Meet the new president of the PSA
If Chris Freeman’s track record of putting ideas into practice is anything to go by, the Pharmaceutical Society of Australia will tick a steady stream of items off its ambitious to-do list during his tenure as president of the society.
He has experience in both community and hospital pharmacy, and was a member of the steering committee for the original pharmacist flu vaccination trial that paved the way for vaccination services in pharmacies.
Dr Freeman (PhD) is passionate about providing a bridge between chronic and acute care, and helped pioneer a role for pharmacists in general practice.
Ten years ago, he took matters into his own hands when he approached Dr Ian Williams, a GP at Camp Hill Healthcare in Brisbane, and they decided to “dip their toes in”.
Now his role at the practice is well established and he has formalised the model of practice by putting in place a research framework to measure the benefits.
“I bring those successes into the PSA role,” says Dr Freeman, who is undertaking an NHMRC fellowship on translating research into practice.
“I have been able to genuinely explore new roles for pharmacists and see them sustainably delivered in patient care.”
Making the most out of pharmacists
Exploring new roles for pharmacists will be a priority for the PSA this year, with Dr Freeman promising to “double down” the society’s efforts to improve pharmacists’ role, recognition and remuneration.
The PSA has published a five-year plan, Pharmacists in 2023, which sets out the actions needed to allow pharmacists to fulfil their scope of practice and meet genuine patient need.
“We are completely underutilised in the current health system and we have the ability to have a greater role,” says Dr Freeman.
“But it must be done on genuine patient need. Yes, we can do it. We have the skills and training to be able to increase or fulfil our scope, but we must make sure there is genuine patient need so we are actually filling a need rather than just doing something we think is good for pharmacists to do.”
Dr Freeman says medicine safety will be a priority area in the next six months.
At the moment, community pharmacists are gatekeepers who catch mistakes as they happen, he says. However, new models of pharmacist care are needed to ensure mistakes don’t occur in the first place.
Getting involved in the 7CPA
Integral to making better use of pharmacists’ skills is funding, which is why the PSA is adamant it should participate in this year’s negotiations for the 7th Community Pharmacy Agreement.
“It would be remiss of the department of health or the Pharmacy Guild to suggest that the PSA doesn’t have a significant role in that area of practice,” he says.
“What we are able to bring is some of the achievements … in terms of roles pharmacist can play and the recognition they should receive based on the integral care they provide to patients.”
One of the issues with the current agreement is most of the money goes to the supply of medicines, Dr Freeman says.
While acknowledging this will remain an integral part of the agreement, the current agreement perpetuates a model where “the more you dispense, the more income you make”.
“It starts to divert away from real investment by the community pharmacy sector into professional services.”
He says the next agreement will ideally include remuneration for pharmacists to have consultations with patients.
“I would like to see the agreement … drive the style of practice that we are all trying to work towards and with a genuine investment in professional services.”
|Dr Chris Freeman: CV|
Integral members of the healthcare team
During his tenure, the PSA will continue to push for access to funding for chronic disease management.
The PSA has repeatedly pointed out to the chair of the MBS Review Taskforce that pharmacists are the only allied health professionals not able to provide services under a chronic disease care plan, he says.
“At the end of the day this is about parity. It is not about us asking for a special pot of money. My vision is to ensure pharmacists are regarded by the public, the government and other health professionals as integral members of the healthcare team rather than just a luxury to have.
“Being left off [chronic disease management items] is a perfect example of that. We were just simply forgotten about.”
Being included on care plans ties in with another PSA ambition: pharmacist prescribing.
The society is working “very closely” with the pharmacy board on a potential model, and is very supportive of a collaborative model, Dr Freeman says.
This would allow pharmacists to stop, start or adjust doses for a patient under the parameters of a doctor’s care plan, he explains.
The PSA is in favour of downscheduling certain medicines to allow pharmacists to practice to their scope and meet patient need, as opposed to independent prescribing.
“For example, trimethoprim for uncomplicated UTI, in my view, should be downscheduled rather than having the pharmacist prescribe.”
The TGA, at the bequest of health ministers, is working with the PSA and other groups to identify molecules that could be added to a new appendix M — which would be similar to S3 but with additional conditions.
“It might be for a very narrow indication, or it might be based on certain symptoms,” Dr Freeman explains, adding he expects the list to be complete this year.
“The society has a very important role in helping to establish protocols for the schedule M medicines to provide training and professional development for the molecules as they are downscheduled.”
Working with GPs
Dr Freeman, who works in general practice one or two days a week, says that establishing pharmacists in general practice will also enhance the role of local community pharmacies.
After working with him, GPs have admitted they didn’t realise pharmacists’ capacity.
He points out that he often acts as a conduit between GPs and surrounding pharmacies, and often targets patients suitable for pharmacy service.
“I identify a lot of patients suitable for a home medicines review and facilitate the referral out to the community pharmacy.
“[This model] has the strong potential to increase service delivery into those community pharmacies.”
More information: Pharmacists in 2023.