s PSA Future of Pharmacy-Technicians to manage dispensing | I2P: Information to Pharmacists - Archive
Publication Date 24/05/2010         Volume. 2 No. 5   
Information to Pharmacists

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Feature Contribution

Do the Maths - 1200 Graduates a Year and Increasing

Neil Johnston

Pharmacists graduating within Australia must have a reasonable assurance that on graduation they will have some form of a job available for them, after due diligence and reasonable effort on their part to get themselves recruited.
The current maths do not stack up - 5000 pharmacies to accommodate 1200 graduates nationally, and increasing.
Who is responsible for the planning for graduates?

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GPs were the ‘gatekeepers’ to the health system. Will they remain so?

James Ellerson

It’s often hard to tell which party is in favour of what outcome when reading some of the media coverage on doctor, pharmacy, nurse practitioner prescribing issues. Here are a few examples to ponder:

• the Guild is opposed to pharmacist prescribing

• pharmacists and nurse practitioners are to be given limited prescribing rights

• most GPs do not actually consult with a patient before issuing a repeat script.

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Is eHealth critical to navigating the world of primary care?

Dr Ian Colclough

Primary health care reform is firmly on the political agenda. For reforms to succeed they must be underpinned by the successful deployment of ehealth; absolutely.
The last decade has witnessed a major lost opportunity for ehealth in Primary Care. Many hundreds of millions of dollars have been wasted on unrealistically ambitious and poorly managed ehealth projects; many of which have failed.
Aptly named Primary Health Care Organisations (PHCO), recently inappropriately renamed ‘Medicare Locals’, will be the centre point of the reform process. Consequently a palpable sense of urgency has developed around ehealth as its central role in the health reform process becomes increasingly apparent to politicians and bureaucrats.

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PSA Future of Pharmacy-Technicians to manage dispensing

Neil Johnston

Comment has been recently made in pharmacy media on the PSA Issues Paper on the “Future of Pharmacy in Australia” in respect of the upskilling of dispensing technicians to dispense without pharmacist oversight.
Comments offered on this aspect included reduced job opportunities for pharmacists, pressure to lower dispensing fees, opportunity to develop clinical services e.g. the ability to perform HMR’s.
No doubt more comment will follow as the paper is digested and potential flow-on impacts are thought through.
Writers will be participating through the pages of the i2P e-magazine to hopefully help build the future version of this PSA paper.

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Health: The Pollies are playing us as well as Orianthi plays the guitar.

Chris Wright

Our politicians are spinning like fury as we head towards the election and despite the fact their gift for spin doesn’t match Orianthi Panagaris’ gift for playing guitar they are getting away with electoral blue murder.
As for “fixing” the health system, the rhetoric is never matched by performance. After all, it is questionable that “fixing” health actually translates to votes, simply because the money required to make an impact is too great an amount compared to the votes gained…besides “fixing” is subjective anyway.

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What is it with pharmacy?

Garry Boyd

The colleges are churning out Pharmacists at a rate that would embarrass the most discerning “people-smuggler”……..

Apologies for the errant humor leading to an election.
Some 1,200 bright-eyed and bushy-tailed fine and mostly young pharmacists are hitting the job market and will somehow try to squeeze into 5,000 pharmacies.
Worse, a similar number will follow them fairly smartly.

What’s it all about, I wonder?

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Looking for answers

Barry Urquhart

Everyone, it seems, is looking for answers. For most there are none “out there”. Those who ask the right questions generally find the right answers “within”.

Solutions abound, looking for problems. Few can define and even fewer recognise the nature and presence of specific problems. Resources are being liberally allocated to furnishing, deploying or paying for preset solutions. Disappointment and dissatisfaction seem inevitable.

Experts are readily accessible. Expertise is harder to find. The business landscape appears to be lush with new green shoots, yet barren. Much like the desert and the Lake Eyre regions of central Australia.

The climates of regions throughout the world are changing. Temperatures are rising. Record cold snaps are also being recorded. Extended dry spells are evident, offset by deluges of flooding proportions.

Prognostications by some economists conclude “boom times” have arrived or are on the near horizon. Many consumers have obviously not heard or read of the confidence building forecasts. They are constraining purchases and outlays. Retailers, particularly smaller entities, are confused, and are finding trading is tough.

In recent times we have worked with clients from a broad spectrum of sectors producing formats, templates and frameworks which enable them to “look within”.

