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PHARMACY REVIEW OFFICIAL JOURNAL OF THE PHARMACY GUILD OF AUSTRALIA

PHARMACY REVIEW OFFICIAL JOURNAL OF THE PHARMACY GUILD OF AUSTRALIA

8 PHARMACY REVIEW 2012

PHARMACY REVIEW is published annually by the Pharmacy Guild of Australia

National Secretariat Level 2 15 National Circuit BARTON ACT 2600 Telephone: 02 6270 1888 Facsimile: 02 6270 1800 Editor: Diana O’Neil

Editorial content does not necessarily reflect o!cial policy of the Guild. ISSN 01314-6316

National PresidentKos Sclavos

National Vice PresidentsSi Banks Terry Battalis John Dowling Amanda Galbraith Tim Logan Lenette Mullen George Tambassis Ian Todd

National CouncillorsHarvey Cuthill Peter McBeath Nick Panayiaris Toni Riley Dipak Sanghvi Paul Sinclair Trent Twomey Harry Zafer

National SecretariatExecutive Director Wendy Phillips

Business Development and eHealthDirector Patrick Reid

Communications Director Greg Turnbull

Community Pharmacy Agreement

ProgramsDirector Fiona Mitchell

Corporate ServicesDirector John Taylor

Policy and Regulatory A!airsDirector Ann Dalton

Guild Pharmacy AcademyDirector Anthony Tassone

Health EconomicsDirector Stephen Armstrong

Quality Assurance and StandardsDirector Andrew Matthews

Table of Contents

National President 6

David Quilty 9

Executive Director 10

Event news 12

Rural and Indigenous 16, 31

Pharmacy Health Checks Deliver 17

Palliative Care 18

Diabetes 19

Business 21

Pharmacy Practice Incentives 23

Pharmacy Assistant of the Year 2012 25

Quality Accreditation 27

Price Disclosure 28

Information and Care 32

Research 33

OTC Medicines 34

Medicare Locals 36

Retail Leasing 38

Leaders and Owners 39

New Directors 41

MedsCheck 43

Coughs and Colds 45

Home Medicines Review 46

Front coverMid-20th century reproduction of early 16th century Italian Duraso Syrup Jug.

The word Sy d'artemesia written across its face translates to 'Syrup of Mugwort'.

This piece is part of the Pharmacy Guild of Australia's collection on display at the National Secretariat, Canberra

Thank you to Ralph Tapping, pharmacist and Curator of the PDL Collection of Historic Pharmacy Artefacts.�



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Community pharmacies play an increasingly important role as health care hubs—the central point of advice and information about the full range of health care issues.

Kos says . . .

There is no doubt 2012 will go down as the year of outstanding achievement in professional programs in community pharmacy despite extensive challenges being faced by our sector. There has been outstanding uptake of the new professional programs and striking documented results to match. This success has been no fluke with the Guild implementing a national strategy to overlap the Fifth Community Pharmacy Agreement (5CPA).

It is one thing to plan but it is another to implement. The Federal government itself has had a di!cult year implementing in health as can be seen by its ambitious eHealth agenda. There are elements of the 5CPA that required work from State and Territory governments and they have not been delivered on time.

In contrast to this, key Agreement elements including new professional programs have been delivered on time. Of great pride is the fact that we have launched new clinical pharmacy programs, MedsCheck and Diabetes MedsCheck, and enrolment has exceeded expectations. This success has meant that for the second year in a row all funding in the Agreement has been allocated.

Patients Trust Pharmacists

Our profession is often its own worst critic but we should be judged on what our patients think of us. With that in mind I was delighted in May to see the latest Roy Morgan Research ‘Image of Professions’ survey provides a well-earned pat on the back for community pharmacists. Pharmacists maintained their position at second on the list of 30 professions in the

survey of Australians aged over 14. Pharmacists held second spot with a score of 88 per cent, which relates to the number of respondents ranking them ‘very high’ or ‘high’ for ethics and honesty.

This was up 1 per cent from the previous poll. Nurses maintained their coveted and long-standing position at the top of the list with 90 per cent.

Of the 30 professions ranked this year, a majority (18 professions) declined, while six increased and the other six were unchanged. Other professions that also gained high ratings for ethics and honesty included doctors (83 per cent, down 4 per cent), school teachers (76 per cent, unchanged), dentists (75 per cent, down 1 per cent), engineers (70 per cent, down 1 per cent), High Court judges (70 per cent, down 5 per cent), State Supreme Court judges (69 per cent, down 6 per cent) and police (69 per cent, unchanged). By the way, public opinion pollsters came in 16th (28 per cent) and journalists 24th (12 per cent)!

The Roadmap

The Guild’s strategic direction for community pharmacy is a key driver of activity, and the Roadmap (www.guild.org.au/roadmap) now comprises forty-five ‘Program Development Templates’. They detail current and anticipated community pharmacy programs and services, and the practical means for implementing them at a national level. The Roadmap is the culmination of many months of hard work, with the specific goal of producing a document that would be a meaningful, practical point of reference to anyone involved in, or with an interest in, the community pharmacy sector.

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Electronic prescriptions

As the eHealth momentum continued to build across Australia, the team at Fred IT Group played a vital part in the development and operation of eRx Script Exchange and the MedView Medications Repository, ensuring community pharmacy remains at the forefront of innovation.

eRx continues to go from strength to strength as the leading electronic prescription exchange in Australia. With over 3,000 pharmacies and 13,000 GPs having used eRx to generate more than 3.5 million ePrescription records per week, I continue to encourage all pharmacies to get involved. eRx continues to help deliver better health outcomes for our patients as well as allowing pharmacists to spend more valuable time with them.

The consolidation of medicines information, providing faster, more complete and clinically vital patient medications histories, has also become a reality. Through Fred’s Commonwealth-funded MedView trial in Geelong, medications information—for consenting patients from community pharmacies, GPs, Geelong Hospital and Aged Care facilities—can now be utilised by authorised health practitioners to deliver improved health outcomes. Fred has been contracted to build this exciting development into the Commonwealth’s Personally Controlled Electronic Health Record, so again I implore pharmacists to get involved as the opportunity arises.

QCPP

No one would have predicted that we would now have 4,736, or nearly 91 per cent of pharmacies, accredited under the Quality Care Pharmacy Program. This is an outstanding result which opened opportunities for these pharmacies to participate in Pharmacy Practice Incentive (PPIs) Program in the Fifth Community Pharmacy Agreement. Under this program and Guild developed software, GuildCare, we see the average pharmacy recording over sixty clinical interventions a month. A stunning 2 million health records have now been recorded, demonstrating the value that community pharmacy brings to the health care system.

What a Year for GuildCare!

When we launched GuildCare in 2011, I would never have thought that we would reach over 2 million completed professional services cases in 15 months. Since its launch, GuildCare has continually expanded its o"ering having added two new programs to their Primary Package (INR and Lipid recording), further enhancing our Private Service o"ering. With plans to add more to the Private Services later this year, look out for information on the launch of these programs.

Recently GuildCare added MedsCheck Services and Home Medicines Review programs, with over 85 per cent of GuildCare subscribers adding the MedsCheck Services module, which is great news. In addition, GuildCare have also expanded their range of New to Therapy and Compliance programs with the addition of Micardis/Twynsta, which were recently launched on its own platform. GuildCare pride themselves as the one tool pharmacists can trust to meet their entire professional program needs.

Academy

In other great news from the Guild Pharmacy Academy, the Pharmacy Guild’s own CPD repository, ‘myCPD’, now has over 7000 registered users accessing a wide range of online CPD courses including: new drug briefs, complementary medicine refreshers and business management e-learning modules. The Guild Pharmacy Academy also released two CPD accredited online modules covering the MedsCheck program which were accessed by a whopping 300 pharmacists in the first week alone. A Diabetes MedsCheck module proudly supported by Roche will be available in November 2012.

The myCPD platform now has a new ‘look and feel’ with a streamlined process, and so is much easier to use. Pharmacists have reported that they like how easy it is to track their CPD credits and to achieve CPD online and from attendance of Guild events so stay tuned and be sure to visit www.mycpd.org.au

The Guild Intern Training Program (ITP) continues to grow from strength to strength, now being o"ered in Queensland, Tasmania, New South Wales and most recently Western Australia. Enrolment numbers are growing each intake as Guild members recognise that the Guild ITP helps train interns to be ‘employment ready’ with a focus on 5CPA professional programs, and the needs of Guild members and community pharmacy owners. If you have an intern at your pharmacy and are located in NSW, Queensland, WA or Tasmania, and would like to find out more contact your local branch or visit www.guild.org.au/academy and click on ‘Intern Training Program’.



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Rural Pharmacy Services

The Pharmacy Guild’s Community Pharmacies for Rural and Indigenous Australia (CPRIA) recently met to progress its ambitious agenda—to build on the long history of the Guild in advocating and supporting access to health services in rural and remote Australia. The committee has changed its name from the Rural Remote and Indigenous Special Interest Group to CPRIA to better reflect the Pharmacy Guild’s focus in the area of health policy and advocacy for rural and Indigenous Australia through the infrastructure of community pharmacy.

Joint Forum in March

A continuing robust partnership between the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Pharmacy Guild of Australia has seen vast improvements in Aboriginal and Torres Strait Islanders getting the prescription medicines they need, along with tailored advice and assistance. A national joint QUMAX and S100 forum in Melbourne in March was attend by more than 250 delegates and they discussed the need to integrate three vital programs that support medicines access and quality use of medicines for the Aboriginal and Torres Strait Islander population.

NDSS

There are always issues that crop up that are a drain on resources. Before Christmas, members of the Guild were informed that the revised version of the Access Point Agreement negotiated between the Guild and Diabetes Australia (DA) addressed the major concerns of the Guild. The variations sought by the Guild were intended to make the arrangements more workable so that community pharmacies could get on with providing NDSS services to the public.

April 2012 Price Reductions

All these successful outcomes mentioned above are against a very di!cult fiscal environment. On 1 April we saw massive price reductions—the largest set of PBS price reductions in the history of the scheme. The outcome of this is that we have seen a $5 drop in the average cost of prescriptions—falling from just over $44 to just over $39. This is a really significant fall, underlining the ongoing sustainability of the PBS.

Just when we thought we’d seen enough of price cuts, in August the news came of a voluntary 25 per cent price reduction for atorvastatin and this will add to the strain on community pharmacy businesses from 1 December. The government has received a price reduction o"er of 25 per cent on atorvastatin, from an undisclosed sponsor company. The price reduction will also a"ect rosuvastatin. The foreshadowed price cut for rosuvastatin is 20.81 per cent from 1 December.

Workforce

There are other issues that concern the profession. A primary issue for many is the oversupply of pharmacists caused by the large increase in graduates each year.

This is an issue that must be addressed by the profession collectively in 2013.

Guild’s National Conference APP

The Australian Pharmacy Professional (APP) conference on the Gold Coast was a marvellous success, with over 4,000 registrants, compelling speakers, and a vibrant trade exhibition.

The opportunities for networking were unsurpassed, along with significant CPD benefits. One of the highlights at APP this year was the inaugural Alan Russell Oration, delivered by the chief executive of the United Kingdom’s National Pharmacy Association, Michael Holden. Mr Holden spoke on the British ‘Healthy Living Pharmacy Initiative’.

