SHPA - Current Issues

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Ongoing issues about progress of pharmaceutical reforms in public hospitals - October 2005
Thanks to all those who assisted with the collation and the review of the summary of current issues in this letter that has gone to the Department of Health and Ageing with follow-up meetings between SHPA to take place. (members only)

Understanding the Medicines Management Pathway - December 2004
The SHPA vision is "excellence in medicines management through leading edge pharmacy practice and research". The medicines management pathway concept has been used in many settings recently. It describes the cognitive and physical steps involved in the use of medicines, with a central focus on the consumer. There are nine key steps and three background processes, and as the processes and steps are interdependent, they influence each other.

Pharmacists working in hospitals have an established role at all steps of the medicines management pathway. With more professional services being offered via community pharmacy and other pharmacy practice settings, the medicines management pathway concept will play an increasingly greater role across the continuum of care.

Read the article Understanding the medicines management pathway by Stowasser DA, Allinson YM and O'Leary KM. J Pharm Pract Res 2004; 34: 293-6 and view the medicines management pathway cycle diagram.advocacy

SHPA response to the National Health Workforce Strategic Framework - July 2004

SHPA response to report on pharmaceutical reforms in Victoria - June 2004
SHPA has written to all Health Ministers and key stakeholders with comment on the six main recommendations identified to address shortcomings and the importance of working together to achieve those improvements ASAP. Federal President Helen Matthews discussed the issues at the national APAC meeting in June.

The report Pharmaceutical Reforms in Victoria's Public Hospitals: Impacts on Service Providers and Patients was released on 27 May 2004. The Executive Summary contains the five key findings, one for each identified stakeholder group - Directors of hospital pharmacy, hospital pharmacists, hospital doctors, community general practitioners and hospital patients. Detail with stakeholder comments is available in the full report (a large file and may take time to download).

SHPA Discussion Paper - Moving Forward - The Funding of Medicines in Australia's Hospitals - May 2004
Developing a national system for subsidizing medicines has been taken up by Health Ministers and discussions have commenced on this as well as streamlining the administrative and prescribing issues related to the current pharmaceutical reforms. The SHPA discussion paper has gone to all Health Ministers. The final model should maximize access to a full range of medicines using a quality use of medicines approach for the different levels of patient care, as well as positive support for all steps of the medicines management pathway.

The SHPA Clinical Pharmacy Intervention Study (CPIS) has been published - April 2004
A Prospective Multicentre Study of Pharmacist Initiated Changes to Drug Therapy and Patient Management in Acute Care Government Funded Hospitals by Michael J. Dooley, Karen M. Allen, Christopher J. Doecke, Kirsten J. Galbraith, George R. Taylor, Jennifer Bright, Dianne L. Carey; British Journal of Clinical Pharmacology (BJCP) Vol. 57 Issue 4 Page 513 April 2004.

SHPA funded the CPIS as a key research initiative and as all authors are members of SHPA, the BJCP has kindly agreed to allow the article as a pdf file to be hosted on the SHPA website. This is an electronic version of an article published in British Journal of Clinical Pharmacology: complete citation information for the final version of the paper, as published in the print edition of British Journal of Clinical Pharmacology, is available on the Blackwell Synergy online delivery service, accessible via the journal's website http://www.blackwellpublishing.com/ The full contents of BJCP Vol. 57 Issue 4 may be accessed at http://www.blackwell-synergy.com/links/toc/bcp/57/4

Hospitals that participated in the CPIS were Austin and Repatriation Medical Centre and Geelong Hospital (Victoria), St Vincent's Hospital Sydney and Royal North Shore Hospital (New South Wales), Royal Brisbane Hospital (Queensland), Fremantle Hospital and Royal Perth Hospital (Western Australia) and Royal Hobart Hospital (Tasmania). The authors acknowledge: Mark Bicknell, John Elkerton, Meredith Freeman, Wayne Gregg, Karen Harrhy, Anna McClure, Mark Raines, Thirza Titchen, Sylvia Cuell, Garth Birdsey, Martin Bleasel, Kent Garrett, Helen Leather, Kim Sucic, Donna Taylor, Meredith Verge, Greg Weeks, Julie Wilkes, Chris Alderman, Susan Poole, Brita Pekarsky and all participating pharmacists and members of the independent clinical review panels who worked on the CPIS project.

- CPIS - letter to all Health Ministers
- CPIS Media Release

> Workforce

SHPA's February 2007 updated response to the National Health Workforce Strategic Framework
This document updates the previous information provided by SHPA in response to the National Health Strategic Framework during 2004. It covers the most recent information about the hospital pharmacist workforce and the role of hospital pharmacy technicians. A national workforce action plan for hospital pharmacy is proposed highlighting the need for active retention and recruitment stratgies for pharmacists.

SHPA input (July 2004) into the evaluation of the Rural and Remote Workforce Development Program (RRPWDP)
SHPA recognises the particular stress that exists in the rural and remote pharmacist workforce and strongly endorses programs designed to support this vital ingredient of our national rural health workforce. There are a number of elements of the current RRPWDP which apply only to community pharmacy practice. The main benefits of the current program that do flow to hospital pharmacy practice relate to support to access continuing education services.
Therefore SHPA has made suggestion under the headings of:
1. Useful extensions of features of the current program
2. New ideas to support increased training of pre-registration pharmacists in rural hospitals
3. Developing future pharmacists who can support rural and remote health in a new practice paradigm.

