Pharmacist value overlooked in productivity report

While welcoming its vision of a more integrated and patient-centred Australian healthcare system, the latest report from the Australian Government’s Productivity Commission disregards the pivotal and multidimensional roles played by pharmacists in clinical settings, the Society of Hospital Pharmacists of Australia said today.

Of the two primary recommendations in Shifting the Dial: 5 Year Productivity Review, SHPA does not support the recommendation to move away from community pharmacy as a central mechanism for dispensing medicines to Australian patients, but does support recommendations to increase and expand the role of Australian pharmacists.

SHPA Chief Executive Kristin Michaels says the adoption of automated ‘machine dispensing’ supervised by ‘less trained and qualified’ individuals in the retail pharmacy sector would be a simplistic approach that shows a lack of understanding of the complexity of patients’ medicine needs.

‘Patients need support when receiving medication, and this recommendation devalues the unique expertise pharmacists provide in protecting the community by ensuring optimal quality use of medicines.

‘There are three key components, as advocated by SHPA – clinical review, dispensing, and patient counselling and education – and weakening these pillars will lead to patient hardship and significant subsequent costs.’

Ms Michaels says recommendations around automated dispensing must be cognizant of pharmacists’ expertise and experience and of the potential risks associated with medication use.

‘In some settings for certain patient cohorts, it would be appropriate to implement automated dispensing as part of a comprehensive approach that utilises technology to increase the provision of information and expand understanding of medicines across healthcare professions.

‘Hospital pharmacists have been at the front line of adopting innovative use of digital technology, such as automated and telehealth solutions, and are supportive of further adoption, however patient care is paramount.’

Ms Michaels says any savings made through reducing access to health professionals will lead to reduced care, and increased costs associated with medication-related hardship.

‘In particular, it is concerning to see the report’s recommendation that universities reduce pharmacy graduates, which is counterintuitive to evidence showing employing more pharmacists across hospital, primary and aged care settings will improve patient experiences and outcomes and reduce preventable hospitalisations.

‘The recommendation should be focused on ensuring universities provide a capable pharmacy workforce to provide for the needs of the Australian community and this must include pharmacists trained to meet the growing demand for cognitive clinical services.

‘Consistent evidence shows that pharmacists, working within a multidisciplinary team and partnering with patients, improve medication use.’

Ms Michaels says SHPA welcomes the reports call to increase the role of pharmacists in clinical settings, and its focus on primary care.

‘We agree pharmacists should play a remunerated collaborative role with other primary health professionals, where there is evidence of the cost-effectiveness of this approach – this aligns with our response to the interim report of the Review of Pharmacy Remuneration and Regulation (King Review) calling for aligned funding of clinical pharmacy services in the community similar to allied health services, and submission to the 2017-18 Federal Budget seeking investment to enable extended patient access to clinical pharmacy expertise.

‘On behalf of our members, who are progressive advocates for clinical excellence, SHPA also welcomes calls to extend telehealth services to reduce patient travel and waiting times and to use My Health Record and other IT platforms to actively involve people in their health decisions.’