A political highlight of the four day conference was, of course, the attendance and address by the Federal Minister for Health, Tanya Plibersek. She presented the QCPP Pharmacy of the Year Award to Scott McCahon from Cape York Guardian Pharmacy in Queensland. An inspirational winner indeed.

We particularly welcomed the Minister’s confirmation that the Government would not support a Senate Inquiry into the Fifth Community Pharmacy Agreement, as proposed by the Australian Greens.

Patient Support

I would like to finish on the positive and thank community pharmacy for the outstanding work done in 2012 in assisting patient support groups. Community pharmacies play an increasingly important role as health care hubs—the central point for advice and information about the full range of health care issues. For this reason, pharmacies are often prominent in the minds of people across the broader health industry, especially those working in community-based health and disease state organisations, who want to communicate with their constituencies, and in many cases raise awareness among the general public about important health issues and the need for increased Government attention and funding. The Guild maintains excellent relations with a vast number of organisations in the sector, and we do what we can to help them in their various missions and projects. That work would not be possible without the community pharmacy network playing its role and I want to thank the profession for their support.

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Pharmacy Guild welcomes David QuiltyFarewell Wendy and welcome to David

The Executive Director of the Pharmacy Guild of Australia, Wendy Phillips, is to retire from the position on 1 December 2012, after twenty years with the Guild.

Wendy Phillips joined the Guild’s National Secretariat in 1992 as the Director of its Strategic Policy Division and in 2006 was promoted to the newly created position of Deputy Executive Director. She became Executive Director in 2008.

Wendy Phillips has made an outstanding contribution to the Guild and to community pharmacy over many years, and is recognised as a committed, e"ective and influential leader. She will be leaving with the heartfelt thanks and best wishes of the National Council, the Guild and our industry.

She has overseen the development of many major Guild policies, which have been aimed at increasing the recognition of the health care role of pharmacists and the value of the current network of community pharmacies. Wendy’s extensive knowledge of the Guild’s corporate history, as well as her strategic thinking and unerring good grace will be missed by all.

I thank her for her commitment and friendship.

I’m delighted to welcome our new Executive Director, David Quilty. David will enjoy working with our committed team.

I thank our sta" for their contribution to our success in 2012.�

In consultation with Wendy Phillips, the National Council of the Guild undertook a search for an appropriate appointee to the important position of Executive Director. The Guild recently announced that that person is David Quilty, a well-respected former senior executive at Telstra, and an experienced Federal Ministerial Chief of Sta".

David Quilty is a highly-regarded strategic adviser and corporate a"airs professional who has served with distinction at the highest levels of business and Government for nearly two decades. He is also a former Group Managing Director of Public Policy and Communications at Telstra.

At Telstra he was responsible for developing and implementing a Board-approved whole-of-company corporate citizenship and community engagement strategy for Telstra and the Telstra Foundation.

Previously he worked as a chief of sta" to the then Minister for Communications, Senator Richard Alston, and also as a senior adviser to Prime Minister John Howard. Both in this role and as a senior adviser in the Cabinet Policy Unit, David advised on health policy issues, including the PBS.

‘I am a fervent believer in the importance of pharmacies as primary health care providers and community-based businesses. It is a privilege to join an organisation that represents Australia’s most respected profession in such a professional and e!ective manner’.

David Quilty will take over from Wendy Phillips from 1 December.�




!e strength of the Guild is that we are one national organisation with politically active branches in every state and territory, with one overriding objective—to support our members and maintain the current system of community pharmacy in Australia.

The calendar year 2012 has been one of significant developments for community pharmacy. For me personally, it also marks the end of my career with the Pharmacy Guild of Australia. I have enjoyed my time at the Guild enormously both as a Director of Strategic Policy, then as Deputy Executive Director and for the past four years as Executive Director. The work has always been stimulating, the issues challenging and the outcomes mostly rewarding.

Certainly there have been plenty of challenges this year, with the most significant price cuts in the history of the Pharmaceutical Benefits Scheme taking e"ect from 1 April. There was also the important national rollout of MedsCheck and Diabetes MedsCheck, adding to the suite of medication management services provided by community pharmacies, and remunerated under the Fifth Agreement.

Community pharmacy businesses have had to adapt to these and other developments against a background of di!cult trading conditions and cost pressures which drove a record number of businesses to the wall.

Looking back on the past 20 years it seems as though there has never been any shortage of challenges. One of the most confronting external issue involved National Competition Policy when it was introduced by the Keating Government in 1995 and implemented during the Howard years. As many in pharmacy would recall, this policy, signed o" by every Government in Australia, directly threatened the ownership of pharmacies by pharmacists because it required all regulations to be removed unless it was demonstrated that they provided a public benefit.

For the Guild, this became a campaign of major proportions and was successful mainly because of our representational work at a political level; but also because the Guild focussed all its resources, nationally and working with our branches, to get the result we wanted.

Since I have been the Executive Director, with any major issue I have tried to use this same approach of having all parts of the Guild work together to achieve a result.

The strength of the Guild is that we are one national organisation with politically active branches in every state and territory, with one overriding objective—to support our members and maintain the current system of community pharmacy in Australia.

I have also advocated a course of cooperation and consultation with other organisations if we can gain their support to strengthen our case. However, this is only possible where there is absolute agreement as to the core argument. Otherwise, the single focus is lost and our campaign undermined. An example of this occurred in relation to the Greens’ proposal for a Senate Inquiry into the Fifth Agreement where it was not possible to achieve a single and undiluted pharmacy position and it was necessary for the Guild to work alone.

A key strength of the Guild has been —and still is—the lobbying capacity of the Guild through e"ective political representation at a national and branch level. Over the years, our approach has been to provide a solution rather than a problem when visiting a politician and, while this doesn’t always achieve an immediate result, it creates a positive environment for future negotiations.

One more thing . . .

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I once had a short conversation on a plane with Ken Henry when he was the Secretary of the Treasury, and told him that we liked to quote what he had once said about the Guild, when he described it as one of the most e"ective lobbying organisations in the country. He corrected me and said that what he had actually said was that it was the most e"ective. However this sort of image can also create problems for the Guild.

Through the course of the third and fourth Agreements, the Guild had some di!cult relationships with the Department which caused unnecessary delays in the implementation of new Agreement programs and an underspend of the funds. In the current Agreement that has changed—we have a cooperative and constructive relationship with the Department and there has been timely implementation of all the new programs and a full expenditure of allocated funds.

Of unquestioned value to the Guild’s negotiating capacity is the strength and depth of our health economics and statistical analysis team within the National Secretariat. This is combined with the fact that we rarely lose talented people—we have an excellent retention rate for senior sta" which ensures that corporate knowledge is not lost.

I think, however, that the Guild’s greatest strength is that we know and can focus on our core business which is to ensure the future of community pharmacy. We say ‘the Guild is community pharmacy’.

A pharmacy model which operates like a supermarket, just competing on price, undermines these arguments for pharmacist ownership. The enemy from within is often worse than the enemy from without.

However, on the positive side, health is a growth area and medicines are a key component. As people live longer, they will become increasingly dependent on medicines and this will ensure there is a continued demand for pharmacy services.

The strength of community pharmacy is in the relationships it has with its customers and the services it provides to them. �

We don’t have to dilute our focus by having to represent any other sectional interests as is the case with many organisations.

Notwithstanding this strength, there is no doubting the impact that PBS reforms will have on the viability of many community pharmacies over the next few years and this will be a major challenge for the Guild.

Combined with rising costs in rents and wages, it is easy to foresee increased instability in the market. A Government intent on returning the Budget to surplus—and keeping it there—will only increase this nervousness.

As in past years, the Guild will focus its energies in the lead-up to the Federal election next year in order to obtain binding assurances from all sides of politics to provide some insulation for pharmacy. However, with the current Agreement ending in June 2015, the timing of the negotiations for a Sixth Agreement will not be favourable, commencing soon after a new Government comes into o!ce.

One of the recent business trends in pharmacy—the growth of ‘big box’ discount pharmacies—is a challenge to the Guild’s vision of community pharmacy as a healthcare destination. It potentially opens the door to supermarkets. The Guild has always argued that the best way to maintain the current community pharmacy system is for pharmacies to become indispensable to government through the delivery of programs and services which have demonstrable health outcomes in the community.

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Federal Health Minister, Tanya Plibersek, visited a Sydney pharmacy in early August for a media event about generic medicines and their role in supporting the sustainability of the Pharmaceutical Bene"ts Scheme.

The owners and sta! of Blooms the Chemist at Coogee made the Minister very welcome.

As well as talking to the media, Ms Plibersek was able to meet and chat with sta" at the pharmacy, including pharmacist Lianna Shehadie. The Minister wanted to speak to the national media at the pharmacy to follow-up a recent newspaper story advising people of the benefits and savings that they can make through accepting a generic medicine where appropriate, especially where brand price premiums apply to originator medicines.

The Minister said, ‘The cost of the medicine without the brand premium will be no more than the PBS co-payment of $5.80 for concessional

patients and up to $35.40 for general patients. The alternative brand provides exactly the same health benefit as the more expensive brand for which the pharmaceutical company has decided to charge the consumer more. Patients should always ask their pharmacist when their script is being dispensed whether there is a less costly brand of their medicine available.’

Behind the scenes of the Minister’s pharmacy visit

The Minister was joined at the press briefing by the CEO of the National Prescribing Service (NPS), Dr Lynn Weekes. The NPS message is that consumers can be confident that di"erent brands are just as e"ective, and that cheaper medicines work just as well.

As part of the media promotion of generics, a list of the brands of medicines on the PBS that increased their cost to consumers on 1 August 2012, accompanied with a list of less expensive brands of the same medicines, was posted on the internet at www.pbs.gov.au

The Federal Health Minister and politicians from all sides of politics and all levels of government are most welcome to visit community pharmacies whenever and

wherever possible to see the active healthcare role played by community pharmacists, particularly in providing advice about medicines to consumers, as part of their everyday operation.�

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Gold! Gold! Gold!

A record-breaking 4,499 attendees reveled in the blockbuster four-day program and bigger-than-ever trade exhibition at this year’s Australian Pharmacy Professional conference 2012 (APP), held, as always, at the Gold Coast.

Though it’s been a turbulent year for pharmacy as seismic changes loom on the horizon, the largest theme to emerge from this year’s conference was the sense of opportunity. That includes the opportunity to assert the community pharmacists’ role as primary health care providers through delivering professional services, and the opportunity to participate in eHealth innovations which are set to change the nature of healthcare in Australia.

Conference highlights include the Minister for Health, Tanya Plibersek’s keynote address, numerous international speakers, and a trade exhibition which was bursting at the seams with new exhibitors. The Gala Dinner attendance also recorded its biggest turn out in the history of APP.

Minister Plibersek announced the winner of Pharmacy of the Year 2012. The honour was awarded to Cape York Guardian Pharmacy, located at Weipa, a very small town in Far North Queensland. Cape York Guardian Pharmacy was acknowledged as a category winner for ‘excellence in community engagement’ before winning the top award.

Every year the Queensland branch of the Guild takes responsibility for the extraordinary behind the scenes organisation of APP. Preparations for next year are underway and in March, APP 2013 is set to beat 2012’s outstanding numbers. The conference is now widely acknowledged as THE pharmacy event of the year, as at least 4,499 pharmacy industry personnel can eagerly confirm.�

Below The general hubbub; crowds mill about the Guild stand at th---e most successful APP ever.