Article - Snapshot of the Australian Public Hospital Pharmacy Workforce in 2005.
The most recent snapshot of the hospital pharmacy workforce (pharmacists and hospital pharmacy technicians) this document highlights that the average national vacancy rate for pharmacist positions in public hospitals has slightly improved between 2003 and 2005 (now 7%) but that vacancies rates vary widely across states/territories; that retention strategies are crucial to retaining a highly qualified and skilled workforce and that recruitment of newly registered pharmacists is important in meeting the anticipated increased demand for hospital pharmacist services (ongoing demand for 10% more positions), in particular for clinical pharmacy services.

Article - Pharmacy Clinical and Distribution Service Delivery Models in Australian Public Hospitals
This document, published in June 2004, presents useful information on the clinical service models and medicine distribution models that are being used in hospitals. For example, the study shows that on average 47% of a hospital pharmacist's time is spent on clinical services (up from 41% in 2001), 37% on distribution services and 16% of time is still devoted to development of management policies and procedures that support system-wide interventions for the safe and effective use of medicines.

Article - Pharmaceutical Review: resource implications for the pharmacy component in Australian public hospitals.
This document, published in March 2007, explores the pharmacy resource implications in Australian public hospitals meeting the Australian Health Ministers objective "To also help safer use of medicines, by the end of 2006, every hospital will have in place a process of pharmaceutical review of medication prescribing, dispensing, administration and documenting processes for the use of medicines." The study also documents that despite ongoing shortages the percentage of time pharmacists spend delivering clinical pharmacy services (associated with direct care to patients) has remained at 47%.

Health Training Package HLT02 review project: Hospital Pharmacy Technician Qualifications Framework - September 2005
Read the SHPA submission to the Industry Skills Council. SHPA believes that it is crucial that the qualifications framework for hospital pharmacy technicians support their current role and provides a framework for the further expansion of their role. (members only)

Article - Snapshot of Australian public hospital pharmacy workforce in 2003.
The 2003 snapshot survey of the hospital pharmacy workforce highlights that the average national vacancy rate for pharmacist positions in public hospitals has slightly improved between 2001 and 2003 (from 14% to 10%) and discusses the retention and recruitment strategies that have been shown to reduce vacancy rates. It also has some information about the various recruitment and retention strategies that have used in the in states/territories. This report identified a demand for 10% new positions for pharmacy services (for clinical pharmacy services, medication safety etc.) that were planned by the institutions for the following two years.

Report - Influence on career choices of recently registered pharmacists. Melbourne: Society of Hospital Pharmacists of Australia (Victoria); 2004.
The report describes the findings of a 2004 survey of recently registered pharmacists in Victoria. A major aim was to determine whether hospital-based pre-registration training is an effective means of supplying the hospital pharmacy workforce, and the factors that influence pharmacists' career choices, especially why they choose or don't choose to work in hospital pharmacy. At the time of the study it was reported 85% of pharmacists working in Victorian hospitals had undertaken pre-registration training in a hospital. The study concluded that pre-registration training is a strong indicator for future employment in hospitals. This highlights the need for an increase in funding for pre-registration training places in hospitals in line with the large increase in undergraduate numbers across Australia. (More than 50 newly qualified pharmacists have been recruited to Victorian public hospitals on completion of their hospital pre-registration training in both 2005 and 2006.)

Article - Health Care Intelligence Pty Ltd. A study of the demand and supply of pharmacists 2000 - 2010. Sydney 2003.
Available from http://beta.guild.org.au/research/project_display.asp?id=245
This is the most recent Australian profession wide study of anticipated supply and demand of pharmacists. The two SHPA workforce studies in 2003 and 2005 (numbers 1 and 3) update the information re hospital pharmacy presented in this report.

Article - Snapshot of hospital pharmacy workforce in Australia. J Pharm Pract Res 2002
The 2001 snapshot survey of the hospital pharmacy workforce found an average national vacancy rate for pharmacist positions of 14%. It also identified that the majority of hospital pharmacists work in and the highest number of vacancies are in principle referral hospitals, that one third of the hospital pharmacy workforce have postgraduate qualifications and one third work part-time.

Article - European Association of Hospital Pharmacists Survey 2005
Available from http://www.eahponline.org/asp/survey.asp?m=7
This document highlights differences between service delivery models used across the European Union (excluding the UK) and the different workforce requirements to deliver these services. In the five years since the 2000 survey the number of pharmacists and technicians per hospital has not increased but the number of overnight and same day beds has. Consequently only 13% of the hospitals surveyed offer a clinical pharmacy service and there has been a fall in the number of hospital pharmacies using unit dose and individual patient supply distribution systems and reduction in the pharmacy services offered on discharge and to outpatients.

Article - FIP Global pharmacy workforce and migration report 2006.
Available from http://www.fip.org/www2/subsections/index.php?page=menu_resourcesforhealth
This document is the first global report on the distribution of pharmacists, continuing professional development systems and the migration of pharmacists. It aims to provide a snapshot of current workforce issues and give direction on required actions to build capacity. The report notes an increase in the number of pharmacy schools and highlights the need for investment in retention strategies to reduce the trend of pharmacists not working in pharmacy.

Article - Pharmacy Workforce Census 2005. Royal Pharmaceutical Society of Great Britain.
Available from http://www.rpsgb.org.uk/pdfs/census05.pdf
This reports documents the fall in the number of pharmacists available to work as pharmacists due to changes in the registration process where pharmacists are listed as practising or non-practising (a system recently introduced in Victoria). They also report an increase in the percentage of pharmacists employed in hospitals (20% of the workforce) and that 93% of hospital pharmacists have remained in that sector during the reporting period, a slight fall from the previous census. Work satisfaction was higher for pharmacists working in hospital when compared to those working in the community sector and hospital pharmacists recorded the highest satisfaction regarding patient contact of all sectors. (A similar report on the Victorian pharmacist workforce can be accessed at http://www.health.vic.gov.au/workforce/downloads/pharmacy-labourforce0304.pdf)