require ongoing work.
And we're currently right now as we speak in the process of that,
and of course with anything there is
in the presence of an NDA I can't really speak too much to it,
but I would say that those are work that is ongoing
that will continue,
that will still continue. We have to continue to do and PSA
being the lead in this process,
we're absolutely not slowing down in this regard.
Other challenges, all of the other programs that I've spoken about,
there are ongoing challenges with those programs as well.
I've spoken about in the implementation and the commencement of the aged care
onsite or ACOP program.
Whilst the ACOP program commenced on the 1st of July,
we are seeing as we anticipated a slow
uptake of the program across the country.
And that is largely to do with the
program rules and the implementation. For example,
how are we going to ensure that there is the workforce and implementation
success in rural and remote areas where the needs of residential aged care
homes are quite different and workforce distribution is quite different as well.
There've been also ongoing uncertainty around
what about other emerging areas of practice?
And of course there is the never ending medicine shortages issue
that we face in a country and something
that affects pharmacists the most. I reflected this time last year,
we already had issues with medicine shortages including
ozempic and believe it or not, 12 months. Fast forward 12 months later,
we are still facing that issue. So ozempic is still scarce,
but I'm just using that as one of the many examples of commonly
used medicines that are in scarcity.
And I would say that pharmacists,
because we are frontline and we are the first port of call when people come
forward to us when they need medicines,
I never want to underestimate the amount of pressure and
dilemma that pharmacists would face on the ground when you have a real patient
in front of you needing a medicine, but the medicine is in short supply.
So I think that that absolutely is an ongoing challenge.
And there are also ongoing issues around
whether it's the need whilst we spoke about continued expansion of
scope being an excellent and in a much needed
way forward,
not just for our profession but also for people who live in Australia and for
our health system. Of course there are ongoing challenges that pharmacists would
face. Pharmacists want to know that there is enough and adequate and
appropriate remuneration for the work that they do.
Pharmacists also want to know that there is certainty and stability in the work
in their career, but also importantly,
we must also never underestimate the amount of effort that pharmacists would
have to put in to be able to do these expanded scope.
We are calling for pharmacists of course, as we continue to expand the scope,
there are upskilling that is required by our profession.
So as a pharmacist, as a practising pharmacist myself,
I never want to underestimate
the amount of work and effort. Imagine you're doing a full-time role,
you're helping your community, you're practising,
and then when you get home in your own time,
you're going to have to undertake further studies and upskilling.
I mean I understand pharmacists as well. I think I do as one of the members of
the profession.
Pharmacists are pretty resilient when it comes to things like that.
We just continuously step up and do and do, do more.
If it's in a rules that we must do this,
we would absolutely go forward and do it. But it does come,
it's costing us time, money, effort,
time away from family and this sort of stuff. But I have absolute full,
I would say trust and belief and confidence in our profession.
Whilst I have that, as I said,
I never want to underestimate the amount of pressure that our profession
continues to face.
0: I might ask another question.
So when we were thinking about that from 2023 as to what you expected
2024 to look like, do you think that it's probably met those expectations?
1: I would say largely yes.
Largely yes because in 2023 when 60
dispensing policy was first announced,
we were all anticipating 2024 to deliver on a
successful eighth community pharmacy agreement. And I think we have seen that.
That's excellent. And from a PSA perspective,
we've always felt strongly around professionalism standards and
guidelines and having that to continue to guide the profession.
And that has also been successfully achieved through the strategic agreement
which PSA signed on behalf of the profession for the very first time with the
Commonwealth government. We also,
in light of all of these changes,
we felt that our profession absolutely needed a very clear roadmap in terms of
what our practice would look like into the next six years into
2030. And this year,
PSA has also launched our pharmacist in 2030,
which is a visionary roadmap to our practice in the next six years
in terms of how pharmacist skills and experience can be fully
utilized to improve qualities of medicines, medicine,
stewardship, medicine safety, improving patient's access to care,
improving equity access to care. And all of these things are,
I think things that we anticipated to deliver 12 months ago and that we had
seen successfully delivered. The other thing also is that this year,
PSA has also launched our PSA
foundation,
which is obviously an initiative of the PSA.