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In mid-2011, the ACT Branch embarked on a yearlong project to spread the word about cardiovascular health through community pharmacies.

It was directed at the ACT community including Aboriginal and Torres Strait islander peoples and facilitated by a grant from the ACT Health Directorate’s Health Promotion department.

The overall objectives were to increase awareness of cardiovascular health to pharmacists, pharmacy sta" and the community, and provide pharmacists with the knowledge and tools to educate their community about cardiovascular health.

In order to achieve the goal, the ACT Branch established a partnership with the Heart Foundation ACT, and set about utilising the Heart Foundation’s approved messages of Women and Heart Disease, and the Warning Signs of Heart Attack for promotional materials, such as script folders, and educational presentations to pharmacists and sta".

The Branch also developed health promotion kits, which included approved QCPP guidelines on health promotion activities, DVD and USB with Powerpoint presentations, and marketing collateral. The kits provided pharmacists with everything they needed to get started on health promotion activities.

The Branch also tapped into the Heart Foundation’s skills and resources to establish connections for pharmacies to conduct health promotion activities on their premises or in community centres. For example, many pharmacies established Walking Groups for their customers with the meeting point being their pharmacy.

There have been some amazing stories of interventions by pharmacists, who have literally saved lives of customers who have presented at the pharmacy thinking they had indigestion or muscular pain, when in fact they were experiencing the signs of heart attack.

One such pharmacist reported that her participation in the project activities had given her a heightened awareness of the warning signs of heart attack.

The Walking Groups provide more than just exercise: a woman whose husband had recently died, joined the local pharmacy’s Walking Group, and after a few weeks, reported to

WA Forum provides solutions

sta" she had made connection with people in her community again which helped her deal with her grief and loneliness.

This project o"cially ended on 30 June this year; however, it seems to have taken on a life of its own with many pharmacies still utilising the repeat prescription folders, continuing to host Walking Groups and other health promotion activities.

Overall, it was a great experience for those who have been involved, but most importantly for the ACT community. Through the literature and health promotion activities such as the Heart Foundation Walking Groups and Heart Moves programs, pharmacies have engaged their community in greater awareness of cardiovascular health. In addition, they have provided their customers with an insight into other services available at community pharmacies besides script dispensing.�

Healthy hearts project

The fourth Pharmacy WA Forum secured another great panel of leading analysts, business commentators and social media experts across two days in August.

Highlights included Kos Sclavos, ‘live’ via a video link en route to PharmIntercom to give attendees an update on all the news in the world of international pharmacy. Experts took a look at intellectual property and there was a breakfast meeting with WA Small Business Commissioner, David Eaton. Renowned author and journalist for The Australian, Bernard Salt, provided a unique insight into the Australian business market. The sessions included WA Guild Intern Program and how to use social media.�

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Top gong for top end pharmacy in 2012

Cape York Guardian Pharmacy in Weipa, Far North Queensland, is the QCPP Pharmacy of the Year for 2012. The announcement was made by the Minister for Health Tanya Plibersek at the Australian Pharmacy Professional (APP) conference in March.

Owner pharmacist Scott McCahon, who accepted the award on behalf of his team, explained why he entered the competition this year: ‘The pharmacy had reached a point where I was proud of where we’d come from. The community has embraced us since we’ve come here and I wanted to show the town that we deliver a level of service, and a pharmacy, that is comparable with anywhere in Australia.’

The Pharmacy Guild of Australia, in partnership with the Quality Care Pharmacy Program, has been seeking out and acknowledging excellence and innovation through the Pharmacy of the Year award for more than a decade. After reviewing all of the entries seven pharmacies were selected as finalists and visited by the judges.

The three category winners in the running for the overall award in 2012 were Chemmart Superstore Pharmacy, Eaton (WA)

Excellence in business management Martin’s Chemist, St. Mary’s (NSW)

Innovation in professional services Cape York Guardian Pharmacy, Weipa (QLD)

Excellence in community engagement

The exceptional standard of finalists in this year’s competition so impressed the judges Bill Scott (Chairman of Fred Health) and Patrick Reid (a Guild National Director) that they asked the QCPP to recognise a fourth pharmacy, in the form of an Honourable Mention, which went to Priceline Pharmacy, Kiama (NSW).

Cape York Guardian Pharmacy works closely with the local Indigenous communities via the local Primary Health Care Centre, supplying DAAs and S100 Support.

This includes sta" and client education, web-based clinical support and providing a contracted clinical pharmacist with specialist skills in the Quality Use of Medicines.

During the year, Scott McCahon was appointed as head of the Cape York Hospital and Health Board. The appointments are part of the new Queensland Government’s move to return delivery of health services to local control, with board appointments being made for 15 regions across Queensland.

On winning Pharmacy of the Year 2012, Scott McCahon said

‘It was a tremendous thrill and a proud moment for myself, the team and the community of Weipa. The recognition and congratulations received from all sectors of the profession has been an overwhelming and exhilarating experience.

‘It has assisted us to attract professional sta" and raised the profile of the business. But if I had to define a single aspect of the win that resonates most it would be the fact that the community of Weipa share our excitement and proudly tell their friends that our pharmacy won Pharmacy of the Year!’�

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Cultural competence within the pharmacy sector continues as a priority for the Guild with a cultural awareness standard introduced in the Quality Care Pharmacy Program.

Additionally the Guild continues to work closely with the National Aboriginal Community Controlled Health Organisation (NACCHO) on Indigenous policy matters. This enabled the Guild to unite with NACCHO in advocating for improvements to the s100 Remote Aboriginal Health Services Program through the release of a joint position paper, ‘Improving access to Pharmaceutical Benefits Schedule medicines for Aboriginal and Torres Strait Islander people through the Section 100 Remote Aboriginal Health Services Program’. This paper is in response to the report from the Senate Community A"airs References Committee.

The report looked into ‘the e"ectiveness of special arrangements for the supply of Pharmaceutical Benefits Scheme (PBS) medicines to remote Aboriginal Health Services’ (released in October 2011). Both organisations hope that the Government’s response will provide the opportunity to review the Section 100 Remote Aboriginal Health Services Program (s100 RAHSP) in light, not only of the Senate report, but also of the numerous reviews and evaluations which have preceded it.

The development and updating of policy papers continues to flow with the Guild’s National Council endorsing ‘Access to Community Pharmacy Services In Rural/Remote Australia’, ‘Access to the Telehealth Initiative through Community Pharmacy’ and ‘Access to Pharmacy Services by Aboriginal and Torres Strait Islander People’.

The Guild’s Northern Territory Branch President, Terry Battalis, is the CPRIA chairperson and is also a delegate to the National Rural Health Alliance (NRHA) representing the Rural Pharmacists Alliance. The Alliance is made up of the Guild, the Society of Hospital Pharmacists of Australia, the Australian College of Pharmacy, and the National Australian Pharmacy Students’ Association.

The Community Pharmacies for Rural and Indigenous Australia Advisory Group (CPRIA) (formerly known as the Rural Remote and Indigenous Special Interest Group) was established in 2011 by the Guild to address rural and remote population health issues in general, and to ensure Indigenous-specific issues relevant to community pharmacy are addressed under various national health policies.

CPRIA engages with governments and other relevant stakeholders on the role of rural community pharmacy. It seeks to develop ways of enhancing and improving the services provided by community pharmacists to Indigenous communities through initiatives such as the Section 100 Remote Aboriginal Health Service Program and the Closing the Gap PBS Co-payment measure.

Rural and remote focus for re-vamped advisory group

The activities of CPRIA are reported to the Policy and Regulatory A"airs Committee and the National Council to ensure issues a"ecting rural, remote and Indigenous populations are raised at the highest level within the Guild.

The role of community pharmacy in a rural context was highlighted through a number of forums, including our partnership with the Rural

Pharmacists Australia to sit at the National Rural Health Alliance table. CPRIA and RPA members promoted the policy context and work of community pharmacy at a number of national conferences through the year including the Population Health Congress, the Services for Australian Rural and Remote Allied Health Conference, the Indigenous Allied Health Australia conference. �

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Pharmacy Health Checks deliver

The Pharmacy Guild (NSW Branch) and the National Stroke Foundation have been working together to deliver the Pharmacy Health Checks: Know Your Numbers program. It is a year round, incentivised program which provides free, non-invasive health checks to the community in the pharmacy setting. As an extension of the National Stroke Foundation’s Know Your Numbers, the program aims to increase individual awareness of cardiovascular disease and type-2 diabetes through opportunistic blood pressure checks and risk of type-2 diabetes assessments.

Consumers are provided with tailored lifestyle modification information by the pharmacist and those considered high risk are referred on to their general practitioner for further assessment.

The Know Your Numbers program is fully funded by the NSW Ministry of Health under the $10m Community Pharmacy Plan and was launched in May 2012 by the NSW Minister for Health, Jillian Skinner. It is expected over 385 000 free health checks will be performed over the life of the program.

While Know Your Numbers has generally been taken up for short periods each year in other states, the NSW program has a number of distinct features

It is supported by NSW Government incentives of $1000 p.a. which is a recognition that pharmacies cannot be expected to continually provide services for free

It is a state-wide program meeting the Government’s desire for equitable access

It checks for both blood pressure and type 2 diabetes

It is free

It is quality assured and to agreed standards

There are caps each year on the number of pharmacies that can participate

There is an agreement to deliver the services signed by both the Guild and the NSF with the NSW Government.

This is in e"ect a public private partnership with the NSW Government for the use of community pharmacy infrastructure to deliver health outcomes on behalf of the Government and to reduce costs in the state hospital system.

Community pharmacy has proved its value and its willingness to partner with the NSW Government, and it is hoped that this will provide a model for other states and territories.

The Guild and the NSF provide participating pharmacies with the resources, training and support required to successfully carry out the program.

Know Your Numbers mass media advertising campaigns take place nationally during May and September.�

Know your numbers!

May 2012 Launch Left to right

Mr Ian Campbell (Director, Pharmacy Guild NSW Branch), Hon Jillian Skinner (NSW Minister for Health), Mr Bruce Notely-Smith (MP), Clr Robert Belleli (Randwick City Council), Mr Richard Walsh (Walsh’s Village Pharmacy, Maroubra), Dr Erin Lalor (CEO, The National Stroke Foundation), Ms Roslyn Johnson (The National Stroke Foundation), Mr Phillip Walsh.

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In March this year, the Guild provided a submission to the Senate Inquiry on the provision of palliative care in Australia, on the basis that approximately 80 per cent of patients receive palliative care in the community setting. The submission highlighted that community pharmacists are cognisant of the special needs of those receiving palliative care, including the provision and facilitation of support services and longer-term strategies. Additionally, community pharmacists assist in providing such care within the home for as long as possible before the patient might need to move to specialised facilities.

Key submission issues outlined

funding a community pharmacist’s involvement in structured care plan arrangements for palliative care patients, for example, during case conferencing

consistent legislation between states and territories to ensure access to e"ective palliative care medicines is not hampered

a return system to assist in removing high-risk medicines such as controlled drugs and cytotoxics from households when they are no longer required

the benefits to the Government, and to patients and families, to fund Dose Administration Aids (DAAs) services as part of palliative care services, along the lines of the Department of Veterans’ A"airs DAA funding.

