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Australian Journal of Pharmacy : March 2005
Inaugural consultant pharmacy seminar F tainly stretches the meaning of the phrase ‘ease of access’. Not providing such serv- ices raises issues of inequity and false expectations between rural and urban communities. Yet, access is important. So what does all this mean in the con- text of the QUM and RMMRs and where does it place the pharmacist, one of the agreed custodians of QUM? Proposed RMMR changes The proposal to change from a ‘per bed per year’ payment model to a ‘per service’ payment model, increasing the service payment from $100 per bed to $130 per review, and placing an increased emphasis on GP-initiated reviews, reflects the Gov- ernment’s intention that accredited phar- macists retain an active role in supporting the QUM in residential aged care facilities. There is a bit of a double-edged sword in all of this. On one hand, the change to the remuneration model provides a posi- tive opportunity for independent accred- ited pharmacists who have established a good working relationship with the facil- ity and the servicing GPs to enhance their RMMR services. However, those who struggle to meet other than the basic requirements under their medication review contract may be disadvantaged. In other words, ‘quality’ RMMR providers may be rewarded with additional oppor- tunities in a quality-driven environment. Further, the ‘per review’ model appears to greatly disadvantage those who cur- rently provide RMMRs in rural or isolated circumstances, or even in local situations where accessibility is affected by distance. It also has the potential to add to confu- sion (and tension) surrounding the differ- entiation of services provided by the sup- ply pharmacist and the accredited pharmacist, if they are not one and the same. This is particularly the case in the provision of QUM-related services. Such a change will mean that the inde- pendent accredited pharmacist will no longer have direct Government-funded access to provide those ‘whole-of-facility’ services, such as in-service education ses- sions, collaborative drug usage evalua- OLLOWING on from the success of its Accredited Pharmacist Forums, held in conjunction with the APP and PAC conferences, AACP has announced its inaugural Consultant Pharmacy Clinical Seminar. To be held 3–5 June at Hyatt Regency at Sanctuary Cove, Queensland, the seminar, called ‘ConPharm’05—the new direction in consultant pharmacy’, has been designed to specifically meet the needs of accredited consultant pharmacists. AACP chief executive Bill Kelly, said: ‘Feedback received from the forums conducted at APP and PAC indicated a need for a more comprehensive and focused program addressing areas of specific relevance to the role of the consultant pharmacist. ‘ConPharm ’05 will be our way of meeting these needs and we have developed what we believe is an exciting and innovative program. There is a strong evidence-based element to the two-day program which will include a mixture of short clinical tions, cases conferences with GPs, drug information services for nursing and med- ical staff, attending Medication Advisory Committee meetings and so on. Where such QUM activities are not specifically covered by the Pharmacy Ser- vices (supply pharmacist) contract, this potential for confusion surrounding the delivery of such services, indeed, even extending to the discontinuation of such services, is real and of concern. At the very least, pressure could well be placed by the facility on the supply phar- macist to provide such additional services within existing contracts for little, if any, increased remuneration. Alternatively, it may require the supply pharmacist to negotiate payment with an accredited pharmacist to deliver such services on their behalf. No one wins in a system which requires providing more for less, or not much more. Custodianship of QUM at risk? Pharmacists are one of the custodians of QUM, especially in the aged care area, but the proposed changes to the RMMR model do not appear to fully consider the complexities surrounding QUM in the provision of RMMRs.This is clearly not in The AJP thanks the Pharmacy Guild of Australia for its support in the development of this column THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 MARCH 2005 ? 163 presentations, interactive small group sessions, panel discussions and the obligatory networking social functions. Seminar presenters comprise leaders in their respective fields from both the medical and pharmacy practice disciplines. Interprofessional relationships and the political environment are also on the agenda, with representatives from the Australian Divisions of General Practice and the Department of Health and Ageing also participating in the seminar. ‘This is going to be a great event and is something that this particular group of pharmacists has been seeking for sometime,’ said AACP chairman John Bronger. ‘It will provide a unique opportunity for consultant pharmacists to network with each other and medical colleagues,’ he added. Registration for ConPharm ’05 will be via the web (www.aacp.com.au/ conpharm05). For more information: contact Bill Kelly on (02) 6270 1850. the best interest of anyone, nor is it the Government’s stated intention. It is an issue, however, that needs to be given due consideration in order to develop business rules for the new model. The question of who should be rewarded for delivering the QUMelement of RMMRs needs to be worked through. Should it be the supply pharmacist under separate contract arrangements or, as appears to be proposed in the new model, should such payment be part of the increased remuneration associated with a new ‘per review’ model? Either way, the potential for the QUM aspects of RMMRs to be affected appears significant. Unless this situation is addressed, we must ask ourselves: ‘Are we serious about delivering quality in RMMRs to RACFs?’ Or is it merely a case of ‘slap a little qual- ity on the sucker and ship it out’? ¦