Page 27 - Demo

COVER
are really grateful that the pharmacy is operational. Shutting the pharmacy so the pharmacist can have a small break takes away a vital service in these small communities.’
No shortage of HMR requests
There is plenty of potential HMR work in western Queensland. However, the 20-a-month cap limits how many HMRs she can do.
In a submission responding to the Review of Pharmacy Remuneration and Regulation Discussion Paper, Karalyn highlighted that at times she drove 1,800 kilometres in a round trip to see patients.1
She said: ‘The government pays me $125 per round trip to see these patients and no accommodation allowance. This is not $125 per patient. It is $125 per trip and I must be sent the referrals direct from the
GP. If the community pharmacy sends me the HMR referrals I cannot claim the travel allowance.
‘To drive that distance over several days and pay for accommodation makes the service totally unviable. The HMR cap needs to be expanded for these locations as there is very little economic sense sending a pharmacist these distances and restricting how many patients they can see.’
To illustrate her point she cited three requests received for rural and remote HMRs.1
The first, west of Mackay, was for 200 patients with travel time 5–7 hours one way. Most of the patients were waiting for placement in one of the few aged care facilities in the area.
‘The expectation is that they will never achieve placements,’ she said.
The second, west of Rockhampton, was for 60 patients with travel time of seven hours one way. The third, west of Toowoomba, was for 300 patients with travel time of 12 hours one way.
In each case no accommodation was provided and the maximum travel allowance available was $125.
‘All of these areas have asked their local pharmacies if they can provide the services and they cannot. All of these locations have health and hospital service accommodation for visiting medical officers, pay their GPs to fly in and out and have support services such as diabetes educators funded by CheckUp.’ (See: www.checkup.org.au/page/Initiatives/Outreach_Services/)
All of the patients had been investigated and deemed to be at risk due to multiple prescribers, poor health literacy, predominantly Indigenous heritage, lack of recurring health services with the loss of Royal Flying Doctor Service and other programs, and inability to access regional hospital and health services due to a lack of money and ability to travel.1
‘I can only visit 20 patients per month so you can see I would have plenty of work for several years. How do I triage who to see first? Why would I travel these distances and pay for accommodation and travel and receive a measly $125? While the current model is barely adequate in the regional locations, it is not feasible when you have to travel distances that require overnight stays,’ Karalyn said in her submission.1
CHALLENGES
The greatest challenge is the poor remuneration for working outside of a community/hospital practice setting. Another is the lack of understanding of my worth and place in practice by fellow allied health colleagues.
INSPIRATION
I enjoy being able to help people. My first choice of occupation was nursing but I was not physically strong enough so I went to university and became a pharmacist. I enjoy interacting with patients, their families and carers. I particularly like being the ‘Ms Fixit’ who joins the dots and helps them navigate their health pathway. I work closely with the practice nurses and managers and have gained the respect of the GPs. Their respect and confidence inspires me to keep doing what I do.
PHARMACY GOALS
My main goal is to achieve a worthwhile remuneration for what I do and the long distances I travel. The second goal is to work on my succession plan to hand over my remote Home Medicines Review work to someone who loves central Queensland as much as I do.
FUTURE
Hopefully people like me will be independently funded for the roles we perform. I hope the Review of Pharmacy Regulation and Remuneration looks
at dividing out the areas such as ownership from practice so we can start to be recognised within the health arena as needing to be supported and funded in the same way as clinical consultant nurse practitioners.
ADVICE
Never stop pushing the boundaries. Make sure your voice is the loudest in the room. Know your place but push for inclusion and respect.
Australian Pharmacist January 2017 I ©Pharmaceutical Society of Australia Ltd. 25