The Guild was subsequently invited to address the Senate Community A"airs References Committee on 10 July in Canberra, which was attended by Harvey Cuthill (National Councilor and Committee member, Tasmania Branch) and Denis Leahy (Committee Member, New South Wales Branch). The Committee explored the issues regarding

o"-label use of medicines access to medicines in rural and

remote locations the cost and access to syringe

drivers the lack of knowledge of

prescribers regarding scheduling, legislation and availability of medicines used in palliation.

The Guild also provided the Committee with a table comparing the Schedule 8 regulations and were given a question on notice, to provide an overview of pharmacists providing domiciliary palliative care.

The Inquiry Report was released in October 2012, with the recommendations highlighting the need for a greater emphasis and funding to provide community-based palliative care, and a full review of the medications available on the PBS.

The final report also supported a Guild recommendation that the Government expedite the introduction of uniform regulations for the supply of Schedule 8 drugs.

The Guild’s submission, the Hansard of the Committee hearing, and the Inquiry Report can be accessed online through the Parliament of Australia website www.aph.gov.au�

Senate Inquiry on the provision of palliative care

Community pharmacy has traditionally been involved with the distribution of vaccines and is well-placed to participate in vaccine administration and community immunisation programs in a number of ways, including

advocacy and the provision of information

in-pharmacy vaccination by a registered nurse immuniser, and

in the future, in-pharmacy vaccination administered by a suitably trained and credentialed pharmacist.

Internationally, the provision of immunisation services involving pharmacists—who have been trained and certified to administer vaccines, and utilise agreed protocols and collaborative arrangements—is now well-accepted in countries such as the USA, UK, Ireland and Portugal.

Improving access to seasonal

influenza vaccinations through

community pharmacy will

improve public health outcomes

through the prevention

of influenza infection and

associated morbidity.

Increasing influenza vaccinations

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Community pharmacy’s long tradition of playing an important role in the management of diabetes saw an important milestone reached in 2012 —25 years since the establishment of the National Diabetes Services Scheme (NDSS).

This is achieved through a network of over 4,000 independent ‘Access Points’ (formerly known as Sub-Agents) who participate in the Scheme at no cost to the NDSS, and are mandated to provide services that ‘extend beyond just being a shop front for NDSS products’ including providing registrants with

accurate and appropriate information and professional advice on diabetes and e"ective self-management

referrals to appropriate health professionals

advice on the appropriate use of products

NDSS materials access to a person who has

specialised training in NDSS policies and procedures

a reliable supply of products and a supply to meet both the anticipated and actual demand.

Additionally ‘Access points’ receive new registrations for the NDSS and submit them to Diabetes Australia.

Community pharmacies make up 98 per cent of Access Points for the NDSS, electing to be involved in the NDSS due to high level of commitment to

providing a comprehensive diabetes service to the community.

Whilst community pharmacy and the Guild remain committed to the objectives of the NDSS and the management and treatment needs of people with diabetes, the Guild has highlighted continuously to Government and Diabetes Australia that it is unreasonable to expect community pharmacy to continue to participate in the Scheme with no remuneration. An analysis by Medici Capital in February 2011 estimated that based on pharmacy cost and income trends since 2001 the financial impact on community pharmacy Access Points is an average loss of $7,481 per year.

The Guild hopes that e!ciencies within the model of the NDSS are identified as part of the numerous reviews that were conducted in 2012. Any resultant cost savings should be redirected to support Access Points to deliver the NDSS. This will ensure that people with diabetes in Australia have continued access to high quality advice and professional services in their local community at a destination of their choice. �

National Diabetes Services Scheme

In addition, New Zealand introduced a pharmacist-administered influenza vaccination service in late 2011.

The Influenza Specialist Group (ISG) consisting of medical and scientific specialists from Australia and New Zealand reports that each year, an estimated 3,500 Australians die from influenza and its complications and it is estimated that influenza annually causes 18,000 hospitalisations and over 300,000 GP consultations.

The economic loss su"ered by industry and individuals is also significant with a 1996 study indicating that influenza results in an estimated 1.5 million work days lost annually in Australia. The influenza vaccine also has clear economic benefits, with studies showing it can decrease total winter absenteeism in the workplace by 36 per cent.

From a policy perspective it makes sense to augment the current avenues available for immunisation and to reduce health risks, levels of hospitalisation and economic loss in the community. This has been advocated by the Guild at the national, state and territory levels throughout 2012, including a presentation delivered at the National Immunisation Conference in Darwin in June. �

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The PBN was developed to continue the legacy of former Guild National Councillor and pharmacy advocate, the late Judy Liauw, by supporting the Guild’s vision to develop the business nous of pharmacy owners and leaders of the future.

‘The PBN is a fitting forum to continue her legacy of developing our future pharmacy leaders,’ said Jean Shannon of the St. James Ethics Centre.

‘I was touched and proud to be the first speaker of the Judy Liauw Foundation Address.’

The PBN took a practical approach to putting on an event with a unique focus on providing attendees with interactive tools to improve business planning, management and profitability in their pharmacy.

In a learning environment the attend-ees mixed with a range of experts and networked with people from all levels of the pharmacy industry. Pharmacists, retail managers, pharmacy students, pharmacy assistants and CEOs all mingled in the open forum provided by the PBN. ‘The delegates attend-ing the PBN have strongly endorsed our practical and interactive style as unique and rewarding,’ PBN Chair, Patrick Reid said.

The PBN also hosted the final presentations of the National Student Business Plan Competition with the University of South Australia announced as the winner at the Gala Dinner on the Saturday night.

The encouraging atmosphere at the PBN and the ‘hands on’ methods used in di"erent sessions throughout the event ensured that all delegates had real action plans to take back to their pharmacy.

Pharmacy delegates from right across Australia and as far as New Zealand assembled at the National Convention Centre in Canberra for the "rst ever Pharmacy Business Network (PBN) event that ran from 13-16 September.

Networking brings benefits

PicturedLing Na Yan, Chris Braithwaite and Jessica Dawson, from the University of South Australia, winners of the National Student Business Plan Competition, 2012.

Far right, at their presentation: and at right after the awards ceremony.

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One delegate’s feedback form told the story ‘World class presentations, apt and fast-paced. Presenters were highly informed and articulate. Significant issues addressed. Time well-allocated, worth attending 100 per cent.’

Highlights include presentations by the 2012 Pharmacy of the Year winners, how to deal with tricky human resource issues, and the launch of the Guild’s new guidelines on reporting turnover to landlords.�


The Pharmacy Practice Incentives Program (PPI) was launched at a time when community pharmacy had already started the journey in practice change. The Program requirements to deliver and record services to the quality standard have provided support for pharmacies in the development and delivery of services. The unprecedented number of pharmacies that have embraced PPI has created a wave of support from other organisations including key health organisations focused on improving public health.

This year has seen the consolidation of PPI funded by the Australian Government under the 5th Community Pharmacy Agreement. Its aim is to provide incentive payments to approved Section 90 community pharmacies for providing systemised patient focused services that will improve quality use of medicines and patient health outcomes.

Many of the services under PPI were already being delivered but to what extent or quality has been largely unknown. In the past many services were not standardised or defined and pharmacies were not routinely documenting their activities.

This has led to community pharmacies and community pharmacists being under-valued in the role they play in the health outcomes of patients. Some health professional groups, individuals and organisations only recognised community pharmacy as a supplier of pharmaceuticals or as a retailer.

Pharmacy Practice Incentives–supporting change

In July 2011, PPI was launched and to date over 90 per cent of the 5,240 approved community pharmacies in Australia are participating in the Program. This has been an extraordinary result for the Program, indicating that PPI is supporting the needs of community pharmacies and ensuring the quality and consistency of service they provide to their patients.

Of the 4,700 community pharmacies participating over 4,000 are delivering services under all six priority areas: Clinical Interventions, DAAs, Staged Supply, Primary Health Care, Community Services Support and Working with Others.

So, why would so many pharmacies choose to participate in this new Program?

Certainly remuneration is a factor. Under PPI, pharmacies are able to receive incentive payments for delivering specific professional services to the Program requirements. But the $344 million allocated to this Program demonstrates that community pharmacies are being recognised for their role in improving patient health outcomes. It provides some financial support to community pharmacies as they develop and provide professional services to the requirements of the PPI Program.

The PPI priority areas have been developed with the objective of improving quality use of medicines and patient health outcomes. Each priority area and element is defined, which provides a standardised approach to the type and delivery of professional services in community pharmacy.

This provides community pharmacies with the framework and ability to demonstrate the value they add in specific areas of health within the community.

In developing these priority areas, consideration was given to the core activities community pharmacies already perform and their traditional role as experts in medicine. This ensured the Program was not requiring pharmacies to change their focus but to improve the way in which services such as DAAs, Clinical Interventions and Staged Supply were delivered.

By providing definitions it makes these services purposeful and recognised not just by the pharmacy industry but by government and the wider health industry, highlighting the broader role of community pharmacy.

The most important aspect of the Program in supporting pharmacy is systems. PPI has encouraged community pharmacies to develop and implement professional services systematically. This leads to the delivery of consistently high quality services.

This has been achieved by ensuring that pharmacy accreditation is one of the eligibility criteria of the Program, and linking the requirements of each priority area to the quality Standard.

This requirement has provided participating pharmacies with a robust quality framework to work within when developing, recording and delivering services under PPI.

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Through the Program requirements, a pharmacy must document or record their activities under the di"erent PPI priority areas thereby developing evidence of the services provided, evidence that the service is standardised, evidence that it is part of the pharmacy’s routine practice and evidence that the pharmacy is providing patient focused care. The GuildCare software suite, developed by GuildLink, creates e!ciencies as well as a recording function for Clinical Interventions.

In the first 6 months of the Program over 4600 community pharmacies delivered DAA services to almost 134,000 patients each week to the quality standard. This is a significant number of patients receiving a quality patient focused service that we can demonstrate is standardised across the industry as it is delivered within a robust quality framework.

Under Clinical Interventions, in the first six months of the Program, over 4,600 community pharmacies performed almost 14,000 interventions each week. Community pharmacies have always performed clinical interventions but these figures provide us with real evidence of just how often a community pharmacist has identified and recorded a drug related problem and more importantly that this service is performed within a robust quality framework. Indications are that the number of clinical interventions being recorded has continued to increase in 2012.

In time PPI will highlight to others in the broader health industry the important and valuable role of community pharmacy when considering services to improve patient health outcomes across Australia.�

From previous h h h

The Conference was held on the beautiful shores of Waikiki Beach, and a wide range of international speakers spoke on topics including global health, wound care and world economics.

Seven time world champion surfer Layne Beachley gave an inspirational keynote presentation. She talked about her determination to succeed and how her personal life and battle with illness gave her the motivation to establish the foundation Aim for the Stars, which provides financial grants for young women to achieve their dreams.

Dr Alessandro Demaio, University of Copenhagen, presented on global health and the epidemic of chronic disease. He explored the frightening statistics of non-communicable diseases and how pharmacists can assist in the prevention of these diseases.

Dr Demaio’s second presentation outlined how social media and new technologies are the future of medicine and can enhance engagement with pharmacy customers.

Associate Professor Geo" Sussman talked about the specialist wound care pharmacists can provide through their pharmacy.

CommSec’s Chief Economist Craig James gave delegates an overview of how he sees the world’s economy evolving over the next 3 to 10 years and how that will relate to retail pharmacy.

Pharmaceutical consultant David Ford presented on Women’s Health and the Future: Complex Proteins and Targeted Therapies.