And it was launched this year to coincide with World Pharmacy Day,
but it is really a project that had been in progress for the
last 18 months and it is a foundation that has
received a charitable status. We are A-C-N-C-D-G-R registered,
we have a very robust
independent board. And the foundation serves to,
obviously the vision and the mission of the foundation aligns with the
overarching PSA's vision and mission in terms of how pharmacists can improve
quality healthcare for Australians.
But it also is an entity that allows us to do a lot of charitable work and
to continue to support pharmacists and our workforce in terms of how
we can continue to do better. So for example,
the first project of the foundation was to support
pharmacists to be able to undertake mental health as a training
so that we can actually not just look after ourselves,
look after the people around us,
but also continue to provide quality and I would say appropriate
support to people that we care for
in terms of mental health.
And also it was only just last week that it
was announced that the government,
so our health minister, the Honorable Mark Butler,
announced at the Pharmacy Guilds parliamentary dinner of the
new Doctor of pharmacy title for an A QF level nine
extended master's degree,
which is a new degree that will be able to allow obviously lifting the bar
for all of our
prospective students and new graduates,
but also how this will allow reciprocity and alignment with international
practices and bring us in line with international standards.
So I mean all of those things I would say the Doctor of Pharmacy was
something that was actually in the seventh Community Pharmacy agreement and
again in the eighth community pharmacy agreement and now obviously the
formalization of this. So I think
all in all,
there are all of these big pieces of work that we anticipated to see in
2024 that we are seeing whether it's an
outcome or significant progress. But again, as I always say,
it's not the end.
It is something that will require ongoing work and the work is not done yet.
0: Thank you.
So what are some of your thoughts about what pharmacists might be able to
anticipate for 2025? I.
1: Look, I think absolutely the continuation of the evolution of pharmacy
practice in terms of scope,
in terms of where we can see how pharmacists can continue to be wherever
medicines are used. And this means wherever medicines are prescribed, dispensed,
administered and reviewed. We are also going to,
I mentioned about the scope of practice review being released this year with
18 recommendations made to the government.
But what PSA will absolutely not slow down and will even double
our efforts here is in 2025 is to actually
very,
very strongly call on the government to implement as soon as possible
all of the 18 recommendations from the scope of practice review,
there is obviously ongoing primary care, tenure action plan.
We will need to continue to,
that will continue to affect our practice that we will need to continue on.
Now also in 2025,
we are going to anticipate a federal election. Yes,
the dates are not confirmed yet,
but it is the understanding of everybody at the moment that it would occur
around midyear sort of may in the first half of the year.
So we will obviously be
eagerly anticipating what that would look like. Now,
going back to one of my earlier point, really,
PSA has always taken the approach whereby it,
regardless of who is in government and regardless of what the policy changes
might be,
PSA will and will continue to always be there for pharmacists to
support pharmacist practice.
Because regardless of whether one supports any policy
or health policy decisions,
there will still be ongoing need to support pharmacists on the ground.
And of course in 2025,
we should be anticipating an outcome from the other
agreement that we are currently working on provide again,
which will address, I would say,
which will address all the other programs that will no longer be governed within
a community pharmacy agreement.
And that includes all the other emerging areas of practice.
So in 2025, we are definitely anticipating that to continue.
I would say though that 2025 is not going to be a
very different year to 2024,
but I would say that 2025 will continue to bring more certainty
and an upward trajectory to our profession.
And I'm very confident to say that would be the case.
And I would just say that
2025 another year of change,
but we should all be embracing changes and leveraging the
opportunities that are in front of us,
not underestimating the challenges, but again,
that's where we really need to continue to support each other.
And from the pig body's perspective,
we will continue to advocate for pharmacists wherever medicines are used,
and for pharmacists to be adequately supported to improve access
to care by people who live in Australia,
and also improving qualities of medicines and medicine safety.
0: Thank you. So how can pharmacists prepare now for what is to come?
1: I would always say pharmacists should be looking after ourselves better.
I think as it probably is in the DNA of pharmacists,
I would say pharmacists are naturally caring people.
That's what attracts people to the profession and that's what retains
people within the profession.
But I would say how can we adequately prepare ourselves?
It is obviously an ongoing journey where we would be anticipating change.
It is an ongoing journey where pharmacists can slow down and we need to continue
to embrace the change and whether it's upskilling and keep on our toes
around policy changes. But all in all,
we need to look after ourselves. I think as pharmacists,
we don't talk about ourselves enough in terms of how we can look after our own
physical health, mental health, and emotional health.