Real riches are being rediscovered, refined and celebrated. Positive and embracing corporate cultures, are being revisited and pride inculcated, because of what made entities great and competitively advantaged in the first instance.
Distinctive symbols and myths are being recognised, valued and applied for internal cohesion, self motivation and for external profiling.
The article text which features later in this transmission unveils and outlines encouraging lessons and principles on the role and nature of a positive corporate culture.

I commend it to the former executives, the players and besieged supporters of the once high achieving, now disgraced Melbourne Storm Rugby League team.
Barry Urquhart

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NAPE begs more questions than answers- for the moment

Neil Johnston

The ideal of having quality continuing pharmacy education, delivered in digestible “bite-sized” chunks plus convenience of delivery at an economical cost has been a dream for pharmacists for as long as I can remember.
With the advent of the new Australian Pharmacy Board there will be requirement for all pharmacists to undertake suitable education to maintain their registration.
While there are many acceptable education streams coming from the Pharmaceutical Society of Australia (PSA), the Pharmacy Guild of Australia (PGA) and the Australian College of Pharmacy Practice (ACPP), there is not a high degree of planning to anticipate all pharmacist needs.
For example, the delivery of professional services for a fee – there is no identifiable pathway enabling individual pharmacists to develop a professional practice that could be incorporated into a community pharmacy, a primary health care organisation, a medical centre or other suitable location.

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Hmmm, I’m not convinced

Garry Boyd

A Woolworths “spokesman” (they are all still so very alpha at Woolies) has come out (excuse the expression) and declared the loss of interest in not only their “pharmacy” type trademarks but the industry of pharmacy itself.
980218 Pharmacist at Woolworths and 980219 PHARMACIST @ WOOLWORTHS, both previously registered trade marks, have been cancelled.

Comments: 3

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Naturopathy and my Doctor.

Chris Wright

To my pleasant surprise the family doctor offered a choice to address a painful problem highlighted by scans.
Acupuncture or an anti-inflammatory drug?
Acupuncture any day thank you, without the fries.

Comments: 2

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Better patient advice loses out to costly prescription errors

Staff Writer

A University of Otago study which shows pharmacists spend too much time seeking clarification for minor prescription errors has prompted a call for greater awareness among doctors and prescribers of this time-wasting problem.

Lead author and School of Pharmacy Senior Lecturer Dr Rhiannon Braund says the study of 20 Dunedin pharmacies found that in most cases unnecessary minor bureaucratic errors were the reason for pharmacists needing to confirm the intent of prescribers - usually doctors.

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Study shows Australian quality of life varies widely

Staff Writer

A survey of 5000 Australians conducted by the University of Technology Sydney has shown middle aged people express the lowest level in quality of life compared with people in their early 20s or mid 60’s.

The finding which throws the ‘life begins at 40’ cliché into serious doubt is among a number of revelations gained from the study.
Findings of the research will be discussed in a public lecture held at the UTS Great Hall on Tuesday 25 May 2010. Details for the lecture which is open to the public for free can be obtained from the UTS web site www.uts.edu.au/new/speaks/2010/May/2505.htm

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Public participation heats up on climate change

Staff Writer

Australians believe that climate change is here to stay, but their expectations about the severity of change fall well short of what scientists predict.
This is one of the key findings from a three-year study led by The Australian National University. The Climate Change and the Public Sphere project has interviewed more than 100 randomly selected citizens from the ACT and Goulburn about their views on climate change in various, increasingly severe, situations and how they are likely to react to it in the future.

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Killed by cold: heart and stroke deaths peak in winter

Staff Writer

* Perth and Sydney lead the country in winter heart-related deaths

* Tasmanians cope best with the cold

* Brisbane not far behind Sydney for winter deaths

* Darwin fares the best because it doesn't get so cold

Rates of cardiovascular disease increase dramatically in Australian winters because many people don't know how to rug up against the cold, a Queensland University of Technology (QUT) seasonal researcher has found.

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Traumatic brain injury linked to sleep disturbance

Staff Writer

A Monash University study has shown that sleep disturbances and depression symptoms are common among people who have suffered Traumatic Brain Injury (TBI).
The team of researchers from the School of Psychology and Psychiatry measured in a laboratory setting the sleep of 23 patients with TBI with 23 healthy people who had not suffered trauma.
Study leader, Associate Professor Shantha Rajaratnam said patients with TBI showed increased sleep disturbance and reported poorer sleep quality, and higher anxiety and depressive symptoms than healthy volunteers.

