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Australian Journal of Pharmacy : May 2008
News aNd review from the psa One vision for the future Brian Grogan, president, Pharmaceutical Society of Australia the uk’s White paper on proposed changes to the profession may offer a road map for the future in australia. i n its early years the shape of Australia’s pharmacy profession was, to a large extent, shaped by its counterpart in the UK. In the intervening time—as Australia has made its way in the world as a sovereign country—most of the direct linkages have been broken, but it is fair to say that pharmacists in the two countries still share much in common in their approach to professional practice, as well as broadly similar health systems. So it was with great interest that I saw the UK Government release a comprehensive White Paper discussing the pharmacy profession’s future role in that country. Many of the issues covered in the policy document—Building on Strengths, Delivering the Future—are relevant to Australia and the direction which health policy may take in this country. Overall, the UK White Paper outlines a larger role for pharmacists in treating sickness and promoting good health. Building on Strengths, Delivering the Future sets out how pharmacists will work to complement GPs in promoting health, preventing sickness and providing care that is more personal and responsive to individual needs. To summarise the UK Government’s new proposals, the aim is for pharmacies to: 22 • become ‘healthy living’ centres promoting health and helping people to take better care of themselves; • be able to prescribe certain common medicines and be the first port of call for minor ailments. The UK government estimates this would save every GP the equivalent of about an hour each day, adding up to some 57 million GP consultations a year; • provide support for people with long-term conditions, such as high blood pressure or asthma, especially those starting out on a new course of treatment. The UK Government believes pharmacists are well placed to improve compliance and estimates that 50% of the targeted consumers may not be taking their medicines as intended; Labor Government has flagged continuity of care for consumers moving between healthcare settings as a priority. Some of the other proposals foreshadow pharmacists moving into new areas of practice such as pharmacist prescribing, screening for sexually transmitted infections and vascular disease, and vaccination. I have talked before about PSA undertaking policy work on pharmacist prescribing in Australia. This work is a priority for 2008 and I hope we will have more to say on this issue later in the year. Hopefully this will build on the work being undertaken by the Queensland Health Pharmacists Prescribing Working Group, which is currently finalising the groundwork for trials of models investigating the potential for pharmacist prescribing. Under the Queensland trial models, pharmacists are being The ProPosed models do noT involve PharmacisTs maKinG diaGnoses; raTher They involve ProTocol-based sysTems for PrevioUsly esTablished condiTions. • be able to screen for vascular disease and certain sexually transmitted infections, such as chlamydia; • work much more closely with hospitals to provide safe, seamless care; and • play a larger role in vaccination. Some of these proposals will seem familiar to Australian pharmacists and are similar to initiatives already under way in this country. For example, the new the australian journal of pharmacy vol.89 may 2008 deployed in a pre-admission clinic and an outpatient clinic and are responsible for initiating medications (eg. antibiotic prophylaxis before surgery), ceasing medications and maintaining continuity of treatment. The ultimate aim is to develop a competency framework that would have the potential to be applied either in hospitals or the community. It’s important to note that the proposed models do not involve pharmacists making diagnoses; rather they involve protocol- based systems for previously established conditions. The main aim of the trials is to identify the required competencies; and for any such model to succeed there would need to be a framework that—at a minimum—included a credentialing process, compulsory CPD and mandatory re-assessment. While I mentioned at the start that Australia and the UK have broadly similar health systems, there are some important differences that we should take into account. The NHS in the UK has much greater control of the activities of a range of health professionals due to holding direct contracts with them, rather than simply being a channel for funding. The UK White Paper should be viewed with this in mind since one of its major aims seems to be to reduce the burden on doctors, rather than a particular desire to extend the roles of pharmacists. The UK Government can decree changes to the way health professionals practise to a much greater extent than would be possible in Australia. Nevertheless, some of the new roles that are envisaged would seem at first glance to be eminently suitable to be introduced in the Australian health system. We will watch with interest what transpires. n For more on the UK’s White Paper see Medication in Review, page 40.