I think it is really a year, if you think about it,
we have had five years of Covid and an
ongoing other health
changes around us and whether it's RSV or otherwise,
and pharmacists have never, I say slowed down,
pharmacists have never slowed down,
but we are all humans. And really speaking from my heart,
I want to use this opportunity to call out to all pharmacists to look after our
own physical and mental health.
And if we can't look after ourselves and if our cup is not full,
we can't continue to look after other people and we can't look after other
people in a sustainable manner.
So I think we need to look after ourselves and whenever we have the
capacity, because we all have our ups and downs and when we are on the down,
look after ourselves,
but also be open and willing to receive support from the people around us.
And when we're feeling on the up,
it is absolutely incumbent on us to support the people around us.
So continue to look after each other as well,
everyone within our profession and your loved ones around you.
And speaking of looking after everyone amongst ourselves within our profession,
I would say that we are a very small but mighty
profession. And I've said this 12 months ago, and I think that has not changed.
We are a small but a mighty profession.
There are 39,000 of us registered in Australia, just for comparison.
There are over 340,000 nurses,
let alone the other workforce like the allied health and the medical profession.
So we are relatively small in numbers,
but if you think about the amount of weight that we lift in our health system
in terms of helping people to ensure that Australians can continue to have
timely and affordable access to essential medicines to
healthcare, and now improving patient's access to primary care,
all of these things I think are, and not forgetting our hospital pharmacist,
colleagues and pharmacists in other clinical settings where they're actively
improving qualities of medicines and medicines governance.
We are as a profession,
very mighty when it comes to the amount of weight that we
lift from our health system,
but also because we are such a small profession from a
numbers perspective,
it is more paramount that we remain united.
I can't stress enough of these.
I remember when I first started in this journey two and a half years
ago as the president, I felt strongly already at that time,
and that sentiment really has not changed.
Now you fast forward two and a half years later,
I really feel that we need more unity within our profession because we're
such a small profession. Scalability is not always on our side.
And if we continue to have more division amongst ourselves,
that really does not come back to serve our profession well.
We should be working towards more unity,
more consolidation,
and in that way we can better support our profession as a whole moving forward.
Because unity is our string.
We cannot afford any forms of division or duplication.
So I think that's something that we will continue to strive moving forward
into 2025, it is, I would say,
a very,
very unique time when we are seeing significant appetite for
change in our health system.
I know I have not seen pharmacies evolved in 50 years,
but I have been advised by many of my very
wise mentors who have been in the system for 50 years even they agreed that
right now they have never ever seen such
significant appetite for change, nothing like what we're seeing right now.
We are seeing primary 10 year action plan.
We are seeing strengthening Medicare efforts,
we're seeing national health reform agenda, scope of practice review.
We are seeing such significant change
and significant appetite for change because we do know that as a country
with aging population and increased medicine use,
our health system is not sustainable.
Our people are not getting healthcare as quickly as
their condition needs them to be.
And absolutely it is time where there is a lot of appetite for
change, but appetite for change is good.
It's good for our profession and it's good for our profession to support members
of Australia. But we also must make sure
that as a profession we are adequately and strongly represented
and that we have strong unity within our profession.
And PSA,
I'm really saying this as a member of the profession,
PSA is the only government recognized peak body that represents pharmacists
across all areas of practice.
And PSA has always helped the belief that the more
united we are as a profession, the stronger we are,
and therefore the more benefits we can bring back to our profession as a whole.
We should absolutely be doing everything that we can to reduce any tension
within ourselves,
but also we must leverage any opportunity to collaborate with other
profession as well.
Because a multidisciplinary team approach to patient care is
the only way forward.
And that's something that PSA would absolutely continue to strive.
And I really, as I always say,
if someone is a member of the profession,
they need to be a member of the PSA as the body that represents all of the
pharmacists, because that's the only way we can achieve true strong
representation patient
to leverage and capitalize on the current appetite for change to
advance and bring our profession forward. Whether it's removing legislative
barriers, whether it's workforce investment,
and whether it is fighting for better remuneration for pharmacists to be able to
do the role that we do in a sustainable way moving forward,
and to continue to advocate for pharmacies wherever medicines are used.
So 2025, I think in summary, another year of change,
another year of opportunity, but also not to underestimate the challenges.
And I very much look forward to a positive 2025 with
everyone.
0: Fantastic. Thank you.
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