Rural pharmacies are at a loss to find a sustainable pathway forward as 60-day uptake increases.
In a recent article leading pharmacy commentators Bruce Annabel and Mal Scrymgeour provided advice around the steps that pharmacies need to take to ensure future viability.
Annabel and Scrymgeour say that there are several things pharmacies need to do. Among other measures, it is suggested that pharmacies need to maximise professional services (including vaccinations, medication management services, opioid replacement etc) and add new ones – that consult rooms are to be utilised, and that pharmacists should be “accessible, always, when it suits patients.”
Members of RIPAA agree that services are the pathway forward for pharmacy and are excited by the current work to expand the scope of pharmacists. However, rural pharmacies, especially those operated by a sole pharmacist, are struggling to see how all this is possible to any significant degree without financial and workforce support.
The expert advice, while logical, is just not that helpful in a rural context. According to a RIPAA spokesperson, “There is only so much you can manage with only one pharmacist, growth opportunities are limited in locations where the population is not increasing, and in lower socio-economic communities, patients can’t and won’t pay for additional services. Providing additional services in rural, often means providing them at a loss, which will only accelerate our demise.
You can’t be in a consult room with a patient for 20-30 minutes while also overseeing dispensing activities, you cannot be outside the pharmacy at the aged care facility, or undertaking a Home Medicine Review, and at the same time keep the pharmacy open. You can’t be in two places at once – it simply is not possible.
Despite increases in the Regional Pharmacy Maintenance Allowance, the employment costs of hiring an additional pharmacist in rural areas, including the wage costs and other costs such as travel, accommodation etc, far exceed the revenue that new services can bring in. The increased RPMA may help to ensure dispensaries stay open in rural areas for now, but it simply isn’t adequate to enable significant expansion of pharmacy services that are crucial for future sustainability.
And it is not that pharmacies in rural areas don’t have a significant need for an additional pharmacist, with MM5-7 regions already falling significantly, and chronically, short of pharmacist workforce in relation to population and population health need, compared to metropolitan and regional centres.
“Despite the negotiated compensation, rural pharmacies are still on a highway to nowhere with 60-day dispensing and the only path for the future is a properly funded service model that is viable and sustainable in rural locations – a model that supports the crucial role of pharmacists as part of the primary health care team.
“If we fail to achieve this necessary funding reform, rural pharmacies will also face a crisis, just like the crisis that we are already seeing with rural GPs. Does the government want small isolated and remote pharmacies to close, and leave the bush without pharmacy service? Under the current policy settings and funding, there is not much scope for rural pharmacies to reposition themselves for the future. Right now, rural Australians still enjoy relatively good access to pharmacies, but we cannot take that for granted.