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Blood Thinners May Prevent Malaria

Staff Writer

New treatments for malaria are possible after Walter and Eliza Hall Institute scientists found that molecules similar to the blood-thinning drug heparin can stop malaria from infecting red blood cells.
Malaria is an infection of red blood cells that is transmitted by mosquitoes.
The most common form of malaria is caused by the parasite Plasmodium falciparum which burrows into red blood cells where it rapidly multiplies, leading to massive numbers of parasites in the blood stream that can cause severe disease and death.

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PAC 10- A Focus on Pharmacy Practice Change

Staff Writer

Pharmacy practice must shift its primary mission from supplying medicines to helping people make the best use of medicines in order to meet the needs of the public and ensure its survival as a health profession.
This is the view of leading US pharmacy expert Professor William A. Zellmer who will present on the topic of The Imperative for Change in Pharmacy Practice at PAC10 in October this year.

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Drug Company Battles with NZ Pharmacy Guild

Staff Writer

In a recent news item reported in the New Zealand Stuff.co.nz highlights a drug recall problem that had significant associated costs involving community pharmacy participation.
It is a problem that could occur within Australia and is currently before the courts in New Zealand.
The problem does reflect on the existing culture within the pharmacy profession where for too long pharmacists have virtually donated their services in instances where there should have been an expectation of payment for a professional service.
PGA (Australia) could monitor the legal process in New Zealand and adopt a protocol, if the result proves favourable to pharmacy.
The story (found online here) follows below:

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Hmmm, I’m not convinced

Garry Boyd

A Woolworths “spokesman” (they are all still so very alpha at Woolies) has come out (excuse the expression) and declared the loss of interest in not only their “pharmacy” type trademarks but the industry of pharmacy itself.
980218 Pharmacist at Woolworths and 980219 PHARMACIST @ WOOLWORTHS, both previously registered trade marks, have been cancelled.

Comments: 3

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Sunlight shines on clean energy future

Staff Writer

Dr Zhiguo Yi and Professor Ray Withers have found a simple inorganic compound can efficiently oxidise water to release oxygen.
The production of clean energy and the treatment of waste water are set to become easier thanks to ANU researchers.
The scientists – Dr Zhiguo Yi and Professor Ray L Withers of the Research School of Chemistry at ANU, along with colleagues from Japan and China – have demonstrated that a simple inorganic compound, silver orthophosphate, can efficiently be used to oxidise water with only the power of light.
The oxidisation process can be used to convert solar energy to clean energy or break down contaminants in water.
The research is published in Nature Materials.

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The Ascendancy of Warwick Plunkett

Neil Johnston

Prior to negotiations commencing for the Fifth Community Pharmacy Agreement (5CPA) the Pharmaceutical Society of Australia (PSA) and the Pharmacy Guild of Australia agreed that the two organisations would present a unified front in their dealings with government.

That did not happen and many details of the 5CPA were completed in secrecy and without the appropriate input by the PSA.

Explanations were later offered by the PGA, but they rang a little hollow and were certainly outside of the spirit of a unified front.

Certainly, on the surface it appears that the PGA did not honour an agreement and was prepared to discount their formal agreement to the extent that it seemed not to exist at all.

The news item reporting the rift between the two organisations follows and Mark Coleman has been asked to provide a commentary at the foot of this news item.

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PSA Future of Pharmacy-Technicians to manage dispensing

Neil Johnston

articles by this author...

Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services. He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system. He has been editor of i2P since 2000.

Comment has been recently made in pharmacy media on the PSA Issues Paper on the “Future of Pharmacy in Australia” in respect of the upskilling of dispensing technicians to dispense without pharmacist oversight.
Comments offered on this aspect included reduced job opportunities for pharmacists, pressure to lower dispensing fees, opportunity to develop clinical services e.g. the ability to perform HMR’s.
No doubt more comment will follow as the paper is digested and potential flow-on impacts are thought through.
Writers will be participating through the pages of the i2P e-magazine to hopefully help build the future version of this PSA paper.

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Dispensary technicians would obviously be the resource pool that “prescription supervisors” (or other designated title) will initially be drawn from.
That their education will have to be enhanced, particularly in areas of pharmacology, is an immediate requirement.

Looking beyond the first objective of giving pharmacists space and time to develop new services, what limitations will be placed on these people?

