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Onsite pharmacists will soon become a regular fixture of the residential aged care system, with a dedicated government grant coming into effect in July this year.
The role is expected to improve medication safety for a cohort in which people consume on average 9.75 medications, and have a 20 percent chance of being hospitalised for a medication problem.
However, in a climate beset with workforce challenges, some people – including Consultant Pharmacist Deborah Hawthorne – are wondering how feasible the initiative is; and whether it will achieve the desired outcomes.
Ahead of the Pharmacy in Aged Care Forum, Ms Hawthorne discusses some potential barriers.
Barrier 1 – Remuneration
With the funding, community pharmacists could employ a dedicated residential aged care pharmacist with a grade two hospital salary. But, amid widespread workforce shortages, Ms Hawthorne believes this may be insufficient.
“I cannot even walk into a pharmacy these days without being offered a job, because companies are crying out for workers. It was like this before COVID-19 and even more so now. So, it will be interesting to see how these positions will be filled, especially with a grade two salary,” she said.
Unlike other pharmacy roles such as Community or Hospital, Ms Hawthorne also fears residential aged care roles may not offer adequate pay advancement.
“Supplying a flat remuneration option is not the best way to engage a workforce,” she said. “I believe the bar may need to be lifted if we want to attract and retain quality workers.”
Barrier 2 – Geographical equity
Rural, regional and remote parts of Australia have long faced recruitment challenges in healthcare and Ms Hawthorne believes the funding model does not take these areas into consideration.
“There aren’t any provisions, currently, for dedicated telehealth or hybrid pharmacists, which could really disadvantage aged care facilities in remote locations, who are already pushed to find pharmacists.
“Other healthcare roles – nursing, medical pharmacy and allied health – also tend to offer better remuneration packages outside of metro areas, whereas the residential aged care pharmacist roles don’t as they are a flat fee. So, this again will make it more challenging to entice people in areas that are already in great need,” she said.
Barrier 3 – Logistics
Ms Hawthorne challenges the way funding will be allocated during the initiative; in particular, that a facility’s bed count will determine its pharmacist presence.
She says this robs flexibility from the employment arrangement and may not suit some providers.
“It’s quite different to the current ad hoc approach, in which a pharmacist is sent out every month, or upon GP request. Mandating a one day pharmacist presence for homes with up to fifty beds, or a two day presence for homes with 50-100 is quite restrictive and may be off-putting for some pharmacists who require flexible roles – which are hard to come by in the pharmacy space. This could add to the already challenging recruitment environment,” she said.
Ms Hawthorne also questions the decision to give funding directly to community pharmacists to fulfil roles locally.
She says this approach is well-meaning, but fears it may hinder recruitment efforts.
“I was under the impression that the original idea was to promote jobs at the local level, in support of community pharmacies that have taken a hit through other funding mechanisms, which is of particular importance when building capacity in rural and remote areas – but it doesn’t appear to be heading this way.” she argued.
“The community pharmacy that is offered the chance to fill the role doesn’t necessarily have to be the one next door or the one that currently supplies medications to the ACF. It could be a community pharmacy three states away.”
Barrier 4 – Workplace readiness
Requirements around credentialing pose a further challenge, with only a few facilities nationally currently meeting the criteria.
“It is great to see accreditation on the increase, but realistically, it will take a long time to get all our facilities workplace ready as well as credentialed pharmacist feet on the ground.”
Join the debate
Opening up further discussion on issues like this, Ms Hawthorne will chair the upcoming Pharmacy in Aged Care Forum.
This year’s event is collocated with the flagship National Dementia Forum – both held on 12 June 2024 at the Crowne Promenade Melbourne.
Learn more and register your place here.
About Deborah Hawthorne
Deborah Hawthorne is an award-winning pharmacist, best known for her medication review advocacy work.
She runs the largest community of practice for credentialed pharmacists in Australia – Consultant Pharmacists Australia (CoPA) – and works in a variety of primary care settings.
Deborah is involved in education and research and is an adjunct senior lecturer at the University of Western Australia.
She is an inaugural member of the research group COHERENT, consisting of academics from Monash University, University of Western Australia and the University of Sydney who investigate medication management in Australia.
Her special interest areas include chronic pain, de-prescribing, diabetes, intellectual disability and autism.
Deborah was awarded the national Pharmaceutical Society of Australia’s Early Career Pharmacist 2022 award as well as Consultant Pharmacist of 2023 award. She has most recently been nominated for RWAV’S outstanding contribution to Rural Outreach Provision 2024 in the Victorian Health Awards.
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