Australian surgeon Dr Joseph Ischia made the trip from the University of British Columbia in Vancouver to speak on one of the topics he is passionate about, men’s health.

Delegates had the chance to dine at the celebrated restaurant of Iron Chef, Moritmoto, in Waikiki and dance the night away at the Hard Rock Café for the Farewell Dinner�

Hawaii O"shore ConferenceMore than 100 delegates attended the Victoria Branch’s 2012 O!shore Conference in Hawaii in October.

In October, the International Pharmaceutical Federation (FIP) Centennial Congress in Amsterdam provided a timely focus on the importance of community pharmacists in health systems globally.

Over 5,500 participants convened in the birth country of the Federation to highlight the benefits of pursuing the responsible use of medicines.

The Congress saw the release of two key documents, one from the World Health Organisation (WHO), ‘The Pursuit of Responsible Use of Medicines’, and one from the IMS Institute for Healthcare Informatics on ‘Advancing Responsible Use of Medicines’. The IMS report identified an opportunity to avoid an amazing 500 billion US dollars annually in global health spending, through more responsible medicine use. Find out more at www.iamapharmacist.com�

A global focus

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Western AustraliaKath Van Der Straaten, Optimal Pharmacy Plus, Coolbellup

Northern TerritoryDanielle Logan, Alice Springs Pharmacy

South AustraliaRebecca Leslie, Terry White Chemist, Port Lincoln

Queensland Mellisa Cracknell, Ipswich Medical Centre Day and Night Chemist

New South WalesAmelia Harris, Priceline Pharmacy, Forster

Australian Capital TerritoryAllanah Brookhouse, Capital Chemist, Wanniassa

VictoriaSue Quarrell, Pharmasave, Brentford Square

TasmaniaEmma Heazlewood, Terry White Chemist, Fourways

Tasmania makes it two in a row for Pharmacy Assistant of the Year

Emma Heazlewood from Terry White, Fourways in Devonport, Tasmania, has been named the Pharmacy Guild of Australia and GSK’s 2012 National Pharmacy Assistant of the Year (PATY).

Pharmacy assistant of the year 2012

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Emma was absolutely thrilled to be chosen and said it was a great experience to be able to learn from so many fantastic people.

‘All the finalists were such inspiring people,’ she said. ‘I have certainly formed long-lasting relationships and I will be able to use the skills that I have learned in this competition throughout my career.’

John Dowling, Tasmanian Branch President of the Pharmacy Guild of Australia said that this competition is a reflection of the dedication and passion that the finalists have for their jobs and the industry.

‘To be named the Pharmacy Assistant of the Year is to be recognised for your skills and knowledge in your chosen career and this competition brings together outstanding assistants from across Australia,’ Mr Dowling said.

‘We are delighted that Tasmania has now won the national title two years in a row. Claudia Pulko from Dover Pharmacy was Tasmania’s first national winner last year. It clearly demonstrates that the service and care Tasmanians can expect from their community pharmacies is of a very high standard indeed,’ Mr Dowling added.

Emma commenced her career as a pharmacy assistant in a small community pharmacy in 1999.

In 2010 she joined the team at Terry White Chemists Fourways and as a retail manager, led a team of 40 sta" to win the 2011 National Terry White Chemists store of the year.

Emma is completing her Certificate IV and has a passion for mentoring sta! members as she continues to grow her career in pharmacy.

As the national winner, Emma will take home terrific prizes, including $5,000 cash and professional development with Guild Training to the value of $5,100.�

Finalists

‘All the "nalists were such inspiring people’


Refer people with asthma and their carers to Asthma Assist at your local Asthma Foundation

1800 ASTHMA (1800 278 462) asthmaaustralia.org.au

10% of people have asthma1

Up to 90% of people with asthma don’t use their medications properly 2

We have some of the best asthma clinical management guidelines in the world but people with asthma still experience a poorer quality of life and comprised health outcomes. This is particularly true for some more vulnerable groups in the community3

Asthma Foundation educators provide:

— Support via the 1800 ASTHMA (1800 278 462) national information line and their online and face to face services

— Ideas for working in partnership with your doctor and pharmacist

— Information and instructional videos about asthma and self management (asthmaaustralia.org.au)

— Community education sessions for people with asthma and their carers

— Training for schools, childcare services, workplaces and other community settings to become Asthma Friendly.

Asthma Australia is also conducting an Asthma Friendly Pharmacy Pilot study with a view to offering this program nationally in 2013.

Asthma Australia is the recognised national community voice of Australians with asthma and linked conditions and their carers. It comprises the Asthma Foundations from each Australian state and territory working together on national policy, advocacy and programs and promoting research. It is a national, nongovernment, incorporated body with no political affiliations.

1 Asthma Snapshot aihw.gov.au 2 Bashiti IA, Armour CL, Bosnic-Anticevich SZ, Reddel HK.

Evaluation of a novel educational strategy, including inhaler based reminder labels, to improve asthma inhaler technique. Patient Educ Couns. 2008; 72: 26-33

3 Asthma Snapshot ibid.

Qua

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In 2012, 91 per cent of community pharmacies in Australia are accredited by Quality Care Pharmacy Program (QCPP).

This represents an increase from 88 per cent in July 2011 following the introduction of the Pharmacy Practice Incentives (PPI) as part of the 5th Community Pharmacy Agreement. Community pharmacy has accepted PPI as a key process to assist them to support delivery of more professional services. QCPP accreditation ensures that the delivery of PPI priority areas is in accordance with the requirements of a quality framework.

What is accreditation?

Accreditation is now recognised as an essential driver of consumer safety and continuous quality improvement across all industries and businesses. Health care, including pharmacy, is no exception. Pharmacies accredited under QCPP have been assessed against Australian Standard 85000:2011 Quality Care Pharmacy Standard. This is a quality management system for pharmacies enabling them to meet expected standards of professional service and customer care.

The two conditions for accreditation are an explicit definition of quality (i.e. standards) and an independent review process aimed at identifying the level of congruence between practices and quality standards.

Benefits of accreditation

Accreditation is now a well-recognised measure of a high performing business that the community is seeking; not only a statistical measure, but also providing

advertisement to the community of a safe and e!cient organisation or business

opportunities for peer review processes to be undertaken

financial benefits an excellent opportunity to

celebrate achievements and improvements whilst providing a platform to identify further opportunities for improvement.

Accreditation is just good business.

When asked ‘why QCPP accreditation?’, pharmacy feedback includes

‘QCPP has inspired our pharmacy to provide the highest quality of service to our customers resulting in not only foot tra!c, but happier customers’, Garrick Stevenson, Ararat Healthwise Pharmacy, Victoria

‘QCPP creates a benchmark of service we need to maintain and in all cases try to exceed. It gives the pharmacy direction, structure, consistency, and professionalism’, Rachel Miller, Beenleigh Medical Chemmart Pharmacy, Queensland

‘It provides structure, encourages uniformity in how things are done resulting in better quality service received by the customer and improves workflow’, Celia Milander, Figtree Plaza Chemist, NSW.

Comparison of accreditation models

There are standards and accreditation requirements through all phases of pharmacy. Pharmacy schools must be accredited in order to deliver a pharmacy degree that will be recognised by the Pharmacy Board of Australia. Training providers o"ering intern programs must be accredited. CPD providers can also seek accreditation for their education activities via an accredited CPD accreditor (e.g. Pharmacy Guild) and consultant pharmacists must achieve accreditation to deliver medicine management services.

Currently within the health industry alone there are several di"erent accreditation models across a multitude of sectors. Other models include

Aged Care Sector: assessment against aged care standards and regulations

Australian Physiotherapy Association (APA): assessment against practice standards in physiotherapy

General Practitioner Services: accreditation standards maintained by the Royal Australian College for General Practitioners that may provide access to the GP Practice Incentive Program.

Each provides di"erent techniques, benefits and outcomes. Unlike most models, QCPP also provides extensive supporting tools to assist pharmacies successfully achieve accreditation status.

Quality matters

Make every day accreditation day!

Now that QCPP accreditation is an accepted part of community pharmacy practice, our goal is to sustain the improvements and ensure the level of service provided at the time of accreditation is the same every day. QCPP accreditation—it’s just good business! �



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2012 has been a watershed year for the Pharmaceutical Benefits Scheme (PBS). The Government’s Memorandum of Understanding with Medicines Australia, signed in 2010, bore fruit in April with the largest set of price reductions in the history of the scheme. In the same month, the expiry of Pfizer’s atorvastatin patent resulted in more savings through a 16 per cent price reduction which also flowed to rosuvastatin. This has lifted the generic market to a new level of competition. In the short term this provides some much-needed cushioning for community pharmacy at a time when many are struggling with high rents, low script volume growth and low consumer demand. In the next twelve months, the entry of generics for atorvastatin (as well as other significant drugs such as venlafaxine) will also result in a new wave of savings for the Government through price disclosure.

In May, the Commonwealth Budget showed that, compared to the estimates released in the 2011 Budget, estimates of future expenditure had reduced by $2.1 billion over the four years to 30 June 2015, taking into account spending on drugs across the General, Concessional and Repatriation categories (see graph). No new savings measures were implemented in between; Treasury simply got it wrong in 2011. Unfortunately they continue to get it wrong—more on that shortly.

Since the May budget, the PBS news has been even better from a government point of view. The Guild estimates that price reductions announced for 1 December 2012—most significantly on atorvastatin, rosuvastatin and docetaxel—will result in a further saving of over $250 million per year.

The reductions to atorvastatin and rosuvastatin come as a result of an o"er to government from an unnamed manufacturer. Docetaxel is another example of the windfall savings that the Government continues to receive from the e"ect of price disclosure on chemotherapy drugs. Including docetaxel, seven chemotherapy drugs will have had price cuts totalling 70 per cent or more since the introduction of price disclosure, with another five dropping by between 50 per cent and 70 per cent. If Treasury has their figures so wrong from one year to the next, you can guarantee that they had never factored in these chemotherapy drug savings.

Governments all around the world have implemented budget measures to reduce the cost of o!-patent medicines. Overall, Australia’s price disclosure system strikes the right balance.

First and foremost it maintains patient choice and allows a competitive market. Once the competitive market is established for an o"-patent drug, the Government transfers the benefits of that competition through to taxpayers and this is repeated on an annual cycle. It is a fair system and is fully transparent, with the results of all calculations publicly released.

Price Disclosure Delivers: when will Treasury catch on?

Price disclosure has worked for the Government and consumers so far, and will continue to work into the future.

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In the Guild’s view, which is shared by all in the industry, the Government’s budget forecasts continue to underestimate the savings that will flow from price disclosure. Put another way, they continue to overestimate future expenditure on the PBS. Nowhere is this better illustrated than the $2.1 billion downward revision between the 2011 and 2012 Budgets. More recently there was further evidence with the release of the Department of Health and Ageing’s 2012 annual report. The Department’s 2011-12 financial year target for savings, as a result of price disclosure (excluding the 1 April 2012 Expanded and Accelerated Price Disclosure round), was $62.0m. The annual report shows that the actual savings realised in 2011-12 were almost double that target, at $112.5m.

Not surprisingly, the 1 April 2012 Expanded and Accelerated Price Disclosure round of savings did hit the Department’s target (within about 1 per cent). This is because the Medicines Australia MOU had guaranteed an average price reduction of at least 23 per cent, which allowed Treasury to fully book the savings rather than their usual fancifully low estimates.