How will some immediate issues resolve:

(i) in respect of how long they will be able to work over a day without a registered pharmacist being present to fill “knowledge gaps”;

(ii) in respect of developing expanded work opportunities through working in primary health care organisations currently being developed;

(ii) in respect of developing logical pathways for these people to eventually become registered pharmacists through the opportunity of a priority acceptance into a pharmacy school.

Importantly, when a significant error occurs within the dispensing process, what percentage of responsibility will they bear?
A registration process seems inevitable in that legal responsibility can be apportioned, so will this be undertaken by the Australian Pharmacy Board?

The issue of education will be the dominant issue, particularly in rural areas.

A few years ago I was given the opportunity to develop an educational plan that involved all staff within a pharmacy environment in a single health region.
The setting was a rural one and because of that single factor, the cost of education and its delivery was a prohibitive one.
What was needed was a regional/local distribution of educational resources with input and direction drawn from all people working in pharmacies.

The concept I looked at was to accept and train people within their hometown area and develop pathways to enable them to expand their qualifications right up to registered pharmacist status, irrespective of background.
Previous research indicated that people trained in their home areas tended to work and reside there for much longer time periods than for imported employees.

Prior to looking at this assignment I had developed some short courses for training pharmacy assistants through the local TAFE. At that time a considerable percentage of students attracted to the course were there only as an obligation to receive their dole monies – they had no intention of training for a job.

Motivation is hard to maintain when student quality is so poor, so I could only sustain teaching at this level for a limited time.
Eventually, this type of training was taken over by the PGA and that resolved the initial aspects of developing suitable pharmacy assistants.

I next spoke to the regional university to see if they would be prepared to assist in training dispensary technicians to certificate and diploma levels, and then on to a Bachelor of Health science degree, where students could explore other avenues of health science e.g. nursing, naturopathy, exercise etc.
Interest was sparked to the extent that the university was prepared to develop a curriculum and to include a first year pharmacy course in conjunction with a pre-existing pharmacy school.

So I had my system of pathways organised and the knowledge that the major portion of people trained within the local region would tend to work long-term within the region.

Would this prove to be a long-term solution to the lack of resources and training in rural areas?

One further element was identified as necessary and that was the requirement for a mentor to smooth out the bumps for each individual, liaise with community pharmacies and educational establishments and organise conferences and seminars in various parts of the region through rotating venues.

An extension of this process was to identify people within a community pharmacy who could be trained and developed as internal pharmacy mentors, so that external mentoring had a ready pathway and be integrated within each pharmacy environment.
I discovered along the way that mentoring was a great “soft” management tool that had the potential to expand communication and reduce frictions within a working environment.

This training component was important enough to warrant writing a “mentoring manual” so internal pharmacy mentors could refer to it on a daily basis, and be backed up with electronic newsletter updates.

Once establishing this system for “lifelong learning” that was economical, organised and accessible, plus infiltrated as part of the management structure of a pharmacy I was ready to start in earnest, but that story is reserved for a future edition.

May I suggest that PSA in its immediate future model take on the responsibility for training dispensary technicians to various levels by developing suitable alliances with existing training organisations at a local level (public or private).
I stress the importance of being “local”, if the system is going to work.
To do this requires the recruitment of facilitators/mentors within each of the regional health areas already developed by state governments.

Could some of the monies promised for primary health care be diverted to pharmacy in this manner?

Pharmacists are looking to the PSA to take a dominant leadership role in the area of professional services and education.

To take the “high ground” in the training and development of “prescription supervisors” creates an infrastructure that can be expanded to deliver on the other side – the training and development of pharmacists to manage new or expanded professional services (for a fee).

Despite the negatives already suggested by some pharmacists in developing the role of the prescription supervisor, I can only see positives for registered pharmacists to be employed in services that generate revenue to cover their own income in the form of salaries or contract service fees.

Pressure to lower dispensing fees is not really an issue. The dispensing fee is a "value-add" fee created from a "whole of pharmacy" effort, not just from a technician. If the value add components are not completed by a pharmacist and all other dispensary personnel, then a case would exist for lower dispensing fees. On the contrary, the argument becomes one of a higher dispensing fee because of higher technician costs and extra pharmacist input.
There is also no need to be concerned about reduced job opportunities for qualified pharmacists, provided pharmacy owners do the right thing and generate new professional services. 

I would encourage all pharmacists who read i2p to assist in the rebuilding of the pharmacy professional services role by contributing comment, or sending this article to a colleague using the site sharing tools.

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