With Australia’s paramedics on the brink of burnout, exasperated and exhausted from battling high levels of emergency demand, can the country’s community pharmacists step in and help?
Without doubt, the pandemic has introduced unprecedented demand, but according to a joint national statement issued by the Australian Paramedic Association (APA), “the reality is that multiple governments have neglected to properly invest in emergency healthcare, instead, allowing ambulance services to function on the sheer fatigue and goodwill of the workers”.
While outbreaks of Covid-19 across Australia have highlighted how under-resourced the country’s ambulance services have become, response times were steadily worsening well before the pandemic, and the APA has been urgently calling for more staff to keep up with demand across the nation.
The APA statement claims that without proper resourcing, paramedics routinely work through meal breaks and don’t finish on time, often working 15 hours a day in full PPE during the summer heat, all with no break.
“We need to stop blaming patients for the failings of our service and instead invest in changes that can offer callers genuine alternatives to ambulance care,” the APA said. “Our triaging systems need a drastic overhaul, from secondary triage by experienced clinicians to improved call screening and secondary referral networks.”
What can be done?
The challenge is recognised by the Pharmacy Guild, which has repeatedly called for pharmacists to work to their full scope of practice, in part to address this very issue.
In the Guild’s 2021 ‘Scope of Practice of Community Pharmacists’ document it noted Australia’s health system was recognised as one of the best in the world, with particularly high performance in areas of administrative efficiency and healthcare outcomes, but a lower performance in equity and access.
“Community pharmacy location rules mean there is equitable distribution of community pharmacies across Australia, providing the community with easy access to a healthcare professional,” the Guild said. “Each year there are 458 million patient visits to community pharmacies, making pharmacists the most visited and accessible healthcare professional in Australia.”
The management of common conditions is a core component of pharmacy practice. Pharmacists provide management, both pharmacological and non-pharmacological, for common conditions, including wounds, pain (eg, migraine, dental pain, arthritic pain), urinary tract infections, acne, constipation, diarrhoea, hay fever, common colds, head lice, mouth ulcers, gastroesophageal reflux, vaginal thrush and tinea.
For the management of common conditions, pharmacists across all jurisdictions can recommend and supply unscheduled, schedule 2 and schedule 3 medicines. Pharmacists can also provide patient education and advice on lifestyle modifications.
The Guild says pharmacists’ management of common conditions is an under-recognised activity that significantly adds value to the health system.
“Pharmacists can assess and triage these common conditions, and either treat within their scope, or refer to another health professional,” the Guild said. “This assessment, triaging and referral process can help to reduce the burden on emergency departments, and allow GPs to focus on more complex and chronic conditions.”
At an Inquiry last month (February 2022) into the provision of primary, allied and private healthcare, aged care and NDIS care services and its impact on the Queensland public health system, Guild National President Professor Trent Twomey and Queensland Branch President Chris Owen provided evidence in support of a ‘full scope of practice’ trial for community pharmacists in North Queensland.
“With public hospitals and emergency departments already stretched, primary health practitioners practising to their full scope will help to alleviate patient access to world-class healthcare”, said Mr Owen.
“If community pharmacists and other primary healthcare professionals could practise to their full scope, then the incidence and management of chronic diseases could be better managed, preventable hospitalisations and non-urgent emergency department (ED) presentations reduced, and better health outcomes delivered.
“Some of the ED demand is often for conditions that could have been prevented or better managed within a local primary healthcare setting.
“We make no apology for putting patients first, reducing non-urgent ED presentations and preventing hospitalisations.”
For more and to read the feature in full as it appears in the March issue of Retail Pharmacy magazine, visit: retailpharmacymagazine.com.au/magazine/retail-pharmacy-march-2022/