Unless Treasury loses its price disclosure blind spot and allows more realistic forecasting into the future, their overestimate of future PBS expenditure will continue. The May 2012 Budget papers state that ‘PBS growth in 2011-12 and 2012-13 is lower than historical trends, but that growth is expected to return to

its long-term trend of 5 per cent per annum from 2013-14 onwards’. With price disclosure now having such a significant impact, how can Treasury continue to justify a view that growth will ‘return to its long-term trend’, especially during the largest wave of patent expiries the world has seen?

This denial of reality by the o!cialdom can have serious consequences for the debate over the future of the PBS. Arguments are being formed based on an unrealistic

set of o!cial estimates, and some influential groups fail to recognise that. The extent of Treasury’s failure may also be unrecognised by the Government itself, influencing spending decisions such as those relating to the listing of new drugs on the PBS.

Price disclosure has worked for the Government and consumers so far, and will continue to work into the future. It is a permanent measure delivering permanent, large scale savings, driven by a healthy and highly competitive market. In 2013, it is time for Treasury to take a realistic view of the savings that will be delivered in coming years and to factor them into the Government’s o!cial forward estimates.�

!is denial of reality by the o#cialdom can have serious consequences for the debate over the future of the PBS.


In March 2012, for the "rst time, people from urban, rural and remote Australia were brought together as part of a QUMAX and s100 joint forum.

Helping to ‘Close the Gap’

This an example of the work of a partnership between government and industry to ‘Close the Gap’, and the groups involved are the Pharmacy Guild of Australia, the National Aboriginal Community Controlled Health Organisation (NACCHO), and the Department of Health and Ageing.

Representatives of community pharmacies and Aboriginal Health Services were able to share their experiences (through a number of presentations and case studies), build networks and hear from key stakeholders. It also provided the opportunity to suggest improvements as to how pharmacy services could be better delivered to Aboriginal and Torres Strait Islander people.

During 2012, the Fifth Community Pharmacy Agreement (5CPA) also

funded five Aboriginal and Torres Strait Islander students up to $15,000 per year to study pharmacy, and provided access to 16 pharmacy assistant traineeships. These programs help to strengthen participation by Aboriginal and Torres Strait Islanders in the pharmacy workforce, and in turn ensure improved and more culturally appropriate pharmacy services to better meet local needs.

A number of programs provided under the (5CPA) seek to increase access to medicines and enhance the quality use of medicines for Aboriginal and Torres Strait Islander people.

Pharmacists play a critical role in ensuring access to and quality use of medicines in remote Aboriginal communities. �

Pharmacy Assistant Kerry Hudson (featured at right) from Portland in Victoria’s west has done what very few Indigenous Australians have done before.

Kerry is a passionate health worker and has become one of the first in the State to complete her training under the national Aboriginal and Torres Strait Islander Pharmacy Assistant Traineeship Scheme.

Indigenous Programs Manager from the Victoria Branch, Stan Goma, said a pharmacy can at times be perceived as culturally alienating for many people in the Aboriginal community, something Ms Hudson’s presence has already helped change.

‘People as far as Heywood are saying “it’s great to go to the pharmacy and see Kerry there.” It also gives the pharmacy sta! a better understanding of the health needs of the Aboriginal community,’ Mr Goma said.

Pharmacy owner and Guild member Brian Hardley agreed saying, ‘It’s been great having Kerry here to help strengthen the working relationship with the Aboriginal health service and the community.’�

Success for Victorian Indigenous graduate

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GuildLink had an exciting and busy year! New name, realigning of company structure with new websites and new product launches.

GuildLink (previously known as heathlinks.net) comprises two divisions, Medicines Information and Patient Care. Guided by the GuildLink charter, the two divisions deliver di!erent services to pharmacy and the healthcare industry. Whilst being a commercial enterprise, GuildLink’s primary economic driver is to ‘provide information solutions to facilitate the better use of medicines and ultimately better health outcomes for patients’.

The Medicines Information division provides a single point of distribution of medicines information such as Consumer Medicines Information (CMIs), Product Information (PIs) and drug images to healthcare professionals and consumers ensuring users have access to the most current medicines information at all distribution points. Medicines Information distributes CMIs to 5,400 retail and hospital pharmacies, and acts as a conduit between the pharmaceutical companies, health information providers, and consumers. Over 45 health information providers including the TGA, MIMs and AusDI utilise our distributed CMIs and PIs.

Medicines Information delivers unique and innovative solutions including personalised CMIs at the point of dispensing, synthetic audio CMIs, large print CMIs, and the provision for Braille CMIs. Currently, CMI delivery to the point of dispensing occurs on a monthly cycle, with future developments providing real time distribution to ensure that the latest information is provided to consumer.

The smart phone-friendly website, www.medicines.org.au, was established to support the National Strategy for Quality Use of Medicine with the ability to access the most current CMI and PI documents in di"erent formats.

The Patient Care Division is responsible for delivery of software and professional programs to pharmacies throughout Australia. The Patient Care software platform known as GuildCare is a purpose built, highly sophisticated software program that seamlessly integrates with dispensing software.

Information and care from GuildLink

GuildCare pharmacies have recorded over two million completed cases, which are pharmacist-led patient interactions.

The GuildCare o"ering encompasses programs which assist pharmacies in meeting their recording requirements of the Fifth Community Pharmacy Agreement (5CPA) and provide quality, evidence based advice supported by comprehensive reports to their patients. To date, GuildCare pharmacies have recorded over two million completed cases, which are pharmacist-led patient interactions, with Clinical Interventions being the most widely recorded.

In 2012, GuildCare expanded its program range to assist pharmacy with the 5CPA Medication Management program requirements with the addition of MedsCheck Services Module and Home Medicines Review Module. As Medicare approves pharmacies to deliver the MedsCheck services, GuildCare can see a growing uptake with completed cases already in the thousands.

In 2013, GuildCare will be working with pharmacy to expand the suite of programs in other categories that will assist pharmacies in improving patient health outcomes in di"erent disease classifications. Private Services, such as recording and monitoring of Blood Pressure will also gain new modules, which will enable pharmacies to record more services that they already provide within their pharmacy.

GuildCare looks forward to 2013 with plans already in place to o"er pharmacies new and exciting software solutions in their pharmacy. Look out for our new products scheduled to launch at APP 2013.

To read more about divisions of GuildLink visit our new website www.guildlink.com.au�

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!e Research and Development Program, as part of Fifth Community Pharmacy Agreement, continues to be regarded as a major source of funding for pharmacy practice research in Australia.

The Program generates a significant body of knowledge and helps establish Australia as an international leader in the field. The aim of the Program is to fund projects that will contribute to maintaining and improving the health outcomes of Australians. This is achieved through studying evidence-based best practice on issues relating to community pharmacy and the provision of quality services to consumers.

The current health environment has a strong emphasis on positioning the consumer at the centre of healthcare delivery. With the increasing role of the pharmacist in promoting good health, the willingness and the ability of the consumer to make use of the services provided by community pharmacists is paramount.

Therefore, under the 5CPA, all research projects have a strong consumer focus, such as

A project focused on Consumer Needs aims to develop a better understanding of consumer preferences, expectation and needs in context of community pharmacy and the responsiveness of community pharmacy to these factors

A project focused on Chronic Illness seeks to fully explore the perspective of health consumers about the burden of chronic disease, related treatment regimes, their desire in terms of patient centered care and the related role of community pharmacy

Focusing research on consumers

A project focused on Mental Health aims to explore the role of community pharmacy in supporting people with common mental illnesses such as depression and anxiety to better manage their medicines

A project focused on Health Literacy aims to undertake research in health literacy and the role community pharmacy can play in improving consumer outcomes through tailored communication of health information

A project focused on Professional Collaboration aims to identify a best practice model for the integration of community pharmacists in the primary health care setting. Given the model for primary health care in patient centricity, a consumer-centred approach is essential. This project not only explores the needs and expectations for collaborative care from a health professionals’ viewpoint, but seeks to understand consumers’ needs in this regard.

There are already some preliminary findings of various projects available. They can be accessed on the 5CPA Research & Development website at: www.5cpa.com.au/research�

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Update

In December 2010 the Committee advised the Guild that Health Ministers endorsed the retention of the two OTC schedules for a 5-year interim period during which time all available evidence would be considered. The ongoing structure of the OTC medicines schedules will be reviewed by 2015 taking into consideration

evidence supplied by the Guild and other sources

the need to ensure appropriate access to medicines

the wider workforce reforms being undertaken under the National Registration and Accreditation Scheme for the Health Professions.

In addition to considering the Guild’s Mystery Shopper data, there is particular interest in looking at how pharmacy interventions in the supply of OTC medicines impacts on health outcomes and to what extent community pharmacy ‘value adds’ in the sale of OTC medicines.

What are the public risks?

Medicines are not normal items of commerce. If used incorrectly or inappropriately, they have the potential to do significant harm. Given the generally low level of health-literacy for Australians, access to pharmacist advice for OTC medicines provides protection for consumers. This is particularly so for the more vulnerable groups such as children, the elderly, those from poorer socioeconomic backgrounds or those who do not speak or understand English well. The high prevalence of poly-pharmacy also warrants consideration by a pharmacist to ensure there are no interactions between any prescribed, complementary or OTC medicines. A research project funded by the Australian Government under the Fourth Community Pharmacy Agreement identified that the majority of consumers want advice about OTC medicines to be available at the time of purchase.

OTC Medicines – use them well or lose them

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In 2001, the final report of the National Competition Policy Review of Drugs, Poisons and Controlled Substances Legislation (the ‘Galbally Review’) examined federal, state and territory legislation regulating medicines and poisons against national competition principles.

One of the recommendations from the Galbally Review was to investigate the costs and benefits of retaining both Schedule 2 and Schedule 3 over-the-counter medicine schedules or combining them to make one schedule with new criteria. Over the past decade, the National Coordinating Committee on Therapeutic Goods (NCCTG, the Committee) has reviewed available evidence relating to this recommendation and has advised Australian Health Ministers on this issue. To date, this advice has mainly been based on data supplied by the Guild through

its QCPP Mystery Shopper program and research undertaken in the Fourth Community Pharmacy Agreement.

Pharmacy (Schedule 2) Medicines and Pharmacist Only (Schedule 3) Medicines are commonly referred to as over-the-counter or OTC medicines. In the case of Pharmacy Medicines, the current scheduling system and state and territory legislation is set up to ensure consumers have access to pharmacist advice if needed at the time of purchase. The additional requirement of the direct involvement of the pharmacist in the supply of Pharmacist Only Medicines is designed to ensure their safe and appropriate use. This system has been in operation for decades, providing easy access by Australians to e"ective medicines which could otherwise require a prescription.

What are the risks for Community Pharmacy?

If community pharmacy is unable to demonstrate the added value it provides by managing the supply of OTC medicines, there is a significant risk that when reviewed in the future, the OTC scheduling system may be completely revised by

1. Removing the Pharmacy Medicine category and retaining a modified Pharmacist Only Medicine category, resulting in a likely scheduling exemption for a significant number of current Pharmacy Medicines, allowing them to be sold as open sellers through the grocery sector from retailers such as supermarkets, service stations or corner shops, OR

2. Removing the Pharmacist Only Medicine category and retaining a modified Pharmacy Medicine category, with a likely result of a significant number of current Pharmacist Only Medicines being up-scheduled and requiring a prescription for supply, OR

3. Removing both Pharmacy Medicine and Pharmacist Only Medicine categories, creating a system similar to that in the USA where medicines are either restricted to prescription and supply through a pharmacy, or available as open sellers through the grocery sector.

1. Implement a store-wide protocol such as ‘Ask, Assess, Advise’ for managing requests for Pharmacy Medicines and Pharmacist Only Medicines

2. Ensure all sta" are trained in following the protocol and know when to refer to the pharmacist

3. Train sta" to ask strategic questions so that consumers do not feel like they are being ‘grilled’ or that they are ‘criminals’ if they request a Pharmacist Only Medicine

4. Ensure pharmacists are actively involved in managing requests for Pharmacist Only Medicines

5. Consider employing a pharmacist dedicated to ‘front-of-shop’ services including the supply of OTC medicines; there would be many advantages in having a trained health care professional dedicated to assist with all professional services outside the dispensary

6. Documenting situations regarding OTC medicines where intervention by the pharmacist has or is likely to have an impact on the consumer’s health outcome, such as identifying a potential drug interaction.

The Guild will continue working with stakeholders to highlight the value in supplying OTC medicines from community pharmacies and to raise consumer awareness about the need for pharmacy sta! to ask questions as part of community pharmacy’s professional responsibility.

Retention of both OTC schedules requires pharmacists to supply OTC medicines in a professional manner with consideration of the consumers’ health needs first and foremost.�

Barry Schultz MedalThe presentation of the Barry Schultz Medal took place in Adelaide in September, at a function attended by Barry’s family, Guild o"cials and many friends and colleagues of Barry.

The winner of the inaugural Medal is Peter Halstead, the general manager of the Pharmacy Regulation Authority of South Australia, with previous experience as an academic, and 15 years as a community pharmacist. In all of these roles, Peter has gone out of his way to help pharmacy students make the leap from student to intern and beyond.

Barry Schultz was a valued member of the local branch and made an equally significant and memorable contribution at the national level as a National Councillor. He was awarded the Distinguished Service Medal in 2005, and the Guild’s highest honour, Honorary Life Membership in 2009. Barry passed away last year. �

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Call to Action for Community Pharmacy

The current risk to the survival of the Schedule 2 and Schedule 3 categories is a call to action for all community pharmacists and pharmacy sta". It is imperative that all pharmacies have systems and procedures in place that ensure their customers have access to the best professional pharmacy support when purchasing scheduled medicines.

What can be done in individual pharmacies?





A key component of the Australian Government’s National Health Reforms has been the establishment of the nation-wide network of Medicare Locals. Medicare Locals are primary health care organisations which are responsible for coordinating the delivery of primary health care at a regional level as well as identifying and addressing local health care needs and service gaps.

Medicare locals and community pharmacy

As of 1 July 2012, all sixty-one Medicare Locals throughout Australia were in operation. Evolving from the Divisions of General Practice, Medicare Locals have a broader remit than general practice and will become increasingly involved in multi-disciplinary primary health care as well as integrated health care across the di!erent sectors, such as acute care (hospitals) and aged care. Community pharmacists are essential members of the primary health care team, providing consumers with access to and support for the safe and e!ective use of medicines to improve health outcomes.

Throughout 2012, The Guild has responded to many consultations and attended national and local meetings to ensure community pharmacy is recognised as an important and necessary part of primary health care in Australia during the establishment of Medicare Locals. This has resulted in a number of Medicare Locals engaging with community pharmacy. A number of community pharmacists have also been successful in being elected to governance and/or advisory bodies for various Medicare Locals.

How do Medicare Locals operate?

Medicare Locals are independent organisations rather than government bodies, formed from partnerships of local organisations and professionals. While each Medicare Local may operate di"erently to manage and respond to local health needs, they will each need to address criteria set by the Australian Government and perform to a national standard. Medicare Locals will operate at a strategic level, coordinating the multidisciplinary involvement of regional health care providers, including community pharmacy.

Pharmacies adding value

As Medicare Locals take on the responsibility and challenges for meeting the health needs of their local area, they will want to fully utilise the available primary health care workforce. Community pharmacists are the most accessible of all health care professionals, and are supported by a network of trained pharmacy assistants.

Community pharmacies are well-established health service destinations, providing an opportunity for Medicare Locals to capitalise on an existing infrastructure to implement programs and services. Every day, 400,000 Australians visit the network of 5,000-plus community pharmacies for health or medical services and advice, making the community pharmacist one of the most frequently used providers of primary health care. On average, Australians visit a community pharmacy 14 times a year. Visits may be even more frequent for people with chronic illnesses who require regular prescription refills and associated services.

People of all ages use the community pharmacy to purchase non-prescription and complementary medicines, as well as first-aid, skin care or baby care needs. Community pharmacy is often the gateway to other primary health care providers.

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Community pharmacies operate in all regions of Australia, including rural and remote, providing Medicare Locals with an ideal opportunity to service and support people who may not otherwise have regular access to health care providers. Options exist for utilising or extending existing pharmacy services such as general health monitoring or screening for particular health conditions. Similarly, many pharmacies provide services to support people with self-management of conditions such as diabetes or asthma. They also assist with wellness and prevention programs such as weight control or smoking cessation as well as being supply outlets for items such as continence or diabetes supplies.

Medicines—the good and the bad!

Medicines are one of the most common health treatments for Australians, and if used correctly and appropriately, can deliver cost-e"ective health outcomes for the consumer and the health system as a whole. Community pharmacies are the custodians of the Pharmaceutical Benefits Scheme (PBS), which provides high-quality, e"ective and a"ordable medicines to Australians, no matter where they live, and in a timely manner.

But the use of medicines can also come at a cost. In 2002, it was estimated that 1.5 million Australians experienced adverse medicine events annually. More recent reports have estimated up to 5.6 per cent of all hospital admissions and over 30 per cent of admissions for the elderly are associated with adverse medicine events.

Costs have been estimated at a staggering $660 million a year, with over half of these admissions said to be avoidable. Community pharmacies provide a number of services that support the Quality Use of Medicines and minimise adverse outcomes.

Poor adherence to medicines also results in poor health outcomes. Reports released at the recent International Pharmaceutical Federation (FIP) Centennial Congress in Amsterdam indicated that medication non-adherence accounts for 57 per cent of avoidable health costs.

This is why the Guild has so strongly supported systems and IT enablement within community pharmacy to help pharmacists improve the medication adherence for their patients.

In addition to engaging with and utilising community pharmacies to achieve common goals, Medicare Locals should find that the inclusion of community pharmacists on their governance and/or advisory bodies provides opportunities for greater multi-disciplinary team care. This is likely to improve the Quality Use of Medicines within their region as well as forging strong partnerships in achieving cross-sector goals such as reducing hospital admissions due to medicine misadventure or supporting people to live independently within the community through the provision of Dose Administration Aids and Home Medicines Reviews.

Community pharmacists should get involved!

It is incumbent on community pharmacists to get involved. As the Medicare Local must plan for integrated local health service delivery, the role community pharmacy plays must be promoted and considered in every health service model of care in which the e"ective and safe use of medicines is considered important.

The Guild encourages all community pharmacists to become actively involved in their Medicare Local to ensure that community pharmacy is recognised, and that the public benefits from the experience and expertise of the community pharmacy sector, through e"ective collaborative health care coordinated by the Medicare Local. �

At the end of 2012 and at the beginning of 2013, the Guild and the Department of Health and Ageing are working together to ensure community pharmacists make the most of the technology that facilitates the Electronic Transfer of Prescriptions (ETP), allowing each and every pharmacist to

‘Be a leader in innovation’.

There is provision for free information sessions, workshops, on premises visits, assistance to sign on, and resources.

Pharmacist evolved as the first computerised health profession, embracing connectivity through broadband for health. Integrating ETP will allow the next step in the eHealth journey.

Look for the eHealth section at www.5cpa.com.au �

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The work by the Guild to develop these Guidelines has encompassed both the legal framework which governs leasing arrangements for pharmacy premises as well as identifying commercial issues which can arise in retail leasing agreements. Because of the unique position of community pharmacy in Australia, the law in a number of states and territories a"ords protection to pharmacy businesses which is not available to other retail businesses. The Guild has been able to develop some practical suggestions for members in dealing with their landlords. In particular, the Guidelines focus on the reporting of turnover figures to landlords.

The vibrant, changing world of community pharmacy continues to produce new challenges for businesses striving to remain competitive and viable. The Guild continues to take a lead role in commissioning rental reports and developing guidelines to assist community pharmacy owners, aspiring owners, and landlords to better understand the legal context as well as some of the commercial realities facing the highly regulated community pharmacy sector. Community pharmacies and landlords have a manifestly symbiotic relationship: they need each other, and therefore they need to understand each other.

It is a simple fact that in some locations, landlords are earning more from a pharmacy than the owner is earning. It is also a truism of our industry that pharmacy is a ‘price taker’, with most prices controlled by the Government, and pharmacy unable to pass on any increased costs (such as rent) to consumers.

Rents are a significant and increasing cost for community pharmacy, and a cause of constant concern for some businesses as they struggle to remain viable in a di!cult market. Generally, occupancy costs are the third highest expense in a pharmacy business, after cost of goods sold and sta" salaries.

One aspect of rent and lease arrangements that has caused confusion for many pharmacists and landlords over recent years has been the reporting of turnover as part of a tenant’s responsibility under a commercial shopping centre lease. The laws relating to pharmacy owners and so-called ‘turnover rent’ are quite specific and unique to pharmacy. And as usual in Australia they vary considerably from state to state, and in the territories.

To further inform and keep pharmacy owners up to date with the latest retail leasing developments in our industry, the Guild launched a very useful new document this year titled ‘Turnover Rent and Reporting Turnover to Landlords: Pharmacy Guidelines’ .

The document sets out very clearly that although few pharmacies have leases that contain a turnover rent provision, it is common for leases to require pharmacy owners to report monthly sales results to the landlord. As the guidelines state, landlords often justify provisions requiring the supply of turnover figures on the basis that turnover figures are needed to establish the e"ectiveness of shopping centre marketing, for portfolio analysis or to report to shareholders. However, this information can also be used by landlords to drive rents upward.

A particular issue for pharmacy businesses is that current discrepancies in the way sales results are reported provide landlords with inaccurate indicators which can be manipulated to establish a case for higher rents.

Guidelines on retail leasing and reporting turnover

Pharmacy owners are entitled to ensure any new lease agreements comply with the relevant legislative requirements in relation to pharmacy ownership and pecuniary interest and to also carefully consider and seek expert advice before agreeing to supply turnover figures to their landlords in any new lease arrangement. �

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!e Pharmacy Guild of Australia is dedicated to developing new leaders in pharmacy and empowering these leaders with the skills, information and professional networks needed to be leaders in the primary health care system and owners of community pharmacies.

Pharmacy leaders and owners

That is why the Guild continues to establish networks and undertake activities to promote ownership and leadership to aspiring pharmacists.

One of the longest standing Guild initiatives is the National Student Business Plan Competition. This Australia-wide challenge promotes creative entrepreneurship among students preparing for a career in community pharmacy. Developed in 2006 by the Guild to promote innovation and excellence in the community pharmacy environment, the National Student Business Plan Competition is credited with helping students to gain valuable experience, not only in demonstrating the financial viability of their plan, but also how they will capture market share, pay and manage sta", manage capital and achieve return on investment.

Now in its fifth successful year, this initiative continues to receive wide acclaim and patronage from student pharmacists and pharmacy schools. In 2012 the competition was supported by continued sponsorship from Blackmores (principal sponsor), Gold Cross Products and Services, and Pharmaceutical Defence Limited (PDL).

With the catch cry ‘Make your mark: show us your future’, the 2012 competition was the most successful to date attracting 18 entries.

The finals of the 2012 competition were held at the Pharmacy Business Network (PBN) in Canberra, with the winners announced and showcased at the PBN Gala dinner.

This year’s winning team Complete Care Pharmacy from the University of South Australia centred their business in the Riverland regional town of Berri SA. They talked to Guild member and National Councillor Nick Panayiaros about pharmacy business conditions in the Riverland, discussed service gaps and consumer needs with Flinders Centre for Innovation in Cancer, as well as individuals living with cancer and tested their business plan concepts with pharmacists across Australia.

One of the team’s mentors (and fellow pharmacy student) was Suzanne Schultz, daughter of the late Barry Schultz. Suzanne said of her involvement with the team.

‘Like any good coach I am incredibly proud of what our team could achieve with little background knowledge—we worked really, really hard to learn and adapt during the competition.

‘We had world class mentors in pharmacy, academia and business. We presented a real and innovative approach to pharmacy-based cancer services to nearly 180 pharmacists, who could implement those ideas immediately. Being part of this competition gave me a chance to showcase SA and UniSA, and to support the Guild, and contribute to community pharmacy and my fellow students. These young people are demonstrating what it takes to positively lead pharmacy into the future.'�


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It’s been a big and busy year for the Academy.

Mid-year, Melbourne community pharmacist and prominent Guild member, Anthony Tassone was appointed as the new National Director of the Guild Pharmacy Academy. Anthony has had an active role with the Guild for many years as a Victorian Branch Committee member. He joined the Academy as the National Professional Development Manager and first began acting in the Director role in March.

In his time as acting Director, Anthony made very positive contributions to the development of the Academy and has continued to do so in the role.

In the past year, the myCPD online learning platform of the Academy has now grown to have over 7,500 registered users accessing online learning and having CPD records kept on the site.

The platform is experiencing significant upgrades to provide a much more user-friendly and streamlined experience for online learning and CPD recording plus learning about upcoming Guild events.

It was released in late October 2012.

The Guild is a Registered Training Organisation (RTO) and is proud to announce that it received extension of its registration with the Australian Skills Quality Authority (ASQA) for another five years, with a very positive audit report.

It is testament to the high quality training and education service that the Guild delivers to pharmacy assistants through its state and territory branch network across Australia. Therefore, the Academy will soon be unveiling an online induction unit for newly-employed or prospective pharmacy assistants to assist in their learning about the value of community pharmacy, their important role, medicine scheduling, the Quality Care Pharmacy Program, and the role of the Guild. The unit will be an invaluable tool as a resource for induction, and also provide prospective candidates looking for employment as a pharmacy assistant initial learning and understanding of the community pharmacy industry.

Also this year, the Academy, in partnership with some of the state branches of the Guild, continues to build on its Intern Training Program (Guild ITP) for intern pharmacists in Queensland, New South Wales, Tasmania, and as of 2012, Western Australia.

The Guild ITP is designed to make interns ‘employment ready’, ensuring they receive a solid grounding in professional services as part of the Fifth Community Pharmacy Agreement. It is a high quality program that addresses the latest in clinical and business management knowledge. It will not only make candidates ‘employment ready’ for community pharmacy, but also meet the needs of members of Guild as prospective employers.�

A big one for the Guild Pharmacy Academy

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New Director for Tasmania The Tasmanian Branch of the Guild has appointed Dr Greg Luckman as the Branch’s new director. Many Guild members will remember Greg from his time as Assistant Registrar for the Tasmanian Pharmacy Board from 2003 until the introduction of the national registration scheme in 2010.

At that time, Greg transferred to the new organisation, the Australian Health Practitioner Regulation Agency (AHPRA), where he was the Director of Corporate and Board Services in the Hobart o!ce. At AHPRA Greg was responsible for supporting the Tasmanian Boards and Committees as well as the running of the Tasmanian o!ce.

Greg was also Registrar of the Tasmanian Physiotherapy Board and has worked as a research scientist in the Agricultural Science Department of the University of Tasmania where he gained his PhD, specialising in plant physiology.�


From 1 July 2012, the national rollout of the MedsCheck services (MedsCheck and Diabetes MedsCheck) began and to date has been a great success.

Both the MedsCheck and Diabetes MedsCheck are quality use of medicines initiatives which provide for a pharmacist-conducted, in-pharmacy review of consumers who are taking multiple medications and/or have newly diagnosed or poorly controlled type 2 diabetes.

A MedsCheck service aims to

identify problems that the consumer may be experiencing with their medicines

help the consumer learn and understand more about their medicines including how medicines a"ect medical conditions

improve the e"ective use of medicines by the consumer

identify and implement strategies to assist consumers with their medication management.

These new services complement the comprehensive medication review programs such as Home Medicines Reviews (HMRs) and remain an essential part of the suite of professional programs that pharmacy can provide.

The natural evolution of the established and proven HMR service is focused on making sure the right person gets the right service at the right time based on clinical need. October 2011 saw changes that included

highlighting the importance of the patient’s clinical needs at time of referral

empowering the patient to choose the most appropriate pharmacist to interview them at home

enabling the doctor to refer to either the patient’s preferred community pharmacy or an accredited pharmacist of the patient’s choice.

The next step of the evolution is the introduction of the hospital initiated referral pathway. The changes address evidence from the Fourth Community Pharmacy Agreement which found scope for more data collection and improved targeting of the service. The changes are consistent with the National Medicines Policy, acknowledging that relationships between the patient and the community pharmacist are important when support is being provided to a patient in their home.

It is well accepted that medication-related problems are a significant contributor to morbidity, mortality and health care resource utilisation.

A common interest of the Australian Government and the Guild is ensuring that positive health outcomes are attained through the e"cient delivery of patient-focused professional services and programs.

MedsCheck, Diabetes MedsCheck and HMRs are representative of this.

Under the 5CPA the Australian Government has provided significant investment in Medication Management Services (up to $29.6 million for MedsCheck, up to $12.2 million for Diabetes MedsCheck, up to $52.11 million for HMR and $70.0 million for Residential Medication Management Review).

This funding provides for the provision of medication management services to be delivered through community pharmacy and has recognised the significant role that pharmacy can play in the delivery of health care for consumers around Australia. It also provides appropriately remunerated and structured programs for pharmacists to provide patients with access to services that support them to better manage their medicines, reducing the risk of medicine related adverse events and hospitalisations.�

Getting the most out of medicines

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In a fascinating new survey published in October, Australians expressed the highest level of satisfaction with pharmacists when asked about their most recent visit to a range of health care services.

Pharmacists scored 89 per cent and were followed in the rankings by nurses in general practice and private hospitals (both at 85 per cent). Despite being amongst the least used services, residential aged-care facilities rated the lowest with 54 per cent along with mental health providers on 58 per cent.

Top scoring profession

The Menzies-Nous Australian Health Survey 2012 provided key findings about the views held by Australians on their own health, on the Australian health care system and on aged-care services. The 2012 survey is the third biennial national survey conducted by the Menzies Centre for Health Policy and Nous Group.

The Australian Health Survey 2012 was conducted via a phone interview of 1200 people in July 2012.

To enable analysis of trends since 2008, a number of questions

regarding the health of Australians and use of the health care system were consistently asked in 2008, 2010 and 2012.

Worth noting is the very high proportion of Australians who use pharmacy services broken into age segments. The elusive age group in relation to retail of 18 to 24 recorded an 87 per cent use of pharmacy services. The figure sits at 99 per cent of those over 65.�

Follow the link for more www.menzieshealthpolicy.edu.au/mn_survey/index.htm

Community pharmacy should be congratulated on how it responded to the practice changes in the supply of cough and cold medicines for children from 1 September 2012.

Coughs and colds—and kids

The changes came about after the Therapeutic Goods Administration advised that cough and cold products

are not to be used for children under 6 years of age

are to be used only on the advice of a pharmacist or prescriber for children aged from 6 to 11 years.

The labelling of a"ected products is gradually being changed to reflect this advice. Cough and cold products already in the market place can be sold until supply of stock with the old labelling is exhausted. Irrespective of the labelling though, pharmacy sta" members are required to ensure that supply of cough and cold products is consistent with the new recommendations.

The Guild is aware that many pharmacists are indignant that while the pharmacy sector has responded to these changes, supermarkets appear to be una"ected and not required to do anything.

While this may appear to be the case, this issue demonstrates the professionalism of community pharmacy and provides a strong argument for retaining the Schedule 2 – Pharmacy Medicine category. The Guild has and will continue to ensure relevant Government bodies are aware of the e"ort put in by community pharmacy with these types of changes.

The Guild collaborated with Pharmaceutical Defence Limited (PDL) and the Pharmaceutical Society (PSA) in preparing a professional advisory in response to a number of frequently asked questions about the changes.

To access these resources and further information about the changes, community pharmacists can click on ‘Medicine & Pharmacy Practice Issues’ under the ‘Issues & Resources’ button at www.guild.org.au

Consumers can also be directed to www.askyourpharmacist.com.au for further information on how to manage coughs and colds in children. Click on ‘Hot topics and events’.�

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During 2012 there was some concern expressed in the industry about the rising incidence of Home Medicines Reviews (HMRs) being conducted in clinics and surgeries, rather than at a patient’s home as intended under the program.

A Home Medicines Review is designed to assist individuals living at home to maximise the benefits of their medicine regimen and prevent medication related problems.

The Guild certainly supports the views expressed by the president of the Pharmaceutical Society, Grant Kardachi, when he said: ‘They are not called Home Medicines Reviews for nothing. If they were designed to be conducted in a clinic they would probably be called Clinic Medicines Reviews.’

The principal objective of an HMR is to achieve safe, e"ective, and appropriate use of medicines by detecting and addressing medicine-related problems.

Under the Fifth Community Pharmacy Agreement, changes were made to the HMR model from last October which enable the GP to refer to either the patient’s preferred community pharmacy or directly to an accredited pharmacist of the patient’s choice.

This change was consistent with the National Medicines Policy, and acknowledged that relationships between the patient and the pharmacist are important when support is being provided to a patient in their home.

Home is where the HMR is …

The change was certainly not intended to facilitate a growth in HMRs routinely being performed outside the home of the patient. This trend is a threat to the ongoing funding of HMRs and should be discouraged as a breach of the program guidelines.

HMRs are not intended to be conducted in clinics and the strength of the service is that they are conducted in the patient’s home where the pharmacist can review all the medicines and devices available.

As the PSA’s Guidelines state: ‘Best practice requires that all aspects of the HMR service are conducted by an accredited pharmacist in the consumer’s home.’ There can be genuine exceptions, in relation to cultural or safety concerns, but they should be rare.�

Level 2, 15 National Circuit Barton, ACT 2600 ��PO Box 7036, Canberra Business Centre, ACT 2610 Australia Telephone: + 61 2 6270 1888 � Facsimile: + 61 2 6270 1800 ��Email: [email protected] ��Internet: www.guild.org.au